This institutional ethnographic study aims to examine the implementation of integrated mental health programmes in Bihar from the standpoint of health workers. It explores the interconnection between institutional processes and their effect on mental health service delivery. Data collection methods included interviews, observations, official documents and programme records. The analysis suggested the gaps in the local service delivery mechanism because of poor communication, inadequate programme guidelines and lack of administrative support to health workers. Health workers used their own understanding and working knowledge to deliver mental health services and support the organisational goal of delivering services, even when they lacked resources and administrative support. This can have a harmful impact on patients. The study concludes that there is an urgent need to study the assumptions of the integrated approach in mental health service delivery. It calls for immediate support to health workers to strengthen mental health service delivery.
Vikash Kumar (Wed,) studied this question.