Dear OTist,

Hope all of you are doing well. I am writing this letter to express my serious concern about the consequences of the exclusion of the role of OT in National Mental Health Policy (NMHP), 11th plan. Myself and one of my psychiatrist friend already raised our concerns in different forum in Orissa & Andhra Pradesh. As an OTist I am seriously worried about the impact this decision can have on mental health patients in the decades to come and on the prospects of the development of OT as a specialty in psychiatry.

There are 4 reasons why OTs should not be excluded from NMHP.

1. Lack of OT input in acute psychiatric units is an old and unacceptable practice as vast majority of patients does not know what to do on the wards than just taking medication.
2. It will seriously harm the prospects of developing the training of OT in mental health for coming decades.
3. Everyone agrees that the care we offer to psychiatric patients needs to be patient centred and not professional centred or service centred. If the department of Health and Family Welfare excludes OTs, it will only create another barrier for the provision of coordinated and seamless care.

4.future role of OTs in Old Age Psychiatry. I am sure you are aware of the ageing of the population and the fact that the prevalence of Dementia reaching epidemic levels in India in the coming decades.

From my training and experience I vouch for the immensely important role of OTs in assessing the ADLs of dementing patients and in the provision of aids and other solutions for the disabilities caused by dementia. In the need of the hour we will not have enough OTs in psychiatry and there will be huge suffering of patients unless we promote their training in mental health now.

Unfortunately people in India seem to have very little understanding of the role of OT in psychiatry and this includes psychiatrists. The idea that rehabilitation starts only after resolution of acute episode of psychosis or mood disorder is an older concept. The work of an occupational therapist should start from the day the patient is admitted, of course we are not talking about very acutely ill psychotic or mood disordered patients. But once the very acute phase is over, there are no activities whatsoever for patients on inpatient wards. They just need to stay in the hospital to receive medication. Rest of the time they do not know what to do. This is the same case regardless whether it is government or private hospital. This is not an acceptable situation for patients.

The matter was already communicated to AIOTA presidents and all office bearers. Hope all your effort bring changes in the upliftment of OT in the field of Mental health.

Best wishes.

Jeetendra Mohapatra
Treasurer WBAIOTA
Dept.of OT,NIOH,Kolkata.
Phone - 9748069845