We have organized community mental health programs in Malappuram, Kozhikode and Kasargode districts for nearly 10 years from 2007 to 2017. The programs in Kozhikode and Malappuram were started in 2007 and Kasargode in 2009. We had 48 clinics in PHC level in Malappuram district, 20 clinics in PHC/CHC level in Kozhikode and 17 clinics in Kasargode. During the 10 years around 15 thousand patients were given free psychiatric treatment including drugs. We could support several community based rehabilitation centres as part of the project.

The aim of the program was to provide psychiatry care in the PHC/CHC level as a step towards integrating mental health services with the primary health care system. The programs were implemented in the model of the DMHP of NMHP with appropriate modification suitable to the local needs. A team of psychiatrist, medical officer, psychiatric social worker, clinical psychologist, pharmacist and attender visited selected community health centres/primary health centres once a month to provide psychiatric care to the target population. Training programs for health workers and public awareness programs were routinely organised in these districts which helped increase the awareness and reduce the stigma related to mental illnesses.

When the program began in 2007 it was a unique model of community mental health care delivery with funding from the National Rural health Mission (NRHM) and the NRHM fund for mental health care delivery was for the first time in India.  Apart from the NRHM funding to mental health care, we could develop several replicable models of service delivery along with the CMHP. One such model is local panchayath supporting mental health clinic and rehabilitation activities  which was done in first in Balusseri and subsequently in several other panchayaths. Another model attempted was that of the local palliative care clinics and community based initiatives supporting the mental health clinics.

In Malappuram district the program was implemented as part of the PARIRAKSHA project of the district panchayath for persons with chronic illnesses and in many centres local palliative care volunteer networks were providing medicines and manpower to the program.

The programs were handed over to the DHS on 31st March 2017 due to technical reasons when mental health programs were extended to all the fourteen districts in the estate in a uniform pattern under the DHS. Kerala now have the unique distinction, among the Indian states, of having community mental health program in all districts.