By- Deepak Malik
“India does not simply have a mental health challenge… it is facing a possible mental health epidemic,” – Shri Ram Nath Kovind (Former President of India)
Introduction:
Mental health is the state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health which supports individual and societal capacities to form decisions, and relationships, and shape our shared world in a more positive way. 1 Sustaining a sound state of mind and well-being is a fundamental human right and also the major reason for personal growth, community advancement and socio-economic progress. In the present world, a comprehensive understanding of mind and behaviour in all aspects has brought about a transformation in our endeavours to address these issues where incessant activity and commotion often take precedence over personal well-being thus posing a considerable challenge to our mental well-being. 2
Where do we stand today?
The World Health Organization (WHO), projected in 2022 that globally, one out of every eight individuals would suffer from a psychiatric problem, and India constituent the largest portion of people with mental health concerns in different forms accounts for almost 15% of the world’s mental, neurological and substance abuse disorder burden. 1
The shortage of healthcare professionals (especially in the mental health sector) has become a constant concern for the healthcare system. The National Institute of Mental Health and Neurosciences (NIMHANS), on the issue of scarcity of mental healthcare services and their seeking pattern among the population, found that just 30 million people really seek such services, despite the fact that there are around 150 million people who need them at ground level. Similarly, the Lancet also reported that the burden of mental health problems has doubled between 1990 and 2017, rising from 2.5% in 1990 to 4.7% in 2017. 3,4 Additionally, the WHO has predicted that between 2012 and 2033, mental health problems in India would cost a $1.03 trillion devaluation. 5
However, inadequate knowledge of mental health symptoms, social stigma, and lack of proper resources and facilities hinder people from accessing the care they require. 6 Besides, especially in rural areas, there is a huge lack of trained mental health professionals in healthcare setups. In India, as per the Indian Psychiatric Society estimation, there are only 9,000 psychiatrists, or 0.75 per 100,000 individuals, in comparison with mostly developed countries where this ratio is 6.6 per 100,000, while the number of clinical psychologists stands at 3190 (according to the Rehabilitation Council of India report, 2023). Consequently, India necessitates at least 27,000 psychiatrists, in light of the existing population and an additional 38,000 psychiatric social workers, and 38,000 clinical psychologists are imperative, considering the ratio of mental health professionals per 100,000 people. 7,8
Booster dose to mental health issues:
The Pandemic and Mental Health: The global challenges brought about by the COVID-19 pandemic have undoubtedly left an indelible mark on the past few years of history and left a profound impact on mental health. Mental health issues in the context of COVID-19 are particularly complex and challenging due to the significant size of individuals who are socially and economically vulnerable, the substantial burden of precedent mental illness, limited infrastructure related to mental health, insufficient use of digital mental health platforms, and, most importantly, the fear provoked by misinformation spread through social media platforms which ultimately a concern of “infodemic”. The pandemic unleashed a cascade of emotional turmoil. Individuals faced isolation, fear, and uncertainty as lockdowns and social distancing measures took hold. The grief of losing loved ones, coupled with the relentless stream of alarming news, cast a shadow of despair across communities worldwide. The pandemic has set in motion a series of emotional upheavals, feelings of loneliness, fear and uncertainty to due lockdowns, grief of losing loved ones, and economic repercussions further exacerbating the strain on an individual’s mental well-being.9
Stigma and Mental Health: Due to poor awareness, ignorance and outright emotional bond, generally, people suffering from any kind of mental health issue are labelled as ‘lunatics’ in society which results in a vicious cycle of shame, suffering and underreporting, and feeling of exclusion among them. A survey report in 2018 stated that only 27% of the population expressed their support for someone perceived as having a mental illness. A similar percentage (26%) of participants admitted to actively harbouring fear towards those with mental illness. Additionally, 47% of the participants claimed that they had the notion of the mentally ill person as “retard” and “mad”. Furthermore, 44% had notions that individuals with mental illnesses are always violent, while a further 41% believed that interacting with the mentally ill could negatively impact the mental health of an otherwise healthy individual.10,11
The imperative of early intervention: Similar to physical health, mental health also requires timely consideration. Unaddressed mental health conditions possess the potentiality to intensify, impacting not solely the individual but also their families and communities. Therefore, it is more important to prioritize early intervention and the government should come forward to guarantee that mental health services are accessible to everyone.
Step towards Mental health:
This year’s commemoration of World Mental Health compels our recognition of a jarring truth: mental health isn’t a luxury but a fundamental necessity. As proponents of transformation, it is incumbent upon us to champion all-encompassing systems of mental health services. This includes raising budgets for mental health services, launching destigmatization campaigns, and integration of mental health education within our educational institutions and workplaces.
However, surpassing the realm of policies and programs, our collective consciousness must undergo a metamorphosis. Each of us has a pivotal role to fulfil in nurturing our own mental well-being and supporting those in our midst. As families, communities, and institutions, we must cultivate environments that promote a sense of security, enabling individuals to openly articulate their challenges without fear of condemnation. 12-15
Conclusion:
In conclusion, the diverse nature of mental health in society saturates all aspects of our lives. The significance of tackling mental health problems in India cannot be exaggerated, particularly given the profound impact on human well-being. Further, acknowledging the importance of mental health issues which impact a significant segment of the population is of utmost priority, and can have severe repercussions if neglected. Hence, rigorous efforts are essential in the effective management of such challenges. Also, the reduction of societal stigma associated with mental illness paramount importance in the context of addressing mental health issues in India.
References:
1. World Health Organization. Promoting mental health: concepts, emerging evidence, practice, summary report. Geneva: WHO; 2004. Available from URL: http://www.who.int/mental_health/evidence/en/promoting_mhh.pdf (Accessed 15 September 2023)
2. World Health Organization. World Health Report 2001 Mental Health; New Understanding, New Hope. Geneva: WHO, 2001.
3. Our Better World (Internet access). Available at: www.ourbetterworld.org (Accessed 15 September 2023)
4. India State-Level Disease Burden Initiative Mental Disorders Collaborators. The burden of mental disorders across the states of India: The Global Burden of Disease Study 1990–2017. Lancet Psychiat. 2020;7:148–61.
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9. Aguiar Melo MC, de Sousa Soares D. Impact of social distancing on mental health during the COVID-19 pandemic: An urgent discussion. Int J Soc Psychiatry. 2020;66:625-6
10. Health Issues India (Internet access). Available at: https://healthissuesindia.com/mental-health/ (Accessed 16 September 2023)
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13. Fricchione GL, Borba CP, Alem A, et al. Capacity building in global mental health: professional training. Harv Rev Psychiatry. 2012, 20:47- 57. 10.3109/10673229.2012.655211
14. Caulfield A, Vatansever D, Lambert G, et al. WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers. BMJ Open. 2019, 9. 10.1136/bmjopen-2018-024059
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