Patients with severe mental health conditions in Maharashtra are being forced to travel hundreds of kilometres for admission as none of the state’s 32 district hospitals has a functional 10-bed inpatient psychiatric unit mandated under the District Mental Health Programme (DMHP).
The shortfall is adding to the burden on the four regional mental hospitals (RMHs) in Pune, Thane, Nagpur and Ratnagiri, while families face long journeys, higher costs and difficulty securing admission when patients’ conditions worsen.
“We have to strengthen the comprehensive mental health programme, activate indoor facilities and expand outreach. People come from far-off places, even 500 kilometres away. Treatment at the primary level and early intervention can prevent patients from reaching a severe condition,” said Dr Shrinivas Kolod, additional director (mental health) and chief executive officer of the State Mental Health Authority, Maharashtra.
Launched in 1996 under the National Mental Health Programme, the DMHP aims to decentralise mental healthcare and integrate it with general healthcare services. District hospitals are expected to have 10-bed psychiatric wards for admission, treatment, counselling, medication, rehabilitation and follow-up.
However, while the programme is operational, the inpatient component remains non-functional at district hospitals. Staff appointed under the programme, including psychiatrists, clinical psychologists, psychiatric nurses and psychiatric social workers, are also being utilised for other healthcare services.
{{/usCountry}}However, while the programme is operational, the inpatient component remains non-functional at district hospitals. Staff appointed under the programme, including psychiatrists, clinical psychologists, psychiatric nurses and psychiatric social workers, are also being utilised for other healthcare services.
{{/usCountry}}Health activist Sharad Shetty wrote to the Maharashtra government on August 31 seeking implementation of 10-bed psychiatric units in every district hospital.
“Every district hospital should have a 10-bed psychiatric inpatient unit so that patients do not have to travel long distances for basic mental healthcare. Several district hospitals have staff appointed under the programme. However, they are not implementing the programme,” Shetty said.
Patients requiring admission are consequently referred to RMHs. The four hospitals in the state recorded about 2.29 lakh outpatient and indoor patients in 2025-26, according to official figures: Nagpur (73,208), Pune (64,598), Thane (60,803) and Ratnagiri (30,489). The combined patient load was about 2.12 lakh in each of the previous two years.
“We have to travel a long distance every time the patient needs treatment. The travel costs add to our burden, and getting admission is another struggle,” said a relative of a patient at RMH, Pune.
Kolod said civil surgeons should appoint additional teams and specialists wherever required, while medical residents under the district residency programme could also be used for patient care.