Current Status of Mental Health in India

By Akanksha Sharma

By Akanksha Sharma

Introduction 

       

In a country that is pressed for material resources, human resources, and infrastructure, healthcare is a critical concern for people. However, the majority of people in India perceive health as physical health, and to be in good health is seen as being free from any disease that has outward biological manifestations. Until 2017, suicide was a criminal offense under Indian law. And even today, there are individuals who prefer visiting god-men and babas for resolving matters of mental illness. The realm of mental health is strongly associated with religious superstition in the country. Episodes of hallucinations and hyperventilation are considered by many as cases of demonic possession, that must be waived off by going to the local tantric. Changes in mood, loss of appetite and many other symptoms associated with depression are credited to the mysterious ‘Nazar’ or evil eye. When mental health itself is such a new and upcoming concept in India, one can make a logical deduction that its status is still in the rudimentary, beginning stages. 

Incidence of Mental Illness & the Treatment Gap

According to the World Health Organization (or the WHO), by 2020 approximately 20 percent of Indian citizens will be suffering from some form of mental illness. Currently, the strength of mental health professionals in India, to cater to the 1.38 billion people (latest UN data) that live here, is a meager 4000. The treatment gap is a staggering 83 percent. The mental health crisis in the country will not only impact people, their wellness and lives but also the economy. The WHO forecasts economic losses as a result of mental health problems in India at US$ 1.3 trillion from 2012 to 2030. Indeed, mental health is intimately linked to working outcomes and performance at the workplace. Absenteeism due to stress, anxiety, and depression at work has become extremely common. However, it is not just working professionals that suffer. 20 percent of all Indian mothers suffer from postpartum depression. 

Mental Health Legislation & Stakeholders 

The Mental Healthcare Act of 2017 ushered in a new era when it came to legislation on mental health in India. Keeping the United Nation’s Convention on the Rights of Persons with Disabilities (UNCRPD) in mind, the law is now oriented towards the human rights of patients and accords certain freedoms and options to people living with mental illness. Following are some of the important points that one should know about the act: attempt to suicide is no longer a criminal offense, patients have the right to live in proper accommodations, providers of medical insurance in India must cover mental health illnesses, the government must provide required funds to ensure access to mental health care services and the number of mental health professionals must be increased. The stakeholders identified by the act, to execute the provisions within it are the Central Mental Health Authority (CMHA) and the State Mental Health Authority (SMHA). The SMHAs are also obligated to form Mental Health Review Boards (MHRBs). All the mental health professionals need to register themselves with the respective boards.  

Apart from government actors, several non-government actors such as start-ups, nonprofits, foundations, and even corporates, are playing their own part in improving access to mental health care. Many start-ups are focussed on providing good quality, subsidized care to the urban poor, particularly school-going adolescents. Technology focussed start-ups are providing platforms on mobile and digital, at subsidized costs where people can avail mental-health support. The rise of Artificial Intelligence (AI) and the huge penetration of mobile and interconnectivity in India is giving rise to innovations such as mental health AI chat-bot Wysa. At the same time, corporates are stepping up their Employee Assistance Programmes (EAPs). 

Tackling Stigma & the Way Forward

In order to re-direct people with mental health illnesses towards appropriate care, instead of superstitious placebos, it is important to make mental illness free of stigma collectively, as a society. When social stigma will be removed, so will the self-stigma that people suffering from mental illness face. Organizations such as the Live Laugh Love Foundation (LLLF) are conducting projects and activities with adolescents and youth, parents and general physicians to give a fillip to this initiative. On an individual level, it is important for people to develop empathy, and be open to listening to their suffering family, friends or peers non-judgementally. The small actions on an individual level will be responsible for creating big ripples of change as a society. 

There must be more educational opportunities available to future mental healthcare professionals such as psychiatrists, psychologists, counselors, social workers, and psychiatric nurses. Some proportion of funding from the government should be diverted towards creating more educational programs for these courses, as in the future the incidence of mental illnesses in India is predicted to increase. Furthermore, the compensation allocated to these professionals should be regulated and standardized, so as to remove barriers from interested individuals joining this field.

In conclusion, there needs to be a multi-pronged approach to improving the status of mental health in India. All the state and non-state actors, along with individuals need to make concerted efforts towards this humanitarian goal.

About the Author: 

Akanksha Sharma is a Psychological Counsellor and a Mental Health Content Specialist. You can write to her at akanksha.sharma158@gmail.com or contact her on LinkedIn.

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