Opinion

Making mental health a public health priority

Paul Abraham | Updated on May 31, 2021

We cannot be in denial about mental health issues anymore   -  istock.com/solarseven

India must draw lessons from other countries as well as draw upon its own ancient wisdom to holistically treat this unaddressed health challenge

In the year and a half since the World Health Organisation declared Covid-19 a global pandemic, millions of lives around the globe have been significantly upended.

While the catastrophic loss to life and post recovery health issues have been central to this pandemic there are many areas where we will face a trail of disruption for a long while to come. Learning loss due to missed school, insecurities of job loss, stress due to prolonged periods of loneliness, strained relationships due to excessive proximity, the feeling of lack of control and helplessness in general and the inability to navigate the emerging world with current capacities are all issues.

While the physical healthcare framework and its inadequacies have been discussed what doesn’t make it to the table is the impact to, existence of and scale of the mental health challenge.

Mental illness has been a global problem resulting in widespread stress and debilitation. It has also caused large scale economic loss due to its insidious impact. Children struggling to cope, domestic violence, suicide, productivity loss due to absenteeism are all manifestations.

As per Health Poverty Action UK more than 300 million people worldwide suffer from depression. What is more alarming are the treatment disparities. 35-50 per cent of people with severe mental health disorders in the Global North receive inadequate or no treatment; but that figure doubles to 76-85 per cent for people living in the South. A similar disparity can be observed in disadvantaged groups such as women, children and people living below poverty line who are disproportionately affected by the lack of access.

In fact, a 2020 report by the WHO exposes the heightened disruption in mental health services due to the pandemic. In an environment where mental health prevalence is heightened, this is a desperate call to attention and action.

India and its Mental Health Services Gap

Mental health issues in India are hugely complex. Data on mental illness is remarkably patchy. Considering mental illness is stigmatised and considered taboo, most data is based on self-reporting of conditions and extrapolation. Nonetheless, socio-economic causes, undiagnosed pre-existing conditions, human resources shortage, fragmented service delivery models and lack of research capacity for implementation and policy change are also contributing to the country’s gaps in mental health treatment.

Why does mental health need to be a priority?

Globally mental health illnesses are affecting almost over 970 million people annually. Some like Depression, Anxiety, PTSD are naturally intangible, often making individuals look normal while gradually making them incapable of living a normal life. Consequences are drop in productivity, alienation, stress and sometimes even suicide.

We need an urgent action plan which starts with acceptance of the problem. We cannot be in denial anymore. We need to have assessment tools and techniques which communities are made aware of and allowed to use with ease e.g. an annual exercise in schools to determine how many youngsters may be impacted and being lost to the system.

We need a significant investment in trained resources for counselling and supporting rehabilitation. We need role models to talk openly about the problem and showcase journeys that will inspire others to recognise and come forward to seek help and attention.

Recognition and asking for help and treatment is key. Corporates and influencers have come out in the open to address emotional well being. However treatment is often constrained due to the high costs. In India, seeking help from a mental health professional could cost anything between ₹1,500-5,000 a session. Often corrective interventions are long drawn.

Drafting a robust and inclusive response

The current flux and the increasingly uncharted territories we face in the future requires a serious change in perspective. We need to commit to a world where physical health is matched by a belief in the importance of mental well being.

Human wellness is about body and mind. Lasting change is possible only through a collaborative effort of policy-makers, regulators, creative communities including the arts, investment in institutional support mechanisms like hospitals, treatment centres, qualified health care support and community support mechanisms.

We will also need large scale social security support or insurance to cover costs. Mental illnesses should be covered in health insurance policies. To make sure that implementation of these policies is more accessible to patients — the regulators, policy makers and companies should consistently work with each other to ensure empathetic recognition and a supportive claims and settlement architecture.

The government must ensure that treatment is widely available and costs are regulated thus making accessibility and affordability key components of a successful response system.

While we may need to evolve our own model to address mental health, India should readily replicate successful frameworks from other countries. We can also draw on our ancient wisdom of holistic healing and adopt an integrated approach to address and support this huge unaddressed need.

The writer is President, Hinduja Foundation

Published on May 31, 2021

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