Psychiatric care

It was recently reported that over 50 per cent of the cases of serious mental disorder go untreated in India. The National Mental Health Mission, a programme launched by the government in 1982, has not performed well in more than two decades of its existence. The problems afflicting the mission are too many. The National Institute of Mental Health and Neuro-Sciences (NIMHANS), the premier institution in the country in the area, has submitted a plan to the government to reform the mental healthcare programme. There has been a recognition of the need to rework the entire programme but the difficulties are much more than in the case of any other medical programme.

There are an estimated 15 million people in the country who suffer from serious psychiatric disorders and about 30 million are afflicted with mild or moderate problems. A large number of cases go unrecognised. The stigma associated with mental disorders forces many people to suppress them. Ignorance, superstitions, treatment by witch doctors and quacks are rampant in the case of mental disorders. Very often they aggravate the condition. Modern institutional facilities for diagnosis and treatment are very inadequate and are almost absent at the district and rural levels. Strangely, mental disorders do not form part of the National Rural Health Mission. The number of psychiatrists and the availability of support personnel and facilities are very low. Since mental health is an important indicator of general health, there is the need to expand the reach of mental health services to cover all those who need them. Special programmes meant for children and women are needed. More than 10 per cent of the children suffer from some form of disorder. Delivering mental health services through schools can be an option because detecting and treating children’s problems is otherwise difficult.

Information, education of people and communication of the right message are important in the case of mental health than with any other programme. Community and family support also is vital in addressing the problem, especially because most disorders can be treated without hospitalisation. The allocation for mental healthcare has always been very inadequate. Faster social and economic changes and greater pressures on individuals make people more vulnerable to mental disorders. The government and society should give more serious attention to it.