Professional Documents
Culture Documents
The WHO Mental Health Gap Action Programme (mhGAP) has been developed
with the aims of training and capacity building in order to deliver services for
people with mental, neurological and substance use disorders for countries
especially with low and middle income. According to the WHO “Mental,
neurological and substance use disorders are common in all regions of the world,
affecting every community and age groups across all income countries. While 14%
of the global burden of disease is attributed to these disorders, most of the
people affected -75% in many low-income countries- do not have access to the
treatment they need”
Kashmir is going through conflict since 1947 and in the last 25 years there has
been armed conflict which has led to many fold increase in mental disorders.
Conflict is continuing and people are still suffering, with limited access to mental
health services .There is only one psychiatric hospital based in capital Srinagar
with 25 to 30 psychiatrists for the whole population of Kashmir valley .There are
no psychiatric services at the primary care level and very limited access to
psychiatrist at district level as per the information gathered from director health
services Kashmir. Below chart shows increase in mental illness in Kashmir since
1985.
INFORMATION FROM GOVERNMENT PSYCHIATRIC DISEASE HOSPITAL
mhGAP is being implemented in over 50 countries in the world and this is the first programme in the
Indian subcontinent.
The Kashmir pilot project is supported by WHO Geneva WHO South Asia and Royal College of
Psychiatrists UK.
1. Training of the mental health team at the identified nodal institutes within the state
2. Increasing awareness about mental health problems and effective health seeking pattern.
3. Adequate provision of services to promote early detection and treatment of mental illness in the
community itself with both OPD and indoor treatment and appropriate follow up measures.
4. Collecting data and experience for future planning, research and improving service provision.
LIMITATION TO IMPLEMENTATION OF DMHP were identified in a report by ----- dated ------------------
The project has support from the director of health services in Kashmir. The
project is being coordinated by a local lead Psychiatrist Dr Sayed Aqeel Hussain
in Kashmir as the focal point through a coordinating steering committee.
Training was repeated in August 2014 and focused on primary care physicians
in Ganderbal district. Meeting was held with CMO, BMO and medical officers of
Ganderbal district to establish a robust supervision, monitoring and evaluation
system over the following year as per supervision and monitoring framework.
Budget is limited and necessarily will need funding to implement the proposed
project although Director of Health Services has provided some financial support
for training and further support will be difficult to fit into current budget from
Director of health Services.
A log frame has been developed for the programme, which covers initiation,
budget, training, supervision, monitoring and evaluation. Most of the materials
and tools of WHO can be used directly for the project but some may need local
adaptation. (Please see the enclosed logframe)
Proposal
Ganderbal has been chosen as a pilot site to implement this programme and will
act as model of good practice for dissemination to other districts of state.
Support from the health department is essential for this to be implemented and
incorporated into the District Mental Health programme seamlessly.
Implementation Strategy
To date there have been 3 phases of training in Kashmir supported by the Director
of Health Kashmir.
There has been extensive background preparation for the implementation of the
pilot. (See folder)
Funding is one of the limitations of the project although so far we have been able
to get support from Director Health services Kashmir and some local voluntary
organizations and voluntary worker. (Budget details encloseds)
WHO Monitoring and evaluation strategy document will be used. (See folder)
This will demonstrate success of the programme in a measureable way.
Framework for the project implementation has been established and Dr Sayed
Akeel Hussain and Dr Muzaffer Khan are joint project coordinators.
It is innovative in being sole mhGAP project in India to our knowledge but a lot
of mhGAP interest developing throughout the country
Following a series of meetings over last one year steering group with below
terms of reference was formed for development and implementation of the
project in district Ganderbal. According to 2011 census, Ganderbal has population
of 297446 of which 158720 are males and 138726 females. There are total 50,594
children aged 0-6 of which 27,159 boys and 23,435 girls forming 17.01 percent of
the population of Ganderbal District. Average literacy rate of Ganderbal district is
58.04 percent Males 68.85 percent and Females 45.71 percent. (Please see
enclosed details of Ganderbal District health structure)
Stake holders
WHO
PRIME
Professional links
E support for Developing Mental Health Service in Kashmir, India has been
put in place and following have agreed to provide advice and technical
support for the project.
List of references
http://mhpolicy.files.wordpress.com/2012/07/final-dmhp-design-xii-
plan2.pdf
http://sayedaqeel.wix.com/kndri
http://jkhealth.org/districtjam.php?link=Ganderbal
http://bjp.rcpsych.org/content/204/6/415/reply
http://www.rcpsych.ac.uk/pdf/VIPSIG%20Summer%202014%20New
sletter.pdf