Indigenous people and mental health

In 1992, the World Federation for Mental Health decided to observe October 10 as World Mental Health Day to create awareness about mental health and its diseases.

Mental illnesses are the leading cause of ill-health and disability worldwide. According to the World Health Organization (WHO), around 450 million people suffer from mental disorders globally. One in four people in the world is affected by mental or neurological disorders at some point in their lives.

There are different forms of mental illness such as depression, schizophrenia, bipolar affective disorder, dementia, intellectual disabilities, developmental disorders like autism etc. Depression is the most common mental disorder affecting more than 26% of the US adult population. It has been estimated that by 2020, depression will be the second leading cause of disability worldwide.

There may be multiple reasons for mental illnesses, including deprivation and poverty, illiteracy or less education, low income, lifetime disorders such as panic, phobia, alcohol dependence and other substance abuse.

Diagnoses and treatment

The treatments may differ from person to person, and include psychotherapy, medication, hospitalisation, peer support and support groups. Further, the risk of mental illness can be reduced by following simple steps such as keeping a healthy diet, regular exercise, avoiding stress, discussing problems with others, avoiding use of alcohol and drugs, relaxing the mind and body, and creating awareness among people to initiate early treatment.

The National Commission on Macroeconomics and Health study (2005) reports that 5% of people suffer from common mental disorders: depression and anxiety. Further, the National Mental Health Survey (2015) estimates 10.6% mental morbidity among people above the age of 18 years.

The prevalence of mental disorders in different groups is: 0 to 3-year-olds — 13.8%, 4 to 16-year-olds — 12% and industrial workers — 14-37%. But it has still to cover information on mental health issues among indigenous people or 75 particularly vulnerable tribal groups (PVTG) who are the unreached people.

The National Mental Health Programme (NMHP) was started in 1982 to improve the mental health of people in India. The Ministry of Health and Family Welfare formulated the District Mental Health Programme (DHMP) in 1996. DHMP aims to offer mental health services to disadvantaged sections and communities and rural areas, integrate them with other services and ensure early detection and treatment of patients suffering from mental illness within the community. Today DHMP has been implemented in 123 districts in India, including tribal-dominated ones.

Services underused

The country implemented the National Mental Health Policy in 2014 and also enacted the Mental Healthcare Act in 2017 to strengthen mental health services. Mental health in the workplace was the theme observed last year. A large amount of time is spent at work during one’s adult life. Experiences at workplace are important factors contributing to overall wellbeing of an individual.

Workplace initiatives to promote mental health and to support employees who have mental disorders are not only beneficial to their health but also increase their productivity at work. Harassment and bullying at work are commonly reported problems and can adversely impact mental health, resulting in reduced productivity, harmful use of substances or alcohol, absenteeism, increased staff turnover and a negative impact on family and social interactions.

Many mental illnesses can be treated, but access to treatment is often difficult and even when they are available, societal stigma may prevent people from seeking services. Moreover, it is important we reach those people who are living in remote areas — tribal people, indigenous people or PVTG.

The role of voluntary organisations and NGOs may be very important and act as a catalyst for change in the treatment of mental illness. Many VOs in India are working in the mental health space — Sangath Society in Goa, Umeed and Research Society in Mumbai, Schizophrenia Research Foundation (SCARF) and The Banyan in Chennai, Manas in West Bengal, the Medico-Pastoral Association (MPA) in Bengaluru and Shristi in Madurai focus on severe mental disorders.

Their efforts can help improve the mental health of our people and reach the indigenous peoples, our most unreached, for better diversified impact!

(The writer is Associate Profes­sor & Head, Department of Medical Anthropology, IHBAS, Delhi)