Institute of Mental Health (IMH), Erragadda – Case Study for UPSC

The Institute of Mental Health (IMH) at Erragadda, Hyderabad, one of Telangana’s largest psychiatric facilities, highlights both progress and challenges in India’s mental healthcare system.
Recent issues such as a food poisoning outbreak (June 2025) and ongoing infrastructure expansion (₹25 crore multi-functional block under construction) bring it into focus.

Historical Background

Established in 1907 at Jalna (Nizam’s rule).
Shifted to Erragadda, Hyderabad (1908) on land leased from the Royal Air Force.
Today, it is spread across ~40 acres and remains Telangana’s only standalone psychiatric hospital in the public sector.

OPD Footfall: 400–500 patients daily.
In-patient Capacity: ~600 beds (50 reserved for prisoners).
Special Units:
- Psychiatric evaluation for inmates.
- De-addiction services (22–30 beds).
- Day Treatment Centre (DTC) for outpatient counselling.
New Block (under construction):
- Clinical Psychology, Psychiatric Social Work, Psychiatric Nursing.
- Rehabilitation Centre.
- rTMS (Repetitive Transcranial Magnetic Stimulation).
- Smart classrooms, library, hostels for PG students.

Stigma & Social Exclusion
- Patients often avoid or discontinue treatment due to social stigma.
- Families sometimes refuse to take back patients after recovery → Legal complications.
Infrastructure Issues
- Overcrowding in OPD.
- Wards (esp. for forensic/closed patients) need better upkeep.
Funding & Bureaucracy
- New building delayed due to partial fund release (₹25 crore project).
Follow-up & Compliance
- 30–40% patients don’t return after first visit (similar to diabetes/hypertension).
Manpower Shortages
- 6 professors + limited assistant professors for large footfall.
- Dependence on postgraduate students for additional support.
Public Health Burden
- Rise in depression, anxiety, suicides post-COVID-19.
- Increase in substance-use disorders.

Mental Healthcare Act, 2017:
- Right to affordable mental health care.
- Decriminalises suicide attempts (Section 115).
- Mandates mental health insurance.
National Mental Health Programme (NMHP), 1982.
District Mental Health Programme (DMHP) under NMHP – aims to decentralise services.
Tele-MANAS (2022) – national tele-mental health helpline.
National Suicide Prevention Strategy (2022) – first of its kind in India.

GS Paper II (Governance): Health policies, institutional role in social justice.
GS Paper II (Polity): Mental Healthcare Act, rights of vulnerable sections.
GS Paper III (Science & Tech): Use of rTMS and psychiatric technology.
GS Paper IV (Ethics): Compassion in public service; dignity of patients.
Essay: “Mental health is as important as physical health” / “Stigma as a barrier to social justice.”

GS II, UPSC Mains 2021: “National Commission for Women has been able to aid women in achieving their rights, but there is still scope for improvement.” (↔ can relate to institutional support for mental health patients).
GS II, UPSC Mains 2021: “Examine the main provisions of the National Mental Health Care Act, 2017. What are the challenges in its implementation?”
Essay Paper, UPSC 2018: “Alternative technologies for a climate smart future” – Though about environment, parallels with alternative approaches like tele-mental health.
GS II, UPSC Mains 2017: “Examine the role of WHO in providing global health security during outbreaks. Highlight India’s response to WHO’s guidelines.” (↔ post-COVID rise in mental health issues).

Strengthen District Mental Health Programme – decentralise care to reduce IMH burden.
Increase Funding – higher allocation in health budget (currently <1% for mental health).
Awareness Campaigns – reduce stigma, encourage treatment.
Manpower Expansion – more psychiatrists, psychologists, social workers.
Integration with Primary Health – mental health services at PHCs.
Rehabilitation Homes – for abandoned patients post-recovery.
Digital Solutions – Tele-MANAS, e-counselling, AI-based monitoring.