Mental Health by the Year 2000 A.d.

The historic Alma-Ata Declaration has now become a household word. Its ultimate goal—health for all by the year 2000 A.D. is a dream worth realizing. This seemingly simple and straightforward statement is a tremendous venture in the field of health care and is breathtaking in its scope. The emphasis in health care would follow the principles of Primary Health Clare as mentioned in the Alma Ata Declaration and which aims at deprofessionalizing and decentralizing health care. Achievement of the goals as envisaged above will have to include approaches and strategies for the improvement of all aspects of health, physical, mental and social. Since all are signatories to it, it does attain a somewhat mandatory status. Our concern of course relates to the prospects of adequate care being provided to the mentally unwell. We are well aware that mental health, in the past, was a relatively neglected area in the national and state health planning. This neglect is, however, now giving way to an increasing consciousness of the essentiality of the mental health component in schemes of health planning. Previous misconceptions regarding mental illness are being disproved; the importance of mental health skills in improving the quality of general health services is being recognized, and the aim of healthy psychosocial development of the people is rapidly gaining prominence. However, these are rather slow whereas the problems requiring our attention are growing in all dimensions. They require a strong commitment from the Government and dedicated endeavours by a vast number of health personnel of all categories as well as by the entire community. A consideration of the existing state of mental health delivery systems in India indicates that there is a strong disparity between requirement and existing facilities. It has been estimated that no more than 10% of those requiring urgent mental health care are receiving the needed help with the existing services. Moreover, these health services are mainly concentrated in the urban areas, thus further emphasizing the disparity, mentioned above, in the rural areas, which constitute 80% of our population. Deliberating over these matters, almost 15 years ago, an expert committee of the Indian Psychiatric Society-concluded that "Even if almost all the five-year plan efforts in the fields of health were only geared to increasing the number of psychiatrists, it would be impossible to provide an adequate number of hospital beds and mental specialists even in the next 50—100 years.. ." …