Assessment of Mental Health Services in Public Health Facilities of a North Indian District

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Abstract

Background The District Mental Health Program (DMHP) was launched in India to enhance access to mental health care in underserved areas through outreach, awareness, and treatment services. However, data on the quality and implementation of DMHP services remain limited. Methods This mixed-methods study was conducted in Faridabad district, Haryana, during April–May 2019. Six public health facilities, three Primary Health Centres, one Community Health Centre, one Sub-District Hospital, and one District Hospital; were selected. Data collection included structured facility assessments based on DMHP and WHO-AIMS frameworks and in-depth interviews with ten key stakeholders. Quantitative and qualitative data were analyzed to assess service delivery, infrastructure, drug availability, and systemic barriers. Results The study identified major gaps in service delivery. Only one medical officer had received DMHP training, and no community health workers were trained. Psychologists and psychiatric social workers were absent from most secondary care facilities, and no facility had inpatient psychiatric units. Psychotropic drug supply was inconsistent, particularly at PHCs. Mental health promotional activities were limited. Key barriers included contractual employment, low remuneration, inadequate infrastructure, stigma, and poor community awareness. Conclusion Strengthening human resources, training, infrastructure, and consistent drug supply is critical for improving DMHP implementation at the district level.

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