By Dr. Badri Narayanan Gopalakrishnan and Monica IES
Globally, 1 in 8 people have some form of mental disorder (WHO, 2022). Mental illness is said to be the next biggest epidemic in the world, and if ignored can have dire consequences, especially for the economy and for humanity as a whole. Mental health disorders contribute to 15% of the global disease burden and morbidity (WHO, 2022). Depression is one of the leading causes of disability. It’s important to note that suicide is the fourth leading cause of death among her 15-29 year olds worldwide. The same WHO (2022) report also states that India has one of the largest populations of people with some form of mental health problem in the world. An independent economic analysis using the Institute for Health Metrics and Evaluation (IHME) data set on disability-adjusted life years (DALYs), published by the Wilson Center in the United States, found that depression alone is worth approximately $61 billion annually in the United States. It turns out that economic losses can occur. India by 2030.
Also, the National Mental Health Survey (2016) found that about 11 percent of the Indian population suffers from any diagnosable mental illness. This equates to approximately 14.96 billion people. However, it is important to recognize that such studies often suffer from significant downward bias due to underreporting. A recent study by The Lancet (2021) on mental health shows a rather grim picture, reflecting that 74% of Indians suffer from stress and 88% suffer from some form of anxiety disorder. increase. It is noteworthy that most (more than 80%) of psychiatric patients in India are untreated (NMHS, 2016).
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In India, the gap between those who need care and those who can receive it is enormous. Many challenges exist from both the demand and supply sides. Demand for mental health services is often hampered by lack of awareness of the disease and its associated myths and prejudices, lack of knowledge of available treatments and limited affordability. On the supply side, there is a severe shortage of mental health professionals such as psychiatrists and psychologists, low budget spending on mental health, and inadequate policy attention to mental health. According to the National Mental Health Survey (2016), there are only 0.77 psychiatrists, 0.21 clinical psychologists and 0.23 psychiatric nurses per 100,000 population.
Vikshit Bharat goal
The mental health situation in India requires urgent attention and aggressive policy intervention by the government. A healthy and thriving human capital base is essential for India to achieve its Vikshit Bharat goals. Interventions also need to address multiple factors, as multifaceted determinants influence treatment disparities in mental illness.
First, building reliable and detailed data is critical for evidence-based policymaking in mental health care. Regular data on mental health patients’ state, city/province, gender, age group, occupation, etc. will give a more realistic picture of the problem and facilitate the development of targeted interventions.
To address supply-side challenges, governments should work with relevant stakeholders to ensure a minimum level of mental health care availability and access for all, especially the most vulnerable and disadvantaged segments of the population. It is necessary to formulate a comprehensive infrastructure plan for Most of the country’s state-run mental hospitals were established long ago and are now dilapidated. Therefore, it has become imperative for the government to modernize state mental hospitals in mission mode. Governments can offer incentives to health care providers to encourage them to invest in mental health infrastructure.
budget for mental health
Health care budgets should prioritize the allocation of appropriate resources to promote mental health. The focus should be on strengthening the power of mental health professionals, first by ensuring that each medical school has a psychiatric department, and then by gradually increasing the number of psychiatric departments in medical schools. be. Elements of psychiatric care should be integrated with primary care. This requires innovative models that deepen the penetration of mental health-related services and staff.
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For example, you can leverage Accredited Social Health Activists (ASHA), a key link between the health system and the community, to provide mental health services. ASHA personnel play a key role in raising mental health awareness, reducing stigma associated with mental illness, encouraging locals to seek professional help, and referrals to appropriate health care providers. can be fulfilled.
In addition, there is also an urgent need to strengthen human resources at the administrative level (e.g. health service departments) and deploy full-time staff dedicated to mental health management at the district/zira/village grassroots level. & block level of state/UT. The use of technology can be key here to enhance access and affordability to mental health services.
Talent shortages can be addressed through digital academies/institutions. Additionally, most states have not yet enacted the Mental Health Care Act of 2017. States should be sensitized to implement the Mental Health Care Act of 2017 and be urged to establish their own statutory bodies, such as state mental health authorities and review boards related to the Act. .
Now, on the demand side, the lack of affordable mental health facilities is one of the main, but not the only, reasons for the current disparity in treatment of mental illness in India. Because of the stigma associated with mental illness, many people in India still prefer to go to ojas, tantras and bogus therapies rather than see a psychiatrist. Serious efforts need to be stepped up to raise awareness, identify risk factors and address misunderstandings and fears in different local languages. A citizen-friendly repository of information about available treatments can reduce information asymmetries.
Mental health awareness should be integrated into school curricula, and open dialogue and discussion should be encouraged at the higher education level. More positive names such as Wellbeing Centers can be developed for mental health institutions to combat and reduce stigma associated with mental health. At the community and societal level, it is important that families and caregivers have the necessary knowledge, skills and empathetic attitudes to provide effective mental health care. In this regard, policy interventions should be designed to encourage positive behavioral change.
Mental health services are currently provided through the National Mental Health Program (NMHP) and its operating arm, the District Mental Health Program (DMHP). Additionally, India also recently launched the National Telemental Mental Health Program (TeleMANAS) in October 2022. However, there is an urgent need to establish rigorous mechanisms for regular review and monitoring of DMHP activities. In addition, in order to make Tele MANAS more efficient and effective, further strengthening, dissemination, stabilization, and cooperation with DMHP are necessary. To ensure the success of DMHP/NMHP efforts, governments should prioritize promoting stronger partnerships with mental health agencies, medical colleges and academic institutions.
At the same time, it is important to recognize the importance of relevant and useful local knowledge and practices. Mental health care can use an integrative approach to wellness. Measures such as dinacharya (daily regimen), ritucharya (seasonal regimen), sadvurtta (codes of virtue), and the introduction of yoga to maintain mental health are important for possible adoption in national mental health programmes. strategy.
If this issue is not recognized in the policy arena, India could also find itself in a state of emergency. Mental illness is chronic and causes severe economic losses to both individuals and entire nations. It is therefore of utmost importance that governments give mental health due policy attention. By prioritizing mental health, governments can help individuals and communities thrive and create stronger, healthier and more resilient societies. It is time for governments to prioritize mental health and take decisive and urgent steps to combat this growing mental health emergency.
(Author Dr. Badri Narayanan Gopalakrishnan is a Fellow of NITI Ayog and Ms. Monica IES is Assistant Director of NITI Ayog. Views expressed are personal.)
