Introduction:

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. (WHO) With over 18% of India’s population aged 10-17, the future of the country will be driven by this segment.

The isolation and fear in this lockdown era is driving an escalating nervousness among many people. Not just those with pre-existing conditions like anxiety, depression and OCD (obsessive compulsive disorder), but also the elderly who are struggling with new levels of loneliness and helplessness.

Body:

Status of Mental health in India

• According to an estimate by the World Health Organization (WHO), mental illness makes about 15% of the total disease conditions around the world.
• The same estimate also suggests that India has one of the largest populations affected from mental illness.
• As a result, WHO has labelled India as the world’s ‘most depressing country’.
• Moreover, between 1990 to 2017, one in seven people from India have suffered from mental illness ranging from depression, anxiety to severe conditions such as schizophrenia, according to a study. It is no exaggeration to suggest that the country is under a mental health epidemic.
• More than 450 million people suffer from mental disorders. According to WHO, by the year 2020, depression will constitute the second largest disease burden worldwide (Murray & Lopez, 1996).

Importance of mental health:

• Emotional and mental health is important because it’s a vital part of your life and impacts your thoughts, behaviors and emotions.
• Being healthy emotionally can promote productivity and effectiveness in activities like work, school or caregiving.
• It plays an important part in the health of your relationships, and allows you to adapt to changes in your life and cope with adversity.
• Our mental health encompasses our psychological, emotional and social well-being. This means it impacts how we feel, think and behave each day.
• Our mental health also contributes to our decision making process, how we cope with stress and how we relate to others in our lives.
• Global burden of mental health will be well beyond the treatment capacities of developed and developing countries.
• The social and economic costs associated with growing burden of mental ill health focused the possibilities for promoting mental health as well as preventing and treating mental illness.

Reasons for degenerating mental health of late:

• The first and foremost reason for India to lose its mental health is the lack of awareness and sensitivity about the issue.
• There is a big stigma around people suffering from any kind of mental health issues.
• They are often tagged as ‘lunatics’ by the society. This leads to a vicious cycle of shame, suffering and isolation of the patients.
• Issues with Mental Healthcare Act, 2017:
  • The Act neglects the prevention and promotion of mental well-being and recognizes mental illness as a clinical issue which can only be treated by medicines and clinical procedures.
  • The Act does not provide a clear procedure for preparing the Advance Directive. Further, doctors are of the opinion that they are in the best position to take decisions on aspects of treatment since patients or their nominated representatives may have limited knowledge on mental health and mental illness.
  • The Act provides a narrow and restricted definition of mental health professionals and does not include psychotherapists, counsellors and psychoanalysts.
  • Further, given the infrastructural and human resource constraints, the implementation of the Act poses a huge challenge.
• Also, there is a serious shortage of mental healthcare workforce in India.
• According to WHO, in 2011, there were 0·301 psychiatrists and 0·047 psychologists for every 100,000 patients suffering from a mental health disorder in India.
• Treatment gap: According to estimates nearly 92% of the people who need mental health care and treatment do not have access to any form of mental health care.
• The economic burden of mental illness contributes significantly to the treatment gap in India. There are both direct (cost of long-term treatment) and indirect costs (the inability of the patient and caregiver to work, social isolation, psychological stress) contribute significantly to the economic burden.
• Violations of human rights have been reported in mental asylums and also at homes and places of traditional healing. In India, mental hospitals still practice certain obscure practices that violate human rights. Further poor infrastructure such as closed structures, a lack of maintenance, unclean toilets and sleeping areas etc clearly violate the basic human right to a life with dignity.

Way Forward:

• Mental health situation in India demands active policy interventions and resource allocation by the government.
• To reduce the stigma around mental health, we need measure to train and sensitize the community/society.
• This can happen only when we have persistent nationwide effort to educate the society about mental diseases.
• We also need steps to connect the patients with each other by forming a peer network, so that they could listen and support each other.
• Moreover, people experiencing mental health problems should get the same access to safe and effective care as those with physical health problems.
• Additionally, mental illness must mandatorily be put under the ambit of life insurance. This will help people to see mental illness with the same lens as they use for physical diseases.
• When it comes to providing the right care to patients with mental illness, we need mental healthcare intervention to the patients, we need innovative models to deepen the penetration of services and staff. One such model is accredited social health activist (ASHA) by the ministry of health and family welfare, Government of India. Under this model, community health workers not only educate and sensitize women and children about mental diseases but also guide them to reach the right expert in their locality.
• We need a constant stream of funds for educating and creating awareness about mental health and chronic issues around it.
• The need of the hour is to provoke masses to learn about mental health through campaigns like Swachh Mansikta Abhiyan. This will help them address mental issues in a timely and effective manner and live a stress-free life.
• The campaign will also encourage people to talk about their mental well-being and reach out to a therapist or psychiatrist, in case they need to do so.

Conclusion:

Timely intervention, awareness about the issue, availability of professional help and appropriate policies is the only way to improve the situation. It is thus imperative to believe and propagate that people with mental illness deserve to live their lives with dignity and confidence. It requires a collaborative public-private-social partnership to change things considerably.