Bridging the mental health treatment gap in India: A Policy-oriented framework using the care cascade approach.

IF 2 4区 医学 Q3 PSYCHIATRY
Indian Journal of Psychiatry Pub Date : 2025-09-01 Epub Date: 2025-09-16 DOI:10.4103/indianjpsychiatry_640_25
Aninda Debnath, Rajesh Sagar, Harshal Ramesh Salve
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引用次数: 0

Abstract

India carries one of the world's highest mental health treatment gaps. Despite the Mental Healthcare Act 2017 and national programme expansions, large proportions of people with common and severe mental disorders remain undiagnosed or untreated. The care cascade framework, originally applied in HIV and tuberculosis, provides a structured approach to identify points of attrition across seven stages: awareness, help-seeking, access, diagnosis, initiation of treatment, continuity of care, and recovery. Evidence from programme evaluations highlights major drop-offs at recognition, initiation, and long-term adherence. Task-sharing with non-specialist providers, digital platforms such as Tele-MANAS, strengthened District Mental Health Programme services, and integration through Health and Wellness Centres have improved reach but remain fragmented and uneven. Cascade-based indicators allow health systems to monitor performance at each stage and to prioritise interventions where the loss is greatest. Embedding this framework within national policy can enable more efficient resource allocation, reduce inequities, and promote recovery-oriented mental health services in India.

Abstract Image

弥合印度精神卫生治疗差距:使用护理级联方法的政策导向框架。
印度是世界上心理健康治疗差距最大的国家之一。尽管《2017年精神保健法》和国家方案扩大,但很大一部分患有常见和严重精神障碍的人仍未得到诊断或治疗。最初应用于艾滋病毒和结核病的护理级联框架提供了一种结构化的方法,以确定七个阶段的损耗点:认识、寻求帮助、可及性、诊断、开始治疗、护理连续性和康复。来自规划评价的证据突出了在认可、启动和长期坚持方面的重大下降。与非专业提供者分担任务、Tele-MANAS等数字平台、加强地区精神卫生方案服务以及通过保健和保健中心进行整合,这些都改善了覆盖面,但仍然分散和不平衡。基于级联的指标使卫生系统能够监测每个阶段的绩效,并在损失最大的地方优先采取干预措施。将这一框架纳入国家政策可使印度能够更有效地分配资源,减少不公平现象,并促进以康复为导向的精神卫生服务。
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来源期刊
Indian Journal of Psychiatry
Indian Journal of Psychiatry Medicine-Psychiatry and Mental Health
CiteScore
4.40
自引率
3.20%
发文量
130
审稿时长
34 weeks
期刊介绍: The Indian Journal of Psychiatry (ISSN 0019-5545), is an official publication of the Indian Psychiatric Society. It is published Bimonthly with one additional supplement (total 5 issues). The IJP publishes original work in all the fields of psychiatry. All papers are peer-reviewed before publication. The issues are published Bimonthly. An additional supplement is also published annually. Articles can be submitted online from www.journalonweb.com . The journal provides immediate free access to all the published articles. The journal does not charge the authors for submission, processing or publication of the articles.
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