Ensuring mental health for all in India

Tasneem Raja | Updated on October 11, 2020 Published on October 11, 2020

This will require greater investment, access, and human resources

Recent reports suggest that India has 197.3 million people who live with a diagnosable mental disorder, today. Forty-five million have depression and, around the same number live with anxiety. About 10 million people live with severe mental illnesses, such as bipolar disorders and schizophrenia.

Mental healthcare, well-being and access to services in the face of existing mental ill-health indicators in India are a complex interplay of social determinants, such as poverty, gender and education on the one hand, and demand-related barriers such as the perceived need for care, paucity of knowledge on mental disorders, and a deep-rooted stigma associated with mental illness. These factors are compounded by the existing treatment services. India has 0.3 psychiatrists and two mental health workers for every 100,000 individuals.

While India was one of the first countries to formulate a National Mental Health Programme (NMHP) — almost five decades ago — there is now a need to effect more change on ground through infusion of fresh funds and investments which, currently, stands at 0.05 per cent of the total Budget allocated to health, annually. Not just the spends, there is also the need for more trained professionals on ground, and the availability of feasible mental health care protocols.

India has taken the first few imperative steps in aligning the mental health policy and legislative framework, attuned to the United Nations Convention on Rights of people living with a Disability, which has been signed and ratified by the country. A key requirement to translate the stated policy and legislative framework into ground reality is the availability of trained human resources.

The Covid pandemic raging in the country and its associated preventative measures, of maintaining physical distance, home quarantine, isolation and hospitalisation, have has brought to the fore the mental ill health crisis simmering below the surface before and during the pandemic. Most of us have experienced one or a combination of irritability, fearfulness, anxiety, problems with sleep, feelings of loneliness and hopelessness.

We may have encountered fear of contracting the infection ourselves or to a loved one, the need for hospitalisation or quarantine and isolation. Though these are largely rational responses, these symptoms of exacerbated stress still need to be addressed. With rising cases, quality human resources, therefore, become important. A strong mix of boosting our own resilience, relying on our supportive networks and reaching out for professional help will all need to come into play to help us tide over this difficult phase.

It is indeed time to face the fact that multi-faceted investment will need to come into play; beginning, at the individual level, where we become aware of our mental health, and then at the level of our loved ones, where we become the support network and medium for appropriate help. Investments at the level of the community, where we give prominence to the mental health of the members of the community and be inclusive. Investments at the health systems level to integrate mental health into primary based care and community outreach.

At the workplace, investments are needed to promote an inclusive environment that fosters the mental health of the workforce.

At the national level, political will, communications and advocacy are essential to effect real change. As a nation, India needs to prioritise mental health care.

State initiatives, such as that taken by the Government of Maharashtra, where it has initiated two massive innovations with Tata Trusts, to reform mental healthcare with wide-ranging implications in the low and middle-income world are exemplary examples of political will necessary to bring mental health care in the forefront of development. These two initiatives include the launch of a district wide community mental health programme in Nagpur that aims to provide a range of mental health care services to five million people, and the path breaking reform of the Regional Mental Hospital of Nagpur developing into a center of excellence, affecting quality of care for people from the 14 districts of the Vidharba region who access care from this tertiary care facility.

It is time we reach out to make mental health care a reality for the people of our country.

The writer is Lead – Mental Health Initiatives, Tata Trusts

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Published on October 11, 2020
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