Mental Healthcare Management System : E-Manas to implement Mental Healthcare Act, 2017

Mental Healthcare Management System : E-Manas to implement Mental Healthcare Act, 2017

Mental Healthcare Management System (e-MANAS): A digital innovation to implement India’s Mental Healthcare Act, 2017 (MHCA 2017)

There is no health without mental health. Recently conducted National Mental Health Survey in India reported a prevalence of 13.7% lifetime and 10.6% current mental morbidity . To address this mammoth problem, an aspirational law was enacted titled “Mental Healthcare Act, 2017” (MHCA
2017) in the parliament.

The MHCA 2017 promises to protect, promote, and fulfil the rights of persons with mental illness (PMI) as stated in the preamble of the legislation. Further, there is an onus on the state to provide affordable mental health care to its citizens. In India, mental health has always been a lesser priority for lawmakers and citizens alike

MHCA-2017 legalizes ’advance directives (AD) where PMI direct future mental health care, choose ’nominated representatives’ (NR) of his/her choice, right to access to psychiatric services, the basic medical records, and to legal aid. This act provide an obligation to state to establish of governmental authorities to oversee services, and to establish ’Mental Health Review Boards (MHRB)’ to review the admissions, discharge, and to monitor certain prohibitory procedures. It also regulates physical restraint and mental health research. It also mandates registration and online access to information regarding mental health establishments (MHEs) and mental health professionals (MHPs), online access to AD, and NR. In this regard, to register, regulate, monitor, be accountable and be transparent in providing mental health care, the e-MANAS portal was envisioned.

Development process of e-MANAS

MHCA 2017 grants a legally binding right to mental healthcare to over 1.3
billion people . Yet the rule of law that exists on paper does not always translate into practice. In order to be accountable, transparent, responsive and fulfil the obligation under the MHCA, 2017, Karnataka State initiated an Information Technology innovation exercise titled ‘Mental Health Management System’ (e-MANAS; the term manas is a vernacular term to denote ‘mind’) in collaboration with TeleMedicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, India and Electronic Health Research Centre, International Institute of Information Technology, Bengaluru, India. Information technology (IT) centric solutions can ensure that legislation and policy decision taken by the government can be quickly executed and implemented at multiple locations, across the length and breadth of the country.

This e-MANAS project was divided into three phases to achieve the objectives: service providers portal, service user portal, and final portal was to integrate first two portals with various other agencies. There were at least 3–4 focus group discussions (FGDs) with relevant stake-holders at each stage.

The portal has following functionality system

1) Mental Health Registry and Repository is a secured cloud data storage of the complete portal under the State health department

2) Patient Portal – Electronic Health Record – outpatient, registering and
management of advanced directives, nominated representative and grievance redressal mechanisms

3) Private Clinical Establishments – seamless data synchronization with the pre-existing e-hospitals of private clinical establishments via Application Programming Interface (portability of data across various platform).

4) Public Clinical Establishments – formation of basic mental health records at primary health care, district hospitals and medical colleges

5) Enrolment of Patients – identification and integration under health insurance scheme titled Arogya Karnataka ID

6) Mental Health Establishments Register & Professionals Register, which can be accessed by any person to know the availability of services

7) Mental Health Authority Dashboard provides snapshot of the mental
healthcare service performance at each level. This performance dashboard aims to access real time data on mental health indicators for policy makers. This portal promotes government accountability, transparency, monitor and helps to analyse the cost-effective analysis of the mental health programs. Mental Health Review Board dash board for Interactions, Reviews and Audits.

8) Management of Community-based assisted services – such as integration with National Mental Health Program (District Mental Health Program and an app developed to help ASHA workers for monitoring of severe mental disorders medications and follow-up for psycho-social needs)

9) Mental Health help-line and mental health ambulance services for persons with mental illness

This MHMS system is provided free of cost to the private and public mental health establishments and mental health professionals across the country.