Institute of Human Behaviour & Allied Sciences (IHBAS), Dilshad Garden, Delhi -110095.
Indian J Psychiatry. 2004 Jul;46(3):195-212.
The information about Urban Mental Health Services has been nearly nonexistent in India, although the developed countries have been focusing on programmes for "Healthy Cities". The initiative taken as part of the WHO-ICMR Pilot Project on Urban Mental Health Services, with a public health perspective is being shared. The objectives of the Health Services Research (HSR) Arm of the project were to study the distribution and the availability of tertiary Mental Health Services, availability of human resources, average service load, mental health service gap, and perceptions of the users and the service providers, regarding the barriers in accessibility of mental health services, unmet service needs and strategies for improvement.The Research Methods involved Mapping Exercises with estimation of Service Loads and Qualitative Research Methods (QRM) like In-Depth Interviews (IDIs), Key Informant Interviews (KIIs), Free Listing and Focused Group Discussions (FGDs). The results indicate uneven availability of mental health services, human resource deficit specially for non-medical mental health professionals and mental health service gap (82% to96%). The average service load in the specialist mental health services is largely carried by the Govt. sector (half to two thirds), followed by the private sector (one third to half), with only a small portion by the NGO sector. The average mental health service load in the primary care general health services is largely carried by the private sector, with significant contribution from the non-formal service providers. The barriers to access, unmet needs and possible strategies as perceived by the community, users and service providers have been identified. The findings are discussed in the context of the mental health programmes and the public policy issues. The implications of the conclusions which suggest that Urban Mental Health Services are far from complete are highlighted.
印度的城市心理健康服务信息几乎不存在，尽管发达国家一直在关注“健康城市”计划。本文分享了世卫组织-印度医学研究理事会城市心理健康服务试点项目中的一项举措，该项目从公共卫生的角度出发。该项目的卫生服务研究（HSR）部分的目标是研究三级精神卫生服务的分布和可及性、人力资源的可用性、平均服务量、精神卫生服务差距以及用户和服务提供者对获取精神卫生服务的障碍、未满足的服务需求以及改进策略的看法。研究方法包括服务量估计的映射练习和定性研究方法（QRM），如深入访谈（IDIs）、关键知情人访谈（KIIs）、自由列表和焦点小组讨论（FGDs）。结果表明，精神卫生服务的可用性不均衡，特别是缺乏非医疗精神卫生专业人员和精神卫生服务差距（82%至 96%）。在专门的精神卫生服务中，平均服务量主要由政府部门承担（一半到三分之二），其次是私营部门（三分之一到一半），只有一小部分由非政府组织部门承担。在初级保健一般卫生服务中的平均精神卫生服务量主要由私营部门承担，非正规服务提供者也做出了重大贡献。社区、用户和服务提供者认为存在获取障碍、未满足的需求和可能的策略。讨论了这些发现与精神卫生计划和公共政策问题的关系。结论表明城市心理健康服务远未完善，突出了其影响。
