How can India address its mental healthcare problem?

Synopsis: Evaluation of India’s state of mental health care and suggestions to improve them.

Background

• Recent reports published in Lancet revealed that one in seven people in India had a mental disorder ranging from mild to severe in 2017.
  • Mental illnesses include anxiety disorders, psychotic disorders, mood disorders, substance use disorders, personality disorders and eating disorders.
• Despite having the necessary components to address the mental healthcare issues, more needs to be done in the context of COVID-19 that has exacerbated mental illnesses.

The mental healthcare situation in India

• The situation is bad especially in the southern states as compared to the northern states due to the nature of development, modernization, urbanization etc.,
• Sharp gender divide: Depressive disorders are more prevalent among females than males due to sexual abuse, gender discrimination, stress due to antenatal and postnatal issues etc

Why mental healthcare situation is bad in India?

• Inadequate public spending on Mental Health: India spends around 1.3% of total health expenditure on mental health, whereas, in developed countries, it ranges from 3% to 15%.
• Inadequate infrastructure for Mental Health: For Instance, the share of mental hospitals per 1,00,000 population is as low as 0.01 according to the WHO.
• Similarly, India fares poorly in the distribution of mental health units, mental health outpatient facilities, community residential facilities etc.,
• Inadequate Mental health resources: Nurses, social workers and psychologists working in the mental health sector in India are way less compared to other countries. For instance, leading countries have 222.6 psychologists per 1,00,000 population whereas India has only 0.069, per 1,00,000 population.

Why Mental Health needs to be given priority?

• One, Causative factor for suicides. The majority of suicides in the world are related to psychiatric problems or mental illnesses. India’s suicide rate was 16.3 per 1,00,000 in 2016 that is very high compared to the Global suicide rate of 10.6 per 1,00,000 population.
• Two, a significant contributor to the total disease burden in India. For instance, the proportional contribution of mental disorders to the total disease burden had doubled between 1990 and 2017.
• Three reduces longevity. According to the World Health Organization (WHO), there is a 10-25-year life expectancy reduction in patients with severe mental disorders.

Government measures on mental health care

• India has rightly enacted the following policies to cater to the needs of the population suffering from Mental illness:
  • The National Mental Health Policy (NMHP) in 2014,
  • Rights-based Mental Healthcare Act in 2017,
  • National Adolescent Health Programme
  • Ayushman Bharat

More needs to be done.

What more steps can be taken?

In order to further address mental health issues and promote mental healthcare, India needs to do the following,

• One, reduce the treatment gap for mental disorders. For instance, Telemedicine can be promoted to reduce the gap.
• Two, increase the number of personnel in the mental healthcare sector.
• Three, remove stigmatization by reducing discriminatory attitudes.
• Four, devise an integrated approach for detecting, treating, and managing patient needs.
• Five, increase counselling facilities, especially in rural areas, with special support for women through the provision of women doctors.
• Six, leverage the benefits of technology. The application of big data and crowdsourcing ideas can help to make informed decision-making.
• Seven, focus on community-based programmes. For Instance, School-based programmes on mental health can improve the mental health of children.
• Eight, create mental health awareness through traditional media, government programmes, the education system, industry, and social media.

Source: The Hindu