Context: Mental health and its deterioration has been a troubling aspect for many people around the world. There has lately been a lot of conversation around self-harm and suicide since they are now being acknowledged as legitimate outcomes of mental health crisis. Doctors insist that suicide is preventable, and one simply needs a lot of self-awareness and basic knowledge in order to keep themselves and their loved ones safe and secure. 

• World Mental Health Day is observed on 10th October every year, with the overall objective of raising awareness of mental health issues around the world and mobilising efforts in support of mental health.
• 2020 Theme: Mental Health for All, Greater Investment – Greater Access
• The Big Event for Mental Health: It is the first ever global online advocacy event on mental health, hosted by the World Health Organisation (WHO) on the day.

Key Points
Impact of Covid-19 on Mental Health: Surveys have indicated that the pandemic is increasing mental health problems.

• Half the respondents from seven countries in a survey by non-profit International Society for the Red Cross and Red Crescent Movement reported negative effects on mental health.
• Practo, an integrated health care company, reported a 665% jump in the number of mental health consultations.
• More than two-thirds of the queries were from those aged 21-40.
• Anxiety, stress and panic attacks were the most commonly discussed topics.
• In the United States, more than 90% of respondents to a survey of Harvard Medical School reported increased worry, frustration, boredom or anxiety.
• The global economic cost of mental illness is expected to be more than USD 16 trillion over the next 20 years, which is more than the cost of any other non-communicable disease.
• More Vulnerable: People in younger age, female gender and those with comorbidities reported more psychological impact.

Causes

• Related to Pandemic: The pandemic has increased isolation and loss of income which are well known triggers of mental health conditions.
• The disease itself has been reported to lead to neurological and mental complications such as delirium, agitation and stroke.
• The Covid-19 has disrupted or halted mental health services in 93% of the countries.
• Funding and aid: Lack of funding for huge challenges posed by pandemic and mental health issues.
• The World Health Organisation (WHO) pointed out that countries are spending less than 2% of their health budget on mental health.
• Only around 1% of the international aid available for health is earmarked for mental health.

Indian Scenario

• A report published in The Lancet Psychiatry in February 2020 indicates that in 2017, there were 197.3 million people with mental disorders in India.
• The top mental illnesses were depressive disorder (45.7 million) and anxiety disorder (44.9 million).
• The contribution of mental disorders to the total DALYs in India increased from 2.5% in 1990 to 4.7% in 2017.
• Depressive disorder and anxiety disorder contributed the most to the total mental disorders DALYs.
• Disability-Adjusted Life Years (DALYs): The burden of disability associated with a disease or disorder can be measured in units called disability-adjusted life years (DALYs).
• DALYs represent the total number of years lost to illness, disability, or premature death within a given population.
• Budgetary Spending: The year 2020 began with a reduction of budget allocation for mental health in India.
• India’s healthcare budget in 2018 was Rs. 52,800 crore, of which Rs. 50 crore was for mental health and that was reduced to Rs 40 crore the following year.
• India is barely spending 0.5% of the health budget on this sector.

Initiatives: The Mental Health Care Act (MHCA) 2017 came into force in 2018 to meet the requirements of the United Nations Convention on the Rights of Persons with Disabilities which India ratified in 2007.

• KIRAN: The Ministry of Social Justice and Empowerment has launched a 24/7 toll-free helpline to provide support to people facing anxiety, stress, depression, suicidal thoughts and other mental health concerns.
• Manodarpan Initiative: It is an initiative of the Ministry of Education under Atmanirbhar Bharat Abhiyan.
• It is aimed to provide psychosocial support to students, family members and teachers for their mental health and well-being during the times of Covid-19.

Mental Health Care Act, 2017

• Right to make an Advance Directive, wherein patients can state on how to be treated or not to be treated for the illness during a mental health situation.

Right to appoint a Nominated Representative: A person shall have the right to appoint a nominated representative to take on his/her behalf, all health related decisions like:

• Right to access mental health care,
• Right to free & quality services,
• Right to get free medicines,
• Right to community living,
• Right to protection from cruel, inhuman and degrading treatment,
• Right to live in an environment, safe and hygienic, having basic amenities,
• Right to legal aid, and
• No Electroconvulsive Therapy (ECT) without anesthesia.

This act brought changes in Section 309 of the Indian Penal Code (which criminalized attempted suicide). The attempt to commit suicide is punishable only as an exception.
Road Ahead

• Increasing the number of psychologists and psychiatrists alone won’t help. Stigma and awareness are two separate issues although interlinked. They need to be addressed in parallel in order to tackle the burden of mental illness.
• Community Partnership: By forming self-help groups of carers families along with NGO’s which brings community participation and helps reduce the social stigma associated with mental illness.

Increase Resources

• Increasing mental healthcare facilities and related infrastructure through more resource allocation in the budget.
• Adequate Mental healthcare professional availability.
• Empathetic Service delivery: Delivery of services should be sensitive, compassionate and free from stigma and discrimination in public healthcare institutions.