One in seven Indians is affected by a mental disorder, says the latest paper published by Indian Council of Medical Research in Lancet Psychiatry , “The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990-2017.”

What is worrisome is that the proportional contribution of mental disorders to the total disease burden in India has almost doubled since 1990, the research states. That means 19.73 crore or 14.3 per cent population of the country is reeling under one or the other mental disorder.

The study was funded by funded by the Bill and Melinda Gates Foundation and ICMR.

In 2017, approximately 4.57 crore people had depressive disorders in India and 4.49 crore had anxiety related disorder. Among the mental disorders that manifest predominantly during adulthood, the highest disease burden in India was caused by depressive and anxiety disorders, followed by schizophrenia and bipolar disorder. “Prevalence of depressive disorders varied 1·9 times among the States, with the highest prevalence observed in Tamil Nadu, Kerala, Goa, and Telangana among states that have high socio-demographic index (SDI), Andhra Pradesh in the middle SDI state group and Odisha in the low SDI state group,” the paper states.

While in southern States, mental disorders amongst adults were high, in northern States the burden lay on children and adolescents.

It further says the higher prevalence of depressive and anxiety disorders in southern States could be related to the higher levels of modernisation and urbanisation in these States and to many other factors that are not yet well understood.

The risk factors for mental disorders include lead exposure, intimate partner violence, childhood sexual abuse, and bullying victimisation.

Also, higher prevalence of depressive and anxiety disorders was observed in females than in males, which could be related to gender discrimination, violence, sexual abuse, antenatal and postnatal stress, and adverse socio-cultural norms. The paper says there is poor implementation of mental health services in India.

“Community-level mental health care and integration of mental health services with other aspects of health care should receive high priority from State governments to improve mental health promotion and care,” said Vinod Paul, Member, NITI Aayog. It has also been found that prevalence of depressive disorders was positively associated with the suicide death rate for both males and females.

A major limitation of this study is that the population-level data on the prevalence of many mental disorders is scant across the States of India, which might have introduced unknown biases in estimates, it says.