District Mental Health Programme Link Clinic: Experience from an Academic Neuropsychiatric Institute of India

Routine follow up appointments for psychiatric diseases don't need to take place in tertiary care facilities because doing so not only causes patients' inconvenience and travel related costs but also results in the improper use of resources. In September 2019, the Tele Medicine Centre of NIMHANS, Bengaluru launched the District Mental Health Program (DMHP) link clinic (DLC) at OPD with the aim of integrating eligible patients to their individual DMHPs for routine follow up care. We used a mixed method study approach.

Self designed referral farms and data record sheets were the tools used for the data entry. For data collection, face to face and telephonic interview methods were used. We carried out both descriptive and thematic analyses to understand the following outcomes of DLC.

Out of 343 referred patients, males were 164 (47.8%) and females were 179 (52.2%). 32.6% of integration was possible. The referral service was reported to be cost effective. Among those who visited DMHPs (n = 207), 102 (49.2%) patients reported being very satisfied, and 81 (39%) patients reported being satisfied. Alteration of current medication, knowledge about DMHP services, economic benefits, availability of DMHP staff, and satisfaction with services are the main themes found in qualitative analysis.

A preliminary report suggests that integrating routine follow ups from tertiary care psychiatric centers into community mental healthcare centers could significantly reduce out of pocket expenditure and time spent.