Health, Sanitation & Nutrition

Mental health refers to cognitive, behavioral, and emotional well-being. It is all about how people think, feel, and behave. People sometimes use the term “mental health” to mean the absence of a mental disorder. According to a Lancet study and Global Health Data Exchange, India accounts for nearly 15% of the global mental health burden and one in seven Indians is estimated to suffer from mental health disorders.

Stigma And Taboo Around Mental Health

1. People should take care of their mental health in the same way they take care of their physical health. However, Judgement and discrimination are often the reasons why many choose to suffer in silence.
2. This phenomenon prevents patients from having the awareness and access to the much needed help from their communities – findings show that 75% of people who have experienced a mental disorder decide not to seek professional help.
3. Mental illness in India is still taboo. The World Health Organization has declared India as one of the most depressed countries in the year 2018-19. India is a developing country that has transformed itself in plenty of ways but despite that, when it comes to mental health, there is a long way to go.
4. No matter how much people have fought, their minds are conditioned with a variety of stereotypes. For example, ‘Boys do not cry if they do so, people question their masculinity. Only girls should cry.
5. Sharing episodes of depression, make them be labelled as ‘mentally weak’. The lack of acceptance towards people with mental illness is one of the topmost reasons that they feel awkward in sharing their problems.
6. They fear that people would judge them, understand them as a weak person and could be teased by their peers. They feel unable and find it difficult to share their problems with anyone.

Factors That Have Contributed To Gaps In Mental Health Service

Healthcare providers are being trained at the district-level through various programmes. Their role is to identify individuals with mental illnesses at the initial stages, provide knowledge about the treatment and facilities available to them, and record treatment adherence. Despite these efforts, India faces a wide treatment gap due to multiple reasons.

1. Mental healthcare initiatives in India focus on a narrow biomedical approach that tends to ignore sociocultural explanations for the occurrence of mental illness.
2. Mental healthcare depends primarily on trained personnel and infrastructure to ensure early diagnosis, treatment, and prevention of mental illness. The lesser density of trained manpower, especially psychiatrists, is a reliable indicator of the human resources availability gap for mental healthcare.
3. The economic burden of mental illness contributes significantly to the treatment gap in India. The costs of long-term treatment, including consultation and medication costs, travelling costs to treatment centres, and the stay in the hospital, all contribute substantially to the economic burden of mental illness.
4. Belief in supernatural, non-medical explanations of mental illness and the easy accessibility of traditional healing resources are important reasons for not seeking medical help for mental illnesses in India.
5. Violations of human rights have been reported in psychiatric hospitals(shaving the heads of patients) as well as at places of traditional healing in India which deter people from seeking treatment.

Need For A Robust Policy

In 1982, the government of India launched the National Mental Health Programme (NMHP) to improve the status of mental health in India. Mental Health Care Act 2017 repealed the Mental Health Act, 1987.

1. There have always been debates about whether India needs a combined health policy with subsections on mental health (as a national health policy) or a completely separate mental health policy.
2. In 2014, the Government of India realised the need for a separate mental health policy and established the National Mental Health Policy (NMHP). Mental health is covered under other policies as well, including those that address disability, social security, and health and family welfare.
3. It is crucial that the approach to mental health care is holistic, taking into account the coordinated efforts of various departments of the Government of India (social security, social justice and empowerment, disability affairs, and health and family welfare).
4. In India, policy documents vary in their definitions of mental illness. The Persons with Disabilities Act, 1995, defines mental illness as any mental disorder other than mental retardation.
5. The Census of India, 2001, describes individuals with mental illnesses as “insane”—this term is subjective and inadequate in classifying all individuals with mental illnesses. Evidently, it is crucial to reconsider these definitions of mental illness.

Way Forward

The World Health Organization made certain recommendations to reduce the treatment gap in mental healthcare.

1. Make mental health treatment accessible in primary care along with the ready availability of psychotropic drugs.
2. There must be a Shift from institution based care which has much stigma and prejudice around it towards community care.
3. The social aspects of mental health i.e taboo and stigma surrounding it must be addressed by generating awareness, educating the public, involving the family, communities, and consumers.
4. Governments across states and centres must establish national mental health programmes, Increase and improve the training of mental health professionals.
5. There must be increased linkages between governmental and non-governmental institutions.
6. Monitoring of the mental health system with quality indicators must take place along with Support for more research.