“In Maharashtra, there are 184 private nursing homes that admit patients in need of psychiatric care,” said Jeetendra Ghadge of the Young Whistleblowers Foundation, who filed the RTI with the state public health department to highlight inadequate infrastructure for the mentally ill. .
Mental health problems are widespread. According to rough estimates, 10% of the population suffers from them, which affects the country’s labor force and economic output. It is time for governments at the local and central level to innovate (for example, train ASHAs who conduct house-to-house checks for infectious diseases and also screen for signs of depression) to find ways to manage the mental health burden of the society.
Maharashtra has the highest number of suicide deaths in India for most years, but public facilities for mental health patients are poor, he said. On the one hand, private nursing homes provide “expensive care,” while state settings are too crippled by severe labor shortages to provide adequate care.
“The state has four psychiatric hospitals in Pune, Thane, Nagpur and Ratnagiri, but no psychiatric nursing homes. All districts in northern, central and eastern Maharashtra are under the Nagpur hospital, which has 940 beds,” Ghadge said.
State officials, however, say bed capacity for patients is adequate.
Status: Hospital bed capacity for mentally ill patients is adequate
State government officials say bed capacity for mentally ill patients is adequate. Dr. Sadhana Tayade, state director of health services, said the 4 state-run mental health hospitals have more than 5,000 beds. “In addition, each district hospital has 10 beds reserved for mental health patients. Private nursing homes licensed to provide psychiatric care have up to 10 beds each. These are adequate for the time being,” she said.
The fact that none of these hospitals are ever full and run at 70% occupancy shows that Maharashtra has adequate beds, he added.
A senior psychiatrist at a government hospital said that most psychiatric illnesses need medical help. “Only 1% of the population is affected by mental health conditions so serious that they require hospitalization. Around the world, the focus is no longer on hospitalization,” he said.
But, as Ghadge said, there aren’t enough OPDs (outpatient department clinics) in the government-funded space. Every primary health center in the state is required to have a special mental health clinic once a week.
“We need psychiatric nursing homes and halfway houses in every district. All government hospitals should have special OPDs for mentally ill patients,” she said. For patients in rural areas, linkage programs with NGOs should be launched.
In Mumbai, most of the big-name private hospitals refuse to admit mental health patients because they are “violent” or suicidal. In the public sector, BMC’s chief health officer, Dr. Mangala Gomare, said super-specialty civic hospitals have OPDs, as well as inpatient facilities for mental patients. “The public health department has to focus on infectious and noncommunicable diseases, but we have realized the need to help patients with mental health problems and we will do something soon,” he said.
Psychiatrist Harish Shetty said affordable and free acute care beds for the poor are the need of the hour.
Dr. Tayade said the state is making efforts to speed up promotions and hire more psychiatrists. “But there is no response from the psychiatrists. According to the center and the World Health Organization, we have started training MBBS doctors, nurses and psychologists,” he said.
The state government had written to the union government to allow it to recruit doctors with PG degrees other than an MD in psychiatry, but the suggestion was rejected. He said that the Mental Health Act of 2017 would be implemented soon.
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