The context of formulation of India's Mental Health Program: implications for global mental health

India, among the low- and middle-income countries, in the 1980s, made an early attempt at formulating a mental health program. India's National Mental Health Program (NMHP) intended to attend to the mental health needs of all her citizens. Some aspects of this program bear significant resemblance to what recent experts in global mental health (GMH) have been proposing. The paper uses India as a country-level example to review and critically analyze the contextual background culminating in the formulation of the NMHP. Literature searches from two bibliographic databases (PubMed and Google Scholar) with supplementary searches and manual search from Indian Journal of Psychiatry were made relating to the context of formulation of India's NMHP. The search helped isolate 12 peer reviewed journal articles, three chapters from books, and one policy group approach paper. This literature has been synthesized to enumerate the various contextual factors. The present analysis identifies two vital factors relevant for international health, viz. the primary health care movement and the changing concepts of institutional care/de-institutionalization in mental health. This then puts in perspective the opportunities allowed and challenges produced, for NMHP, by subsequent changes in public health services in India. The lessons for GMH movement are then pointed out.