Mental health in an unequal world

Lapses in Nagaland’s Mental Health Care System 

Ketholeno Neihu 
Kohima | October 9 

Even as the world vouches for promoting ‘mental health in an unequal world,’ mental health care system in the state continues to take a backseat due to lack of provision in many spheres including delay in State Mental Health Authority’s rules and regulations, absence of mental health programme in interior districts or acute shortage of professional caregivers especially psychiatrists. 

State Mental Health Authority without draft rules & regulations 
A pressing issue is the delay in formulating the State Mental Health Authority’s draft rules and regulations in accordance to Section 46 of the Mental Health Care Act, 2017 as notified by the Union Health Ministry in 2018. 

An official of the State Mental Health Institute, Kohima informed The Morung Express that all the ground works were prepared in 2019; however no reasons were given by the State government on why the proposal was held up at that time. Before it could become an act in 2020, the COVID-19 pandemic set in and ‘over shadowed’ the matter. The same was reinitiated in July this year after necessary addition and modifications were made, the official disclosed. 

According to the latest hearing of a PIL which was filed in the Gauhati High Court, Kohima Bench earlier this year, a submission made by Government Advocate informed that the State Mental Health Authority has been constituted but “the draft rules and regulations is under process for vetting of the Law & Justice Department.” 

In this regard, the Court, in an order on August 4, gave the state government and concerned authorities 3 months to complete the vetting and notify the rules and regulations accordingly. Meantime, the Court also asked to clarify on whether the state has constituted a state Health Review Board and State Mental Health Authority Funds adding that “these are steps required to be taken at the very initial stage so that the authority would be able to function for the purpose for which it is constituted.”

Only 6 Psychiatrists in Nagaland 
Another lapse to the mental health care system is the acute shortage of professional caregivers especially Psychiatrists which has been an underlying reason for failing to extend District Mental Health Programmes across the state. As a result, District Mental Health Programme is functional only in 6 districts including Dimapur, Kohima, Mokokchung, Phek, Tuensang and Longleng till date and Nagaland state has only 6 Psychiatrists in total. According to the rules, each district programme should have a psychiatrist along with Clinical Psychologist, psychiatric nurses and other caregivers. 

State Mental Health Institute 
The only State Mental Health Institute (SMHI) in the state capital continues to require development and attention in various arenas. Foremost being the deplorable road condition towards the road leading to the hospital which is located away from the buzz of the town. In this relation, the official said that institute is looking for answers to replace the very old staff bus through Corporate Social Responsibility funding. Among others, another issue requiring attention was the shortage of psychiatric or trained nurses, senior psychiatrist of the State Mental Health Institute Dr Viketoulie Pienyu stated.  

Inequality beyond systems & govts
Equality in the system will go a long way to addressing mental health issues in the state. As such, mental health care workers on the occasion of World Mental Health Day also advocated the need to give equal attention to mental health. For Clinical Psychologist Imlibenla Mongro equality or inequality is beyond systems, government and the society, as mental health is not given as much importance as physical health. We need to understand the correlation between the two and normalize responding to, “I’m going through stress or I am struggling with anxiety,” she added.