A recent report by the Comptroller and Auditor General (CAG) of India has revealed alarming findings regarding the availability of mental health medications in Uttarakhand. More than half of the healthcare facilities inspected across the state showed a 100% shortage of essential mental health drugs, highlighting severe inadequacies in the National Mental Health Programme (NMHP) implementation.

Key Highlights:
Significant Shortage in Mental Health Drugs:

• 12 of 21 health facilities visited by CAG were deficient in all the required psychotherapeutic drugs.

• Nainital district hospital did not have any of the 19 medicines prescribed by the Health Ministry at the district level.

• Likewise, none of the 14 essential psychotropic drugs existed in 11 sub-district hospitals, community, and primary health centres.

District-Wise Breakdown of Drug Availability:

• Dehradun District Hospital: Had just 10 out of 19 essential medicines.

• Community Health Center, Sahaspur: 3 mandatory drugs only.

• Sub-District Hospital, Premnagar: Just 2 drugs.

• Six other district-level health centers indicated that only 1 drug out of the required 14 was available.

Financial Mismanagement & Underutilization:

• Between 2016-2022, merely 55.44% of the allocated mental health program fund was actually used. Only ₹205 lakh was expended from the budgeted ₹369 lakh.

• The report indicated abnormal fluctuations in expenditure. Significantly, in 2018-19 and 2021-22, the expenditure jumped unexpectedly, with the expenditure amounting to 128.35%. On the other hand, in 2016-17 and 2020-21, the expenditure was considerably lower at approximately 19%.

Quotes from the CAG Report:

• "The overall absence of psychotropic drugs at various levels of care is a pointer to gross failure in the implementation of the National Mental Health Programme. The rise in fund expenditure in 2021-22 is a pointer to some progress; still, overall implementation is substantially deficient."

• The CAG had brought these issues to the notice of the state government in September 2023, but no report has been received as yet.

Expert Observations:
Top psychiatrists of government mental hospitals in Uttarakhand pointed out that these deficiencies are especially disconcerting during a visible spike in the count of mental health patients in the state.The CAG report highlights the imperative of improved resource allocation, proper stocking of critical mental health drugs, and enhanced implementation of mental health schemes in Uttarakhand. The state government must act on these observations in a timely manner to improve the delivery of mental healthcare and patient outcomes.