Mental Health Act 1987 was repealed with more comprehensive Mental Health Care Act (MHCA)-2017 in order to protect, promote and fulfill the rights of the person suffering from mental illness. There is paradigm shift in the nature of the legislation from the protecting the society from persons with Mental illness ( PMIs ) by confining them to mental asylums to providing them with equal opportunities of full participation in social living.
The Mental Healthcare Act (MHCA) 2017 received the assent of the President of India on 7^th April, 2017 and the Final Rules were notified on 29^th May, 2018 by Govt. of India in the Official Gazette and MHCA, 2017 was declared to have come into force w.e.f. 29^th May, 2019. In the Chapter VIII (Section 45-56), of MHCA- 2017 the provisions regarding establishment, composition and constitution, functions of SMHA and other important Sections regarding SMHA have been mentioned.
In the meeting chaired by ACS (Health) HP State Mental Health Authority has been constituted on 29-11-2018 under the new Act and by government notification on 18^th April 2019 Sr. Medical Superintendent Himachal Hospital for Mental Health and Rehabilitation was nominated as CEO under Section 52(1) of MHCA. Six Medical Review Boards have been constituted in the state of Himachal Pradesh.

Himachal Pradesh is small Hill state in Northern India . Population as the census report is 74 lacs in 2018 with an area of 55673 sq. km.

90 % of population lives in rural area

There are 12 districts .

Traditional belief system and faith healing is common modality of treatment of mental illnesses.

However the family system is strong and in majority of cases abandonment by the family does not happen .

Mental Health facilities

• There is one state level Mental hospital with a bed capacity of 62 .
• The Medical colleges are tertiary care GHPU with 30 bedded psychiatry
  ward at IGMC and 10 bedded ward at RPGMCH Tanda .
• 4 Medical colleges which have come up recently has psychiatry department providing psychiatric and de-addiction services.

District Hospitals constitutes GHPU at district level where psychiatrist is posted and can provide psychiatric and de-addiction services.

• DMHP is running in all the districts in HP but because of the shortage of
  mental health professionals the level of services is largely identifying the
  Mental illnesses and refer the patient to appropriate Mental health facility.
• At sub-district level psychiatric service and de-addiction services are
  provided 16 CH 5 CHCs

Schemes for development of Man power

• Scheme A for establishing Centre of Excellence is being implemented at
  RPGMCH Tanda
• Support for faculty ( psychiatrist , Clinical. Psychologist , PSW .  Psychiatric Nurses)
• Scheme B for strengthening the department of psychiatry is implemented at IGMC

According to World Health Report 2001

1.  20 % all patients seen by primary health care professionals have one or more mental disorders.
2. One in four families is likely to have at least one member with a behavioral or mental disorder.
3. Mental disorders account for 10.5% of the global burden of disease (GBD) in 1990, 12% in 2000 and this will increase to 15% by 2020.

The extent of problem of Mental Health in Himachal Pradesh.

Population in Himachal Pradesh (Projected in 2018)	74 lacs
Prevalence of severe psychiatric disorders (20/1000 population)	148000
Prevalence of psychiatry disorder (10%-WHO Report 2001)	740000
Neurosis and Psychosomatic disorders (20-30/1000 Population)	1480000-222000
Mental Retardation (0-1% of all children up to 6 year)	7120

 

SMHA -2017 Present scenario

• HP state Mental Health Authority has been constituted .
• CEO have been appointed .
• 6 District Review boards have been notified.
• In it’s first meeting it was decided that rules notified by the central government will be followed by the SMHA .
• The state regulations of the central government for the state shall be adopted by the SMHA .