Mental health: worrisome state

To realise the widespread extent of mental illness, all you need is to take a glance at some facts and figures. It is appalling to see the epidemic rates at which mental illnesses are on the rise. In fact, the World Health Organisation has predicted that 20% of India’s population will suffer from some form of mental illness by the year 2020.

Depression is the leading cause of disability worldwide, affecting more than 300 million people of all ages. At its worst, depression can lead to suicide. Close to 8,00,000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds. (WHO, 2018). Anxiety is one of the world’s primary health problems, while schizophrenia is a severe mental disorder affecting more than 21 million people worldwide (WHO, 2014). In fact, in 2003, four of the six leading causes of years lived with disability were due to depression, alcohol-use disorders, schizophrenia and bipolar disorder.

The launch of India’s first ever National Mental Health Policy in 2014 marked a major milestone towards acting to promote mental health and awareness today.

The Mental Healthcare Act, which was passed in 2017, decriminalising suicide, is a welcome piece of legislation which encourages a sensitised approach to mental illnesses. The recent amendment in the healthcare bill, offering a provision for insurance benefits to include mental illnesses, reiterates our community’s positive outlook towards the future of mental health in the country.

Looking back at this journey, it is possible to note the growth in awareness and education about mental health and its allied sciences. However, at the same time, it is necessary to identify the existing gaps and work on avenues to build further integrations to promote psychological health and well-being among one and all.

Today, we need to acknowledge that mental health not just as a stigmatised aspect of our society but as an integral part of our health and well-being. It is essential to ensure widespread awareness and sensitivity about mental health concerns to overcome this stigma and, at the same time, promote help-seeking behaviour.

Burden of stigma

Despite the increasing efforts, for a majority of the population, mental health is still largely shrouded in myths. There is still a large cross-section of the society that stigmatises mental illnesses, which majorly leads to hesitancy and reluctance towards seeking professional help. Moreover, fear of such a stigma might also prevent the timely identification and reporting of mental illnesses. In addition to the health and social costs, those suffering from mental illnesses are also victims of human rights violations, stigma and discrimination, both inside and outside psychiatric institutions.

Added to this, we are hugely underequipped to handle mental health issues on such a large scale. Currently, we have only 3,500 psychiatrists for the 20 million Indians suffering from mental illnesses. This means that there is only one psychiatrist for more than 10,000 people; the availability of less than 0.3 health professionals working in the mental health sector per 1 lakh people is an appalling statistic (WHO, 2011).

Until now, less than 1-2% of the health budget has been dedicated to mental health, in comparison to 10-12% in other countries. As far as training and education for mental health professionals go, the scenario is not very different with most medical colleges offering no more than two weeks of clinical postings at any psychiatry unit at the end of their training. Furthermore, the field of psychology is so misunderstood that many young people would not even be encouraged to pursue mental health as a profession.

Reaching out for help

In what is a sign of increasing acceptability, a greater number of people are now willing to reach out to a mental health professional for a wide range of problems. These include not just adverse life circumstances or emotional or adjustment issues, but also more severe forms of mental disorders, including psychosis.

Besides striving to free our society from the clutches of stigmatisation, the need of the hour is to strongly advocate the preventive as well as curative aspects of mental health. We all should come together to work at the grassroots level and help make a difference in the community at large.

The biggest step towards such a goal would be to ensure widespread awareness about mental illnesses, to be able to overcome the reluctance associated with mental health and thereby encourage reporting as well as seeking help.

At the same time, we need to promote adequate training and empowerment of parents, teachers, social workers, staff and all those first-line workers actively engaging with children and adolescents. This will help us get the earliest identification as well as timely interventions for the young minds that are the future of our country.