Mental Health in India

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While human life expectancy has increased over the years, the problems affecting humans have also undergone changes. There has been a rise in chronic or long-term conditions, which not only diminish the overall quality of life but also increase healthcare costs.

According to the World Health Organization, mental health is defined as a state of well-being in which individuals realize their potential and can effectively cope with the normal stressors of life, enabling them to work productively and contribute to society. In India, mental health has been a cause for concern for many years, and understanding these concerns has become essential due to the impact of COVID-19. Although the factors contributing to mental health disturbances and illnesses share common themes, the current global pandemic has introduced new concerns and factors that have resulted in an increased number of deaths.

According to a report published in The Lancet, India has one of the highest rates of suicide deaths in the world (Patel et al., 2012). The Global Burden of Disease Study revealed an increase in suicide deaths compared to the estimates provided by the National Crime Bureau in 2015 (Naghavi, 2016). Additionally, the National Mental Health survey found that mental health issues affected nearly 1.9% of the population in India, with 1 in 20 individuals experiencing depression (Gautham et al., 2020).

Things haven’t improved drastically since then, with the recent National Crime Records Bureau reports showing an increase in suicides during 2019 (1,39,123) suicides as compared to 2018 (1,34,516 suicides). If we were to look at the reasons that afflict the country regarding mental health, a few common themes arise.

1. Mental Health is not a subject people have openly discussed in the past. Unlike physical health concerns, mental health disturbances or difficulties are often perceived negatively. There is a taboo surrounding discussions about mental health, and even in public spaces, people tend to keep such information concealed. This leads to the spread of misinformation and eventually results in stigma, where individuals with mental illness are essentially ostracized by society. Throughout history, anything that deviated from the accepted norms of society was met with suspicion, ridicule, and prohibition.
2. Intersectional factors impact mental health delivery and outreach. India, while being a diverse country, still lacks sufficient representation of this diversity in its mental health initiatives. Barriers to communication, such as location, language, socio-economic status, and disability, exist. However, mental health services are often only accessible to English speakers. Additionally, the economic burden associated with treating mental health illnesses also determines who can access these services.

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Disability is another concern. Disability is a pressing concern in a country where the shortage of competent mental health professionals is already a big challenge. The availability of professionals who can specifically address the needs of individuals with impairments is even scarcer. There is also a notable lack of awareness and understanding regarding queer identities and narratives. In their paper on disability, queer identities, and sexual orientation Nakkeeran and Nakkeran , 2018 advocate for an inclusive social arrangement that embraces diversity.

Although we have some understanding of the mentioned themes, there is still a long way to go before we can start addressing these concerns. One possible approach is to reduce the disparity between healthcare providers and the population in need by improving implementation strategies that address the unequal distribution of resources and involving other stakeholders. Equally important is the training of more individuals to bridge this gap.

With the recent death of a young actor, it has highlighted another systemic problem and the need to decriminalize the mental health space. Holding those who disseminate information to a higher code and requiring them to be legally responsible for their actions. The WHO Mental Health Gap Action Programme (mhGAP) strongly recommended that the health sector must assist and encourage the media to follow responsible practices related to suicidal behavior. Yet there continues to be malicious and stigmatizing news content presented even today.

The time gap between seeking and receiving help is crucial, and we must acknowledge the involvement of other stakeholders responsible for our country’s progress.

If we were to calculate the costs associated with mental health disturbances, illnesses, and disorders, the figure would significantly increase.

This would undoubtedly impact the economy and its growth.

How can we build a nation, strive for progress, and restore normalcy if we fail to address the fundamental human right to care and treatment?

The current healthcare budget falls short in meeting these needs. The expenses allocated for addressing mental health issues will only be exacerbated by the pandemic. Therefore, as mentioned earlier in this article, it is imperative to invest both financially and through policy changes in our nations mental healthcare system, aligning them with the nation’s larger developmental goals.

References

Patel, V., Ramasundarahettige, C., Vijayakumar, L., Thakur, J., Gajalakshmi, V., Gururaj, G., … Jha, P. (2012). Suicide mortality in India: a nationally representative survey. The Lancet, 379(9834), 2343–2351. doi:10.1016/s0140–6736(12)60606–0

Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: a systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. doi:10.1136/bmj.l94

Gautham, M. S., Gururaj, G., Varghese, M., Benegal, V., Rao, G. N., Kokane, A., … Pathak, K. (2020). The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity. International Journal of Social Psychiatry, 002076402090794. doi:10.1177/0020764020907941

Nakkeeran, N., Nakkeeran, B. Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference. Health Res Policy Sys 16, 97 (2018). https://doi.org/10.1186/s12961-018-0366-1

WHO. (2019). Mental Health Gap Action Plan https://www.who.int/mental_health/mhgap/evidence/suicide/q9/en/