Mental Health Provisions in Schools of Kerala: A Narrative Overview of Programs and Interventions

Abstract

In recent years, many interventions that specifically focus on mental wellbeing of children are being made available in schools of Kerala. This paper is a narrative overview of the major school-based mental health interventions currently being implemented in the state. Fifteen programs, selected after applying certain screening procedures, are analyzed using the Institute of Medicine (IOM) frame work. These services are being provided by multiple agencies from different governmental sectors, nongovernmental sector and private sector, and overall developments in the state parallel the developments happening in mental health scenario in schools of high income countries. Nine programs had universal prevention as a component, and the components of selective and indicated prevention were present respectively in three and eight programs. The personnel delivering indicated interventions were minimally trained and had received little specialist guidance. Many programs allude to referral to specialist professionals, but without any clear delineation of the care pathway. There are indications of a lack of coordination between the various programs, precluding synergy of work and efficient fund utilization. The DMHP could fill the service gap by facilitating and coordinating selective and indicated prevention programs in our schools. Creation of a nodal agency within the Education Department itself, with mandate for intersectoral coordination, could be a way ahead in integrating the programs and in ensuring universal access and quality of the interventions.