Through amalgamation

Health is not merely the absence of any disease or infirmity but a state of complete physical, mental and social well-being. Delhi Government, under the leadership of Chief Minister Arvind Kejriwal, came up with a mandate to revolutionize Delhi's healthcare sector. The Delhi government has brought fundamental changes to many aspects of healthcare. One of its most noteworthy initiatives has been the Aam Aadmi Mohalla Clinic. These clinics aim to provide accessible free-of-cost primary healthcare facilities at the doorsteps for the people of Delhi. The first AAMC was started in 2015. These clinics have set new standards of development not just in our country but around the world. Fast forward to 2021, more than 500 Mohalla Clinics are functioning in Delhi, wherein more than 50,000 Delhiites avail services each day, taking the cumulative OPDs to more than five crores. The Delhi Government is further strengthening those to ensure last-mile delivery of healthcare services to the people of Delhi.

Children have repeatedly been recognised as a vulnerable group by social scientists. Their health concerns are mainly in the categories of malnutrition, anaemia, infectious diseases, intestinal parasites, diseases of the skin, eye, ear, dental care etc. Moreover, rising mental health concerns around school-going adolescents have been widely spoken about, but those largely go undiagnosed or ignored. So, under the able guidance of Dy. CM and Minister of Education Manish Sisodia, and vision of the Minister of Health Shri Satyendar Jain, the departments of health and education of the Delhi Government have come together to expand the horizons of Aam Aadmi Mohalla Clinic — giving rise to School Health Clinics. This is another revolutionary initiative after the Aam Aadmi Mohalla Clinic.

As October 10 is recognised as World Mental Health Day, let's consider some statistics related to mental health. According to the World Health Organization National Centre for Mental Health, India tops the list of countries with the highest number of mental and behavioural disorders. It also states that nearly half of all mental health problems begin before the age of 15. A study by the Indian Council of Medical Research says that in India, 12 to 13 per cent of school students suffer from emotional and behavioural issues along with being slow learners. In addition to this, in a survey done by Delhi State Legal Services Authority in 2015, it has come to the fore that out of 225 children in the Sarva Shiksha Abhiyan centres, who drop out, 36.1 per cent are into abuse of various substances including vulcanized solution, which is used as an adhesive to fix a puncture in tyre tubes. Taking all this into account, the Delhi Government's step of introducing School Health Clinics is pathbreaking. In these clinics, students will be provided physical health screening and counselling for mental health. Another reason why this concept truly stands out is that it is the first time in the country that children can avail physical and mental health services right at the school. With this, the Delhi Government will become the first government in the country to do so.

Initially, the School Health Clinics will be introduced in 15 schools of the Government of Delhi on a pilot basis. A Project Management Unit (PMU) has been set up to implement and monitor these clinics. The learnings gained from this pilot project will be studied and developed to incorporate them in every school of the Government of Delhi.

Children usually spend about 8-9 hours in school which is a considerable amount of time. During these long hours, they are vulnerable to minor aches, fevers and even severe injuries. Since mental health problems are not visible, society does not consider these to be real problems. If at all the problem is identified, the high cost of treatment is not sustainable. Above all, access to mental health facilities in India is still a luxury rather than a necessity. With the increasing mental health issues due to the sedentary lifestyle and increased teenage suicide rates in India during the pandemic, this becomes a much-needed step. Often, poor mental and physical health leads to reduced concentration, absenteeism and poor academic performance in school. School Health Clinics will work at the core of all these issues, that is improving the overall well-being of students. They will act as screening and check-up centres for students of all ages and gender so that any disease can be identified at its early stage and treated timely.

School Health Clinics seek to pair the interventions of diagnosis, treatment and prevention of mental and physical health concerns of each student. These School Health Clinics will house compartments for physical health screening, OPD consultation, medicine dispensing and counselling sessions. These clinics will operate for the entire duration of the school shift. In double shift schools, two separate sets of staff will work for the entire duration of each shift. Students will be screened for more than 30 diseases, disabilities and deficiencies every day in these clinics. Students, when identified with any ailment, will be presented to the doctor for OPD treatment during their weekly visit to the school.

Mental healthcare will be targeted through a trained psychologist who will facilitate one to one interaction with students and help them to improve their social and emotional learning; address their traumas, and teach them coping mechanisms to manage stress. These sessions will also ensure a safe space for children and adolescents to communicate about issues they face with their peers or at home. The social and emotional learning in students cannot be looked at in isolation. For that, workshops for awareness will be conducted with the primary actors in the life of students, who are closest to them, that is their parents and teachers. The psychologist would conduct counselling sessions with students. The focus will be on negating peer pressure, to boost self-esteem, strengthen interpersonal relationships, address adolescent and reproductive health, substance misuse management and abilities to cope with stress and anxiety.

During this process, students in need of special care and attention will be referred to secondary and tertiary healthcare facilities and will be followed up regularly till the completion of the treatment. Additionally, each child will be provided with a digital health card to maintain their health portfolio.

The School Health Clinics will ensure the overall well-being of adolescents through primary healthcare in schools by using diagnosis, treatment and prevention methods of addressing physical as well as mental health concerns. And, I am certain that this step will be a trailblazer and will certainly revolutionize the primary healthcare system, not only of Delhi but the whole country.

Views expressed are personal