According to the National Mental Health Survey (NMHS) conducted in 2015-2016, the prevalence of mental disorders in children between the ages of 13-17 was 7.3% in both sexes. Furthermore, 26.8% of girls married are under the legal age, while 8% of girls aged 15-19 are mothers or pregnant. The survey also found that 37% of women aged 15-24 had experienced physical, sexual or mental violence by their husbands, including school-aged children.
The survey found that young children, especially girls, are vulnerable to sexual coercion, unwanted pregnancies, unsafe abortions, physical injuries and digital challenges such as cyberbullying , internet addiction and pornography. These risks in turn affect their physical as well as mental health.
Six years have passed since the Mental Health Care Act of 2017 was passed, codifying the country’s approach to mental health, mental health care and suicide. However, Congress has yet to develop a framework for a national school mental health program.
While the government launched Rashtriya Bal Swasthya Karyakram (RBSK) under the National Health Mission in 2013, the program mainly focused on early detection and management of diseases such as anemia, malnutrition, Developmental disorders, skin/heart/respiratory diseases in children through screening at government schools and Anganwadis.
This program screens children for mental disorders such as autism, learning disabilities, motor skills, cognitive skills, attention deficit, and vision, hearing, and neuromotor impairment. However, mental problems such as stress, anxiety, depression or suicidal thoughts are not addressed in this program.
What is the School Mental Health Program (SMHP)?
According to a report from the United Nations International Children’s Emergency Fund (UNICEF), any mental health program in schools must include five pillars that support a favorable learning environment, access to mental health and early intervention services, teacher well-being, targeted mental health programs that employ the education workforce at the national, state, and local levels, and partnerships that meaning between school, family and community.
Following existing education policies, plans and budgets, UNICEF sets out a basic framework for how to build mental health programs in schools:
Recruit dedicated consultants
ensure remote access to mental health services
promote government helpline numbers
Maintain adequate teaching and non-teaching staff to ensure teacher welfare
promote community-based activities
Spread awareness about mental health, its issues as part of school curriculum
Collaborate with families and communities to better adjust programs and monitor children’s health – thereby enhancing confidence and trust in relationships
What SMHP does India currently have?
In 1982, India launched the National Mental Health Program (NMHP) to ensure access to minimum mental health care for all, encouraging the introduction of health literacy. mental health into general health services and promote community participation in mental health service programs.
According to NMHP, the District Mental Health Program (DMHP) was implemented in 1996 and includes some basic elements of early detection and treatment, training general practitioners to diagnose and treat mental health disorders. Mental illness, awareness and community monitoring.
Over time, the scope of the DMHP has expanded to include improved medical infrastructure, dedicated psychiatric hospitals, centralized training, life skills education and counseling in schools and colleges. equality, addressing work-related stress and preventing suicide. The National Mental Health Policy, passed in 2017, sought to remove the stigma around mental illness, take steps to prevent such illnesses and bring people with mental health problems into mental health into society.
In 2018, the Modi government launched the School Health program under the aegis of the Ayushman Bharat programme, which was launched the same year. The program has a broad focus that includes child health screening under the RBK program, weekly in-class activities on health and wellness, and in-school seminars.
Focusing on the mental health of middle and high school students, the program outlines health promotion activities such as meditation and yoga, bullying prevention, internet safety and media literacy. communication, substance abuse prevention, violence and mental health awareness. Coordination committees at the block, district, state and national levels are tasked with implementing the program. These committees include teachers, district magistrates, education and health officers, state secretaries and Union ministry representatives.
In 2022, the Union Health Ministry also issued a handbook for schools to train teachers, counselors and other staff, stating guidelines for early identification, detection and intervention of diseases. mental health illness.
Since 2020, the outbreak of the Covid-19 epidemic forced students to study at home, separate from their peers, leading to psychosocial problems, loneliness and withdrawn behavior. To address these issues, the government launched the Manodarpan website detailing guidelines, frequently asked questions (FAQs), posters and videos to provide psychosocial support to students. The National Council of Educational Research and Training (NCERT) has launched free counseling services for children, recruiting 270 counselors across regions to address mental problems in children through through direct interactive sessions.
What are the problems in India’s SMHP?
One of the major limitations of India’s mental health sector is lack of human resources. According to the World Mental Health Atlas (2017), India has 0.29 psychiatrists per lakh population (plp) and zero children. Among other professionals, there were 0.8 mental health nurses and 0.07 psychologists. In total, there are only 25,312 mental health professionals in India and only 49 child psychiatrists, as of 2017.
Although there is a school health program under NMHP, India does not have a structure to implement SMHP nationwide. Several awareness programs such as training teachers on mental illness, promoting yoga and meditation, and toll-free consultation numbers are the extent to which India is addressing the issue of child mental health me. Furthermore, most school health programs address specific issues such as substance abuse, suicide prevention, domestic violence, and sexual abuse; There is no unified, comprehensive SMHP to address the mental health and well-being of all students nationwide.
The lack of engagement of stakeholders such as NGOs dealing with psychiatric issues, private hospitals, mental health research facilities and pharmaceutical companies has also hindered the government Deploy SMHP nationwide. According to the World Mental Health Atlas (2017), the Indian government spends only 1.3% of its health expenditure on mental health. With health spending accounting for just 2% of the Coalition budget, funding for mental health is sadly inadequate.
What is the plan ahead?
Heeding the advice of many experts, NITI Aayog is planning to set up a comprehensive school wellness program. According to one Economic Times report, the program will cover students in both government and private schools through policy intervention on existing health promotion and disease prevention measures under the Ayushman Bharat scheme.
The move was triggered by a rise in suicides among students. Since 2011, the number of student suicides has increased steadily from 7,696 students (2011) to 13,089 students (2021), according to National Crime Records Bureau (NCRB) statistics. For those under 18 years old, 1,408 cases cited illness as the reason for suicide; 58% of these diseases are related to mental health. Apart from this, 1,495 cases listed love problems as the cause and 864 cases listed failure in exams.
To address the rise in mental illness, NITI Aayog is in talks with various stakeholders, including union ministries related to Health, Education, Women and Children to develop a plan holistic and comprehensive for students. But this leaves open the question of whether the plan will expand beyond illness to address student mental health.
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