After Finance Minister Nirmala Sitharaman announced the creation of a National Tele-Mental Health Programme during her budget speech on Tuesday, 1 February, with National Institute of Mental Health and Neurosciences (NIMHANS) at its center of operations, FIT spoke to Dr Pratima Murthy, Director of NIMHANS, to answer your questions.
When will it begin? How can people access the services? When will the tele-service be fully rolled out? Read on.
When will the National Tele-Mental Health Programme Begin?
What we hope to do is to roll it out this year itself. But the rolling out will involve getting all the Centers Of Excellence (COEs) on board, training the counsellors, identifying the counsellors, etc.,. So we will have to figure out whether we'll roll it out across the country together, or roll it out in a few states and then expand it to the rest of the country. Otherwise we already have a lot of content which has been developed and we've reviewed the tele-helplines which have already been successful. The groundwork has been done. We will need to have meetings, first with the Ministry and then meet with the COEs so that we can get them in on the preparatory phase.
How long do you think it will take to train and set up the helpline centers across the country?
We've suggested a 3 to 5 year time period, which it will take for the states to set it up and run entirely on their own. We're looking at establishing one tele-mental health center per state. They'll need to have good telephonic communication and the advantage is now everything can be done online. We will also need to offer a menu of services that people can access.
Too caught up to read? Listen to the interview here, instead:
How is this service different from the other programmes?
The difference in this programme is that it looks to states to take ownership of these services. It's not just one organization or just the central government doing it. Every state will be doing it. Finally, people can be addressed in their own languages and counselled in their own languages. And we know where state resources are so that people can get help if they have a serious problem.
We don't want people to travel hundreds of kilometres to get mental health help. So for smaller Union Territories, we would have larger COEs hand-hold the smaller COEs.
How can people avail the services from the National Tele-Mental Health Programme?
Normally, we'd have a toll-free number, usually a common one for the whole country, and depending on which state the call comes from, it'll be referred to that particular state. The counsellor will answer and respond to the call. If the counsellor is unable to handle the situation, the COE will get involved in the call.
The COE has a specialized mental health care professional. Once the COE and counsellor have evaluated the patient and think they need emergency care, they will direct the person to a particular facility because they'll have resource mapping of all the facilities in that particular locality.
What can people expect after their initial call to the helpline?
Very often it takes people weeks to months to access services, so this will be a way to enhance the speed with which they will get access to the services. We still haven't worked out the follow-up and how the follow-up will occur.
At NIMHANS we do a follow-up on all our patients. In the second phase of the pandemic we used to do a telephonic follow-up on our patients. In the last phase of the pandemic we're looking at setting up a technology-based solution to help with the follow-up. Sometimes it just needs one call and the person can confirm they're okay. For some other, more chronic mental health conditions, the person will need more follow-up.
NIMHANS has run Tele-Mental Health helplines for a while now. How successful have they been?
I'll give you the example about our Tobacco Cessation helpline. Pre-pandemic and post-pandemic, we had fewer calls, but the percentage of people who registered with a serious intent to quit and who actually successfully quit rose from 18 percent pre-pandemic to 40 percent post-pandemic.
Similarly, with our psychosocial helpline, we've got a lot of feedback about how grateful people are with the help they've received. Mobile phones have made it much easier to reach people. There's still inequity, because women and children might not have access to phones, but it's still an improvement on travelling 200-300 kilometres to get the help they need.
Do you think this initiative is adequate? Or does more need to be done?
To give credit to the government, a lot has been done in a linear fashion. I think this will be a game-changer simply because of the reach it will have. But yes, a lot has to be done. Initially we were focusing on improving institutions, and then we reached out to develop community services. Everything will need to be synced together and people will need to be able to move effortlessly between the different parts, and that's a big challenge in all parts of the world.