Spare a thought for psychiatric caregivers too

Source– The post is based on the article “Spare a thought for psychiatric caregivers too” published in “The Hindu” on 22nd June 2023.

Syllabus: GS2- Issues related to development and management of health

Relevance- Mental health related issues

News- The article explains the issues faced by caregivers providing support to mental ill people

What is the prevalence of mental disorders faced by the Indian population?

According to National Health Mission estimates, 6%-7% of India’s population suffers from mental disorders. One in four families is likely to have at least one member with a behavioural or mental health disorder.

The situation worsened during the COVID-19 pandemic as long periods of isolation, financial difficulty, and uncertainty about the future increased stress levels across social segments.

Most of these cases remain untreated due to ignorance and social stigma. Without proper diagnosis, the patient and their families keep suffering.

What are issues faced by caregivers?

Over 90% of psychiatric patients in India live with their families. The caregiver is under considerable stress because of the physical and emotional caregiving along with the social isolation, financial difficulties and troublesome behaviour of the patient.

In nuclear families, the role falls on the spouse. Chronic mental illness in a nuclear household disrupts daily life and drains family resources.

Women caregivers face challenges in balancing caregiving, career, child rearing, and household responsibility. They are less likely to receive informal support for psychiatric treatment.

Prolonged caregiving negatively impacts the psychological well-being of caregivers. Caregivers use various strategies to cope which include sharing, spirituality, hobbies. But unhealthy coping mechanisms can negatively impact both caregivers and patients.

The National Mental Health Programme and the decentralised District Mental Health Programme remain focused on the patient but neglect the caregiver.

What is the way forward for the well-being of caregivers?

It is essential to introduce a structured intervention programme to educate and support the caregivers of psychiatric patients. It should educate them about the illness and their roles and responsibilities.

Successful intervention models include cognitive behavioural therapy, psychoeducational skill building, family counselling, and peer-support.

A comprehensive treatment of severe psychiatric illnesses in the future would need building effective partnerships between health-care professionals, informal caregivers, and psychosocial interventions.

What are concerns related to the preparedness of health-care systems to provide caregiver support?

A lack of trained specialists hinders cost-effective intervention model implementation. India has one psychiatrist and psychologist for every four lakh and 16 lakh citizens.

Insufficient budget allocation for mental health patients also raises concerns of developing intervention for psychiatric caregivers.

private mental health institutions services are expensive and beyond reach for many.

Mental illnesses are excluded from the list of ailments covered by leading medical insurers in India.

Government schemes such as the flagship Ayushman Bharat provide coverage for mental disorders. However, coverage by private insurers remains limited.

Several non-governmental organisations and community movements such as Mind root have been engaged in community support work for people with mental illness and their caregivers. However, given the severity of the issue, their scale remains insignificant.