Deconstructing mental health crisis - Part II
Vibi Yhokha Sophie
Kohima | June 30
For every 2.4 lakh population, there is one government psychiatrist in Nagaland. In the face of increasing mental illnesses, the state of mental health in Nagaland presents an even more dismal picture with only five Clinical Psychologists in service and a handful of mental health workers. According to information provided by the National Mental Health Program (NMHP), Nagaland, there are only eight government Psychiatrists, five Clinical Psychologists, five Psychiatric Social Workers and five Psychiatric Nurses to cater to the needs of mental health in the State.
“If you look at the OPD cases, mental health issues are increasing. 15 to 20 percent of cases require psychiatric treatment,” said Dr. T Wabang, MS, State Mental Health Institute (SMHI), Kohima.
At present, the SMHI, Kohima receives 6-7 patients during the peak days of the week and about two or three patients during the weekends. In 2017, the SMHI Kohima recorded a number of 1255 patients who were treated at the Institute, and a total of 1185 patients in 2018.
At the Naga Hospital Authority Kohima, an average of 10 patients seeks consultation on a daily basis.
The District Hospital, Dimapur receives an average of 10 to 15 patients with mental health conditions on a daily basis, according to Kikruwheno T. Medom, Clinical Psychologist, DMHP, District Hospital. “The numbers could be even more but sometimes we have to close down the registration because of patient overload. Psychiatry is one field where even a single patient takes a long time for consultation and for therapy. We are not able to see many patients in a single OPD,” said Medom, who mentions that patients from neighbouring Assam also travel to the Dimapur District Hospital to avail mental health services.
The absence of mental health practitioners in remote districts such as Mon and Longleng have also led patients from these areas to traverse all the way to Dimapur to seek help. “Patients bring each other more by word of mouth, referring friends and families. Sometimes two or three patients travel together to seek treatment,” said the Clinical Psychologist.
Indicating the impact on shortage of practitioners, R. Themmungla, Visiting Consultant (Clinical Psychologist) at SMHI, Kohima who also runs The Cloudroom, a Counselling and Psychological assessment Centre in Kohima, expresses the inability to meet the demands of clients. In a day, the Clinical Psychologist meets three or four clients. In her absence, the Psychologist also faces situations where she is unable to refer her clients to other practitioners due to the scarcity of mental health practitioners.
As the State faces acute shortage, a concerned mental health worker points out that the core problem lies in the inability of the State government to create more posts/jobs for mental health practitioners. It may be mentioned that most of the mental health practitioners such as the Psychologists and Psychiatric Social Workers are employed under the centrally sponsored National Mental Health Program (NMHP).
NMHP State Program Officer, Dr. Keneiteiso Sorhie informed that five districts have been covered under the District Mental Health Program (DMHP) while the remaining districts are proposed to be covered during 2019-2020.
Another expressed, “There is so much to be done in the community in creating awareness and training people. But we don’t get as much financial support for the work that has to be done. We know that the Ministry for Health and Family Welfare puts a lot of emphasis and funding on mental health all over the country but the amount due to us does not reach us.”
While considering mental health as a growing concern in Nagaland, Himato Zhimomi, Principal Secretary, Health and Family Welfare (H&FW) mentioned that the funds from the Centre are limited and “not enough to employ mental health practitioners.”
On the lack of mental health practitioners in the State Service, Zhimomi stated, “The Government of Nagaland does not have enough money to employ Psychiatrists.” However, Zhimomi added, “The Government of Nagaland is taking a view on that.”
Apart from the many provisions ensured under the Mental Healthcare Act 2017 which came into force in May 2018, an important feature of the Act is the directive to each State in the country to set up a State Mental Health Authority (SMHA)to develop quality services with regard to mental health in the State.
In Nagaland, the SMHA was set up last year under the leadership of the Principal Secretary. “Our priority has been to set up mental health practitioners in all districts. There's a whole plethora of people that we have to put in place. That calls for a lot of resources. But that is our number one priority,” stated Zhimomi, hopeful that the DMHP will reach all the districts soon.
