Table 2 History of mental health care integration within the Indian health system*
From: The development of mental health services within primary care in India: learning from oral history
Time periods | Date | Health system and political developments | Mental health developments |
|---|---|---|---|
PRE-INDEPENDENCE | early 20th century | 1935 Act: provinces autonomy for Health activities | Growth of mental hospitals, first general hospital psychiatric unit (GHPU) |
1946 | Bhore Committee Report | ||
1. POST- INDEPENDENCE | Aug 1947 | Independence of India declared | |
1950s | 1st Five Year Plan (FYP) | 1950s: Psychotropic medications developed | |
1954: All India Institute of Mental Health (AIIMH) established, Bangalore | |||
1956 | Second FYP. Rs. 225 crore (5%) for health | Late 1950s: concept of ‘family ward’ (Amritsar and CMC); nurse training at AIIMH | |
1961 | 3rd FYP. Rs. 342 (4.3%) for health; Mudaliar Committee Report | 1960s: More GHPUs and specialists; psychiatric social worker training in AIIMH | |
1969 | 4th FYP. Rs. 840 crores for health | ||
1973 | Medical personnel forced to work in rural areas; Multi Purpose Workers introduced; 1974: 5th FYP. Rs. 796 crores health | 1974:NIMHANS replaces AIIMH and the government mental hospital | |
2. PILOTING MODELS FOR MH CARE EXTENSION | 1975 | WHO report on organisation of mental health services; Community Psychiatry Unit created in NIMHANS | |
1977 | Community health workers and Dais | 1975-1981: WHO: ”strategies for extending mental health care” (including Raipur Rani) | |
1978 | Declaration of Alma-Ata | 1975-1986: Sakalwara – NIMHANS model. Other similar projects: Delhi, Jaipur, Hyderabad | |
1980 | 6th FYP | ||
3. NMHP- INITIAL STEPS | 1982 | National Health Policy | National Mental Health Programme initiated. Budget: 10 million rupees for the first 5 years |
1985 | 7th FYP | Bellary programme (1985–1990) | |
1987 | Mental Health Act | ||
4. POLITICS, POWER and NGOS | 1990s | Increasing number of NGOs. E.g.: 1993: Banyan; 1996: Ashadeep, Sangath, GASS; 1999: Bapu Trust | |
1992 | 8th FYP | Community mental health featured on health budget | |
1994 | Persons with Disability Act | ||
5. DMHP/HUMAN RIGHTS | 1996 | DMHP implemented. Budget: 270 million rupees; | |
1997 | 9th FYP | ||
1998 | The National Human Rights Commission Report | ||
2001 | Erwadi disaster (Tamil Nadu) | ||
6. RESTRATEGISED NMHP | 2002 | 10th FYP; National Health Policy | Re-strategised NMHP. Budget: 1.9 billion rupees |
2004 | National Rural Health Mission. ASHA worker created. | ||
2005 | UN Convention on the Rights of People with Disabilities | ||
7. REINVIGORATED DMHP | 2007-2011 | 11th FYP | 2007: ‘Reinvigorated’ NMHP. Budget: 10 billion rupees |