One trained person, on a rota, is the whole of this rung
A block is the smallest unit at which a specialist becomes affordable. One village cannot keep a yoga teacher busy and cannot pay for one. Twelve villages can keep one busy six days a week, and the block is where that arithmetic is done.
What is already there
The district mental health team already travels out to this level.
The District Mental Health Programme team runs outreach clinics at Community and Primary Health Centres rather than sitting only at the district hospital. The psychiatrist and the clinical psychologist already come to the block. They come to see patients, not to run a practice, and nobody has asked them to do both on the same visit.
The Community Health Centre has medical officers who can screen.
Identification is not the hard part and it does not need a specialist. What is needed is that somebody notices, and the block has the staff to notice.
The district de-addiction centre is a block's referral, not a village's.
District De-Addiction Centres under the national plan carry what residential centres, drop in centres and peer led work carry together. A village sends upward through the block, and the block is where that path has to be written down and known.
What is missing
The block has the people and the referral path. What it does not have is a timetable that says which village on which morning, and one person whose job it is to keep that timetable.
What to do first
Draw a rota on one sheet.
Twelve villages, six mornings, one trained person. Two villages a morning is not possible and one village three mornings a week is. Write the sheet before you look for the person, because the sheet is what the post is justified by.
Attach the practice to a visit that is already happening.
The outreach clinic day. The immunisation day. Anything that already brings people to the centre. A new day in a village calendar is a new thing to forget.
Put the referral path on the wall of every centre in the block.
Three lines. Where a man goes for withdrawal. Where he goes for counselling. The free number for the nights in between. Most blocks have all three and almost no village knows any of them.
What to write down
Villages running, of villages in the block. Then attendance across the block, as one number, because that is the number a district budget responds to.
A block with a rota and a register is not asking the district for permission. It is asking for a line in the district plan.
Where each of these comes from
- District Mental Health Programme under the National Mental Health Programme, Directorate General of Health Services. The district team is a psychiatrist, a clinical psychologist, a psychiatric social worker, a psychiatric or community nurse, a monitoring and evaluation officer, a case registry assistant and a ward assistant, working from the district hospital and out to Community and Primary Health Centres.
- Update on Ayushman Arogya Mandir, Ministry of Health and Family Welfare, PIB. Over 1.7 lakh Sub-Centres and Primary Health Centres upgraded; 12 service packages including mental health and yoga; 5.73 crore wellness sessions held by 30 June 2025.
- National Action Plan for Drug Demand Reduction, Ministry of Social Justice and Empowerment, in force from 1 April 2018. Grants to States and to voluntary organisations for Integrated Rehabilitation Centres for Addicts, Community based Peer Led Interventions, Outreach and Drop In Centres, and District De-Addiction Centres, which carry what the first three carry together. socialjustice.gov.in