mental-health-issues

CONTEXT

According to a Lancet and World Psychiatric Association Commission on depression, the world is failing to tackle the persisting and increasingly serious global crisis of depression.

About the Report

  • It has estimated that 5% of adults worldwide suffer from depression each year, and yet it remains a neglected global health crisis.
  • The poor understanding of the condition and lack of psychosocial & financial resources impact prevention, diagnosis, treatment, and the economic prosperity of nations.
  • Many of the people living with depression are not diagnosed and consequently not treated.
    • About half of people suffering from depression come under this category in high income countries, while it rises to 80-90% in low- and middle-income countries.
  • The pandemic has created additional challenges, with the hardship, bereavement, isolation, and uncertainties, besides limited access to health care exacerbating mental health conditions, and bringing more people to the brink.

STATE OF MENTAL HEALTH IN INDIA

  • According to study by the Indian state-level disease burden initiative, the disease burden in India due to mental this order is increased from 2.5% in 1990 to 4.7% in 2017 in terms of DALY (disability adjusted life years) and was leading contributor to YLDs (years lived with disability) contributing to 14.5% of all YLDs in the country.
  • The prevalence of depression and anxiety disorders as well as eating disorders was found to be significantly higher among women.
  • The association between depression and death by suicide was also found to be higher among women.
  • According to a report by WHO, 7.5% of Indians suffer from some mental disorder and predicts that by the end of 2021 roughly 20% of India would suffer from mental illness.

Factors contributing to Mental Health Burden in India
  • Scarcity of mental health specialists particularly in rural areas.
  • Limited availability and access to mental health services.
  • Knowledge about mental health.
  • Logistical issues like inadequate funding, out-of-pocket expenditure.
  • Poverty and lower levels of literacy.
  • Lack of cost-effective and evidence-based intervention protocol.
  • Lack of follow-up care and community base networks to address mental health.

ISSUES

  • Lack of budgetary allocation: although mental health is now recognised in national policies the expected impact has been weakened by the absence of adequate budgetary allocation.
    • For instance, the national mental health programme has been allocated even less than 0.05% of total health budget over the successive financial years.
  • Lack of resources: low proportion of mental health workforce in India (per 100,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07).
  • Social Stigma: having mental health disorders is perceived with a sense of judgement in India and there is a stigma associated with those having mental health issues.
  • Economic burden: the economic burden of mental illness contributes significantly to the treatment gap in India.

GOVERNMENT INITIATIVES

Mental Healthcare Act, 2017

  • It guarantees every affected person access to mental healthcare and treatment from services run or funded by the government.
  • It has significantly reduced the scope for use of Section 309 IPC and made the attempt to commit suicide punishable only as an exception.

National Mental Health Policy, 2014

  • It was framed with a vision to promote mental health, prevent mental illness, promote de-stigmatisation and desegregation and ensure socio-economic inclusion of persons affected by mental illness by providing accessible, affordable and quality health and social care to all persons throughout  their lifespan with a right based framework.

National Mental Health Programme (NMHP,1982)

  • The programme was launched for detection, management and treatment of mental illness.
  • The program was re-strategized in 2003 to include two schemes, modernisation of state mental hospitals and upgradation of psychiatric means of medical colleges.

MANAS

  • The government launched ‘Mental Health and Normalcy Augmentation System’ (MANAS), a national platform to enhance mental well-being of Indian citizens.

WAY FORWARD

  • There is a need for united action to transform approaches to mental health care and prevention globally.
  • The Lancet- WPA Commission has called for a whole-society approach to preventing depression, on the lines of what has been done for conditions such as heart disease or cancer.
  • Depression can be prevented and treated with sound science, political will, and shared responsibility.
  • The people with experience of depression must be empowered together with families, practitioners, policymakers and civil society to address the tsunami of unmet needs.

Investing in reducing the burden of depression would give millions of people the chance to become healthier, happier and more productive members of society, help to strengthen national economies, and advance the United Nation’s Sustainable Development Goals for 2030.

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