Search

Objectives Work stress is associated with non-communicable diseases, increased healthcare costs, and decreased work productivity among employees in the information technology sector. There is a need for regular work-stress screening among employees using valid and reliable tools. The Tool to Assess and Classify Work Stress (TAWS-16) was developed to overcome limitations in existing stress assessment tools in India. This study aimed to test the reliability of TAWS-16 in a sample of managerial-supervisory employees. Methods This observational reliability study included data from 62 employees. Test-retest and inter-method reliability were investigated using a TAWS-16 web application and interview by telephone, respectively. Kappa values and intra-class correlation coefficients were calculated. Internal consistency was assessed through Cronbach’s alpha. Results For both test-retest and inter-method reliability, the agreement for both work-related factors and symptoms suggestive of work stress exceeded 80%, and all kappa values were 0.40 or higher. Cronbach’s alpha for test-retest and inter-method reliability was 0.983 and 0.941, respectively. Conclusions TAWS-16 demonstrated acceptable reliability. It measured stressors, coping abilities, and psychosomatic symptoms associated with work stress. We recommend using TAWS-16 to holistically identify work stress among employees during periodical health check-ups in India.

Background: Psychiatric disorders are among the leading contributors to disability in India and worldwide. The pattern, prevalence, and distribution of psychiatric disorders in the country and its regions need to be assessed to facilitate early diagnosis and treatment. No study on the epidemiology of psychiatric disorders has been conducted in the Chhattisgarh state. This paper, as part of the National Mental Health Survey (NMHS), discusses the prevalence and pattern of psychiatric disorders in Chhattisgarh state. Methods: A stratified random cluster sampling technique and random selection based on probability proportional to size (PPS) at each stage were adopted. Participants were from three selected districts of Chhattisgarh, such as Janjgir-Champa, Kabirdham, and Raipur. Adults (aged ≥18 years) residing in selected households were interviewed using Mini International Neuropsychiatric Interview (version 6.0), the Fagerstrom test for nicotine dependence, the WHO-SEARO screening questionnaire for generalized tonic-clonic seizures, and screening tools for intellectual disability and autism spectrum disorders. Results: A total of 2841 individuals were interviewed. The state’s lifetime and current prevalence of psychiatric disorders for adults were 14.06% [95% confidence interval (CI) = 13.83–14.29] and 11.66% (95% CI = 11.45–11.87), respectively. Prevalence of substance use disorders, tobacco use disorders, schizophrenia and related disorders, and mood disorders was 32.4% (95% CI = 32.09–32.71), 29.86% (95% CI = 29.56–30.16), 0.8% (95% CI = 0.75–0.86), and 4.44% (95% CI = 4.31–4.58), respectively. High risk for suicide was detected in 0.28% (95% CI = 0.25–0.31). Psychiatric disorders were twice more common in males than in females. Conclusions: The study gives authentic data on the prevalence of psychiatric disorders in Chhattisgarh. This shall pave the way for policymakers and planners to design state-specific plans for dealing with mental disorders and related issues.

ObjectivesThis paper describes the methodology of developing and implementation of a youth focused life skills training and counselling services programme (LSTCP) and assessment of factors associated with life skills of participants pre-training.DesignDevelopment of all aspects of LSTCP (modules, methods and evaluation) was through a consultative process. Experiential learning based facilitation was decided as the approach for training participants. A quasi-experimental design with pre, post and follow-up assessment post-training was finalised. Data collection was done using specifically developed semi-structured self-administered questionnaire.ResultsMultivariable logistic regression with life skills as outcome and various exposure variables was performed. About 2/3rd of participants had high level of life skills (68%). Increased score of extraversion (AOR = 1.57,95% CI = 1.32-1.85), agreeableness (AOR = 1.42,95% CI = 1.16-1.73), conscientiousness (AOR = 1.9,95% CI = 1.55-2.33), physical (AOR = 1.03,95% CI = 1.01-1.04), environmental (AOR = 1.02,95% CI = 1.004-1.03) and social quality of life (AOR = 1.01,95% CI = 1.006-1.02) were associated with high life skills score. Higher score of neuroticism (AOR = 0.66,95% CI = 0.53-0.79) was associated with low life skills score.ConclusionThe results presented provide an opportunity to understand the evolution of factors affecting life skills during the follow-up of this study. This study throws light on development of LSTCP for apparently healthy population in a setting like India and its states.

Promoting positive identity and seeking early support for gender, sex and sexuality (GSS) issues among youth is vital. Understanding and addressing factors associated withGSS among them is critical. We assessed four-year case records (January 2017–December 2020) of all first visit youth mental health promotion clinic (YMHPC) clients (15–35 years) for factors associated with GSS issues in Karnataka. Overall, prevalence of GSS issues was 1.8% (189/10,340). Increased risk of GSS issues was observed among clients reporting suicidality (AOR = 4.27, 95% CI = 2.70–6.74) and relationship issues (AOR = 3.63, 95% CI = 2.36–5.57), followed by issues of safety (AOR = 2.56, 95% CI = 1.72–3.81), personality (AOR = 2.48, 95% CI = 1.60–3.85), health and lifestyle (AOR = 2.27, 95% CI = 1.77–4.19), smokers (AOR = 2.30, 95% CI = 1.24–4.27), and those who felt depressed (AOR = 2.10, 95% CI = 1.43–3.09) and worthless (AOR = 2.08, 95% CI = 1.28–3.39). Clients aged 21–25 years (AOR = 1.80,95% CI = 1.27–2.54), male (AOR = 1.72, 95% CI = 1.20–2.46) and who had been married (AOR = 2.32, 95% CI = 1.51–3.57) had a higher risk of GSS issues than those aged 15–20 years and other counterparts, respectively. Clients who drank alcohol (AOR = 0.49, 95% CI = 0.30–0.81) had reduced risk of GSS issues. The findings re-iterate the importance of early recognition of factors (essential precursors) of GSS issues among youth. The study highlights the importance of promoting awareness and improving primordial prevention of possible GSS issues in later life. This study has important implications on youth mental health promotion programs, especially in countries like India.

Background: Yuva Spandana (YS) is a youth mental health promotion program implemented across all 30 districts of Karnataka. Yuva Parivarthakas (YPs - youth change agents) are trained to provide mental health promotion services to any “youth with issues” through Yuva Spandana Kendras (guidance centers) situated within district stadiums across Karnataka. Aim of the study was to evaluate the change (comparing before and after training) in different learning domains (cognitive – knowledge, affective – attitude, and psychomotor – practice) among trainees (YPs) attending YS training. Methods: Quasiexperimental study design was utilized for this study. A semistructured interview schedule was developed and used before and after the training. Data were analyzed by descriptive statistics. The difference in change of mean score was assessed using the paired t-test. The shift in the proportion of trainees post-training in the three domains was assessed using McNemar's test. Results: The mean (±SD) age of trainees was 27.5 ± 3.3 years. Majority of them were males (63.8%), had completed bachelor's degree (53.4%), and were residing in rural Karnataka (77.7%). The knowledge and attitude scores significantly improved (P < 0.001) post-training, without significant improvement in practical skills. Conclusion: It is recommended that future training programs need to be focused on creating opportunities to YPs in order to increase their practical skills to work with youth having issues.

BACKGROUND: India today is home for the largest youth population in the world. Youth is a formative phase transitioning from childhood to adulthood. Relationship is fundamental for a healthy and satisfactory life. Relationships assume importance and maturity during adolescence and youth. Relationships and mental health have a bidirectional effect. The effect of relationships on mental health is stronger than vice versa. MATERIALS AND METHODS: Two-year case record analysis of 8595 beneficiaries aged 15–35 years attending youth guidance centers (Yuva Spandana Kendras) in Karnataka, India, was undertaken to understand factors affecting relationship issues among them. Multivariate logistic regression was performed with any beneficiary having a relationship issue as outcome. RESULTS: Being a student (adjusted odds ratio [AOR] = 1.49; 95% confidence interval [CI] = 1.18–1.89), occupation (AORbusiness/salaried = 3.04; 95% CI = 2.10–4.40 and AORothers = 1.72; 95% CI = 1.22–2.44), marital status (AORmarried = 1.42; 95% CI = 1.06–1.90 and AORothers = 3.44; 95% CI = 1.45–8.15), having health and lifestyle issues (AOR = 3.61; 95% CI = 3.05–4.27), personality issues (AOR = 2.88; 95% CI = 2.43–3.41), safety issues (AOR = 6.28; 95% CI = 5.01–7.87), gender, sex, and sexuality issues (AOR = 3.10; 95% CI = 1.93–4.98), suicidality (AOR = 1.82; 95% CI = 1.17–2.85), alcohol use (AOR = 5.43; 95% CI = 3.92–7.41), and different emotions experienced (AOR ranging from 0.37 to 3.50), had significant association with relationship issues. CONCLUSION: Investing in health promotion interventions focusing on these precursors of relationship issues among youth seems strategic. Our findings have implications for other states in India and other low-middle-income countries like India.

Background: A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods: The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results: The NMHS MHSA for the year 2015--16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion: MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation. [ABSTRACT FROM AUTHOR]

Background: Youth are considered to be most vulnerable to health and lifestyle issues (HLS) in India. The current study aims to investigate the factors that contribute to health and lifestyle issues among youth attending mental health promotion clinics (YMHP) in Karnataka. Method: Three-year first-visit data from beneficiaries (aged 15–35 years) attending YMHP clinics in Karnataka between 2017 and 2020 were analyzed. Multivariable logistic regression analysis included beneficiaries reporting any HLS issue as the outcome and a host of 57 hypothesized variables as exposures. Results: Overall, 2,615 (25%) beneficiaries reported HLS issues. Years of schooling (AOR 5–7 years = 0.89; 95% confidence interval [CI] =0.60–1.31), (AOR 8–10 years = 0.65; 95% CI = 0.46–0.91), (AOR >10 years = 0.67; 95% CI = 0.49–0.93)], unemployed youth (AOR = 0.52; 95% CI = 0.45–0.61) business and salaried workers (AOR = 1.69; 95% CI = 1.33–2.13), and other occupations (AOR = 2.11; 95% CI = 1.73–2.56), junk food consumption (AOR = 0.76;95% CI = 0.68–0.84), having issues related to relationships with parents (AOR = 3.01; 95% CI = 2.47–3.68) and intergenerational issues (AOR = 1.71; 95% CI = 1.19–2.45), self-development issues (AOR low-self-awareness = 1.57; 95% CI = 1.33–1.85), (AOR low-self-esteem = 1.29; 95% CI = 1.062–1.57), (AOR emotional issues = 1.57; 95% CI = 1.31–1.89), education and academics (AOR = 1.23; 95% CI = 1.09–1.39), safety issues (AOR = 4.11; 95% CI = 3.07–5.50), gender sex and sexuality issues (AOR = 2.44; 95% CI = 1.43–4.15), suicidal ideation (AOR = 1.91; 95% CI = 1.44–2.54), substance use (AOR tobacco chewing = 1.45; 95% CI = 1.09–1.93), (AOR tobacco-smoking = 1.66; 95% CI = 1.18–2.32), (AOR smoking = 4.94; 95% CI = 3.52–6.93) and experiencing emotions (AOR feel anxious = 1.63; 95% CI = 1.41–1.88), (AOR forgetfulness = 1.50; 95% CI = 1.41–1.98), (AOR difficulty in concentration = 1.37; 95% CI = 1.035–1.81), (AOR anger = 1.61; 95% CI = 1.25–2.07), (AOR feel worthless = 2.21; 95% CI = 1.71–2.86) were associated with HLS issues among beneficiaries. Conclusion: This analysis addresses an important but neglected component of HLS issues among youth highlighting the importance of early intervention among youth to prevent the development of diseases later in life. The study has important implications for youth health promotion in India and countries such as India. Health and Lifestyle Issues Among Youth: A record analysis of contributing factors among beneficiaries attending Youth Mental Health promotion clinics (Yuva Spandana Kendras) in Karnataka, India. [ABSTRACT FROM AUTHOR]

Introduction: Encephalitis is a major public health problem worldwide that causes huge emotional and economic loss to humanity. Encephalitis, being a serious illness, affects people of all ages. The aim is to describe the sociodemographic, clinical, etiological, and neuroimaging profile among 101 acute encephalitis syndrome (AES) patients visiting a tertiary neuro-specialty care hospital in India. Methods: Record review of medical records of all patients attending neurology emergency and outpatient services at NIMHANS Hospital, diagnosed with AES in 2019, was conducted. Data were collected using standardized data collection forms for all cases in the study. Descriptive analyses (mean and standard deviation for continuous variables and proportions for categorical variables) were conducted. The Chi-square test/Fisher's exact test was used for the comparison of independent groups for categorical variables, and t-test for comparing means for continuous variables. Results: About 42.6% of AES patients had viral etiology, while in 57.4%, etiology was not ascertained. Common presenting symptoms were fever (96%), altered sensorium (64.4%), seizures (70.3%), headache (42.6%), and vomiting (27.7%). Herpes simplex was the most common (21.8%) identified viral encephalitis, followed by chikungunya (5%), arboviruses (chikungunya and dengue) (4%), Japanese encephalitis (4%), rabies (3%), dengue (1%), and varicella virus (1%). About 40% of AES patients showed cerebrospinal fluid pleocytosis (44%), increased protein (39.6%), abnormal computed tomography brain (44.6%), and magnetic resonance imaging abnormalities (41.6%). Conclusion: The study highlights the need to ascertain etiology and importance of evidence-based management of AES patients. A better understanding of opportunities and limitations in the management and implementation of standard laboratory and diagnostic algorithms can favor better diagnosis and management of AES. [ABSTRACT FROM AUTHOR]

Introduction: With a long-term vision to strengthen the evidence-based trauma care programme in the Kolar district, an objective assessment and grading of the trauma care system (TCS) in public and private hospitals was undertaken. Methods: This cross-sectional assessment used a specifically developed TCS assessment tool to collect data from all Level 2, 3, and 4 hospitals in the Kolar district using a review of records, observation of facilities, and interviews with stakeholders. Data were collected regarding macro areas, human resources, infrastructure, equipment, and drugs in ER, in an objective manner. TCS was scored and compared against criteria set in WHO essential guidelines for Trauma Care. The functioning of TCS was expressed as 'percentage of expected standards' and graded accordingly. Ethical clearance and informed consent were obtained. Results: All available and eligible Level 2, 3, and 4 hospitals in the district (39 hospitals) covering the public and private sector were assessed. TCS in Level 2 and 3 hospitals was functioning at 56% and 59% of expected standards, respectively. TCS was better in Level 4 hospitals, at 83% of expected standards. Scores were lower for macro areas and human resources. Conclusion: TCS in the district is functioning sub-par to expected standards. There is a need for comprehensive strengthening of TCS in both public and private healthcare facilities, especially in macro areas and human resources. Systematic monitoring and periodical TCS assessments are recommended at district levels throughout the country for improved outcomes in India. [ABSTRACT FROM AUTHOR]

Objective To estimate fall-related mortality by type of fall in India. Methods The authors analysed unintentional injury data from the ongoing Million Death Study from 2001-2003 using verbal autopsy and coding of all deaths in accordance with the International statistical classification of diseases and related health problems, tenth revision, in a nationally representative sample of 1.1 million homes throughout the country. Findings Falls accounted for 25% (2003/8023) of all deaths from unintentional injury and were the second leading cause of such deaths. An estimated 160 000 fall-related deaths occurred in India in 2005; of these, nearly 20 000 were in children aged 0-14 years. The unintentional-fall-related mortality rate (MR) per 100000 population was 14.5 (99% confidence interval, Cl: 13.7- 15.4). Rates were similar for males and females at 14.9 (99% Cl: 13.7-16.0) and 14.2 (99% Cl: 13.1-15.4) per 100 000 population, respectively. People aged 70 years or older had the highest mortality rate from unintentional falls (MR: 271.2; 99% Cl: 249.0-293.5), and the rate was higher among women (MR: 281; 99% Cl: 249.7-311.3). Falls on the same level were the most common among older adults, whereas falls from heights were more common in younger age groups. Conclusion In India, unintentional falls are a major public health problem that disproportionately affects older women and children. The contexts in which these falls occur and the resulting morbidity and disability need to be better understood. In India there is an urgent need to develop, test and implement interventions aimed at preventing falls. Objectif Evaluer la mortalite associee aux chutes par type de chute en Inde. Methodes Les auteurs ont analyse les donnees associees aux chutes involontaires extraites de l'etude en cours sur un million de deces de 2001 a 2003 en utilisant l'autopsie verbale et le codage de tousles deces conformement a la Classification statistique internationale des maladies et des problemes de sante connexes, dixiieme revision, darts un echantillon representatif sur le plan national d'1,1 million de foyers dans tout le pays. Resultats Les chutes representaient 25% (2003/8023) de tous les deces resultant de blessures involontaires ainsi que la seconde cause majeure de ces deces. On estime que 160 deces dus a une chute se sent produits en Inde en 2005; parmi ceux-ci, presque 20000 concernaient des enfants ages de 0 a 14 ans. Le taux de mortalite (TM) associe aux chutes involontaires pour une population de 100000 personnes etait de 14,5 (intervalle de confiance a 99% (IC): de 13,7 a 15,4). Les taux etaient similaires pour les hommes et les femmes a 14,9 (IC a 99%: de 13.7-16.0) et 14,2 (IC a 99%: de 13,1 a 15,4) pour une population de 100 000 personnes respectivement. Les individus ages de 70 ans ou plus presentaient ie taux de mortalite resultant de chutes involontaires le plus eleve (TM: 271,2; IC a 99%: de 249.0 a 293,5) et le taux etait plus eleve chez les femmes (TM: 281; IC A 99%: de 249.7-311.3). Les chutes sur le meme niveau etaient plus frequentes parmi les adultes plus ages alors que les chutes depuis une hauteur etaient plus frequentes dans les groupes plus jeunes. Conclusion En Inde, les chutes involontaires representent un probleme de sante publique majeur qui affecte de facon disproportionnee les femmes agees et les enfants. II est necessaire de mieux comprendre le contexte dans lequel ces chutes se produisent, ainsi que la morbidite et l'invalidite qui en resultent. II y a en Inde un besoin urgent de developper, de tester et de mettre en oeuvre des interventions visant a prevenir les chutes. Objetivo Estimar la mortalidad asociada a caidas per tipo de caida en la India. Metodos Los autores analizaron los dates sobre lesiones no intencionadas procedentes del Million Death Study, el estudio del millon de muertes, (aun en curse) de 2001 a 2003 con autopsias verbales y codificacion de todas las muertes de conformidad con la Clasificacion estadistica internacional de enfermedades y problemas relacionados con la salud, decima version, en una muestra representativa a nivel nacional de 1,1 miliones de hogares de todo el pals. Resultados Las caidas representaron el 25% (2003/8023) de todas las muertes per lesiones no intencionadas y fueron la segunda causa mas importante de este tipo de muertes. Se estima queen 2005, en la India se produjeron 160 000 fallecimientos asociados a caidas; de estos, casi 20 fueron de ninos de entre 0 y 14 anos. La tasa de mortalidad (TM) asociada a caidas no intencionadas per cada 100 000 habitantes fue del 14,5 (intervalo de confianza del 99%, IC: 13,7-15,4). Estas tasas fueron similares para hombres y mujeres, 14,9 (IC del 99%: 13,7-16,0) y 14,2 (IC del 99%: 13,1-15,4) per cada 100.000 habitantes, respectivamente. Las personas de 70 anos o mas presentaron la mortalidad mas alta per caidas no intencionadas (TM: 271,2; IC del 99%: 249, 0-293,5), y la tasa fue mayor en mujeres (TM: 281; IC del 99%: 249,7-311,3). Las caidas al mismo nivel fueron las mas comunes en adultos mayores, mientras que las caidas desde altura fueron mas comunes en los grupos de edad mas jovenes. Conclusion En la India, las caidas no intencionadas constituyen un problema de salud publica importante que afecta de forma desproporcionada a mujeres mayores y ninos. Es necesario entender mejor los contextos en los que se producen estas caidas y la morbilidad y discapacidad resultantes. En la India existe una necesidad urgente de preparar, probar e implementar medidas para evitar caidas., Introduction Falls are the second leading cause of unintentional injury mortality and they account for 11% of all unintentional injury deaths worldwide. (1) According to the World Health Organization (WHO), [...]

Background: Despite their higher prevalence, the Common Mental Disorders (CMDs) are under-recognized and under-treated resulting in huge disability. India, home to one-fifth of the global population, could offer insights for organizing better services for CMDs. However, the prevalence and resultant disability in the general population is unknown, and consequently, gaps in management or plan for services are enormous, by default overlooked. Aim: Estimating the current prevalence, disability, socioeconomic impact, and treatment gap of CMDs in a nationally representative sample from India. We attempt to identify the missed opportunities and list priorities for planning. Methodology: The National Mental Health Survey of India (2016) is a multisite nationwide household survey conducted across India using a uniform methodology. Overall, 39,532 adults were surveyed with a response rate of 88%. Diagnoses are based on the Mini International Neuropsychiatric Interview 6.0.0. CMDs for this analysis include depressive and anxiety disorders (generalized anxiety disorder, social phobia, agoraphobia, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder). Results: The weighted prevalence of current CMDs was 5·1% (95% CI: 5.06–5.13). Prevalence was highest in females, among the 40–59 years of age group, and in metros. Nearly 60% of them reported disabilities of varying severity. The treatment gap was 80·4%. On average, patients and their families spent ₹1500/month towards the treatment of CMDs. Conclusions: This survey gives valuable insights regarding the disability and treatment gap due to CMDs and is imperative for reframing mental health policies and planning interventions. This study also suggests an international investigation to understand the difference in the prevalence of CMDs in developing versus developed countries. [ABSTRACT FROM AUTHOR]

Byline: Senthil. Amudhan, Gopalkrishna. Gururaj, Parthasarathy. Satishchandra Epilepsy is a common neurological disorder whose consequences are influenced socially and culturally, especially in India. This review (second of the two part [...]

Byline: Senthil. Amudhan, Gopalkrishna. Gururaj, Parthasarathy. Satishchandra Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India; which contributes to nearly [...]

Context: Occupational health surveillance in India, focused on notifiable diseases, relies heavily on periodic medical examination, and isolated surveys. The opportunities to identify changes in morbidity patterns utilizing data available in workplace on-site clinics is less explored in India context. Aims: Present paper describes longitudinal assessment of morbidity patterns and trends among employees seeking care in occupation health clinic (OHC). The study also intends to explore associations between work department, clinic visits and morbidity pattern. Materials and Methods: Record-based analysis was undertaken on data available (for the period 2010-2014) from two OHCs in a leading automobile industry in India. The doctor, examining every employee, documented the provisional diagnosis in specific software which in turn provides summary diagnosis based on affected body organ system as per ICD-10 categories. This information was used to assess the morbidity pattern and trend among workers. Chi-square test of significance and Extended Mantel-Haenszel chi square test was used assess the association and its linear trend. Results: Respiratory, musculoskeletal and digestive system related diseases were the top three reasons for employees visit to OHC. The nature of morbidity varied across different departments in the industry. There was a significant increase in proportion of employees visiting OHC during 2010-2014. Conclusion: A clinic visit record, with its own strengths and limitations, provides information on morbidity pattern and its trends among workers. Such information will help plan, implement and evaluate health preventive, promotive, and curative services. [ABSTRACT FROM AUTHOR]

Background: Previous attempts of Mental Health Systems Assessment in India were restricted in scope and scale. Information on all aspects of mental health systems (leadership/governance, legislation, financing, service delivery, workforce, access to essential medicines, information systems, intersectoral activities, and monitoring and evaluation) was scarcely available. The National Mental Health Survey-Mental Health Systems Assessment (NMHS-MHSA), a unique endeavor, assessed the performance of mental health systems and services through health systems assessment framework. The present paper discusses the design and methodology adopted under NMHS-MHSA along with emphasizing its implication for India and other LMICs. Methods: NMHS-MHSA was undertaken in 12 Indian states by contextually adapting WHO-AIMS instrument. Data was collated from several secondary sources including interviews of key stakeholders. Utilizing the data a set of 15-quantitative, 5-morbidity and 10-qualitative indicators were developed to summarize the functional status of mental health systems in the surveyed states. This information was authenticated through state level stakeholder's consultation and consensus building workshops following which a state mental health systems report card with indicators was developed. Conclusion: The process and robust method of data compilation enabled NMHS-MHSA to be a reliable and comprehensive method for assessing mental health systems at the state level. It's envisaged that the assessment provides requisite impetus for strengthening mental health program and mental health systems in India. Being less resource intensive, low -and middle- income countries can adopt NMHS-MHSA tool and methodology to assess their mental health systems with contextual modifications. [ABSTRACT FROM AUTHOR]