by Md. Tabrez Alam 10 October 2023
Abstract:
World Mental Health Day on October 10, 2023, with the theme “Mental Health is a Human Right,” presents an opportunity to bring attention to India’s mounting mental health crisis. Despite India’s rapid development, mental health stigma persists, impeding millions from accessing the care they need. This article investigates the multifaceted challenges facing India’s mental health landscape, including inadequate awareness, shortage of mental health professionals, and the economic implications of untreated mental health issues. We also examine the government’s role, recent budget allocations, and key initiatives to address this crisis. By adopting a holistic approach, India can guarantee its citizens receive the support they require and recognize mental health as a fundamental human right.
Introduction:
Life in India presents a daily ordeal, fraught with many challenges encompassing healthcare, employment, transportation, housing, and the seasonal trials of monsoons. The average Indian populace is habituated to navigating this myriad of adversities, often eliciting frustration, anger, sorrow, and anxiety. These hardships are further compounded among vulnerable groups, who grapple with these trials and face discrimination predicated on their identity, caste, class, religion, gender, and other sociocultural factors. Given the inherent complexities of their daily existence, discussions about mental health and conditions like depression or anxiety can appear foreign and irrelevant to many inhabitants of India. In a society where adversity is a constant companion, the mention of “mental health discourse” or the care of individuals grappling with “depression” or “anxiety” is met with perplexity. To numerous individuals, these concerns appear trivial or exaggerated, leading them to perceive those who voice such issues as “fragile,” “outsiders,” or “excuse-makers,” consequently intensifying the prevailing stigma surrounding mental health.
The root cause of this disconnection is attributed to the fact that the current proponents of mental health in India often transplant American models of mental health communication, including their slogans. This approach fails to resonate with the Indian populace, as the conception of mental health, as delineated in Western contexts, does not harmonize with the indigenous perspective in India. According to a World Health Organization (WHO) report, one in four individuals worldwide encounters a mental health issue at some juncture in their life. In India, an investigation supported by the government conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) unveils that one in ten Indians grapples with a mental health condition, and one in twenty contends with depression. Refuting these realities and dismissing them as “sentimental, contemporary nonsense” or invoking the argument that “our forebears never experienced depression” is equivalent to evading the truth. It is imperative to differentiate between ordinary fluctuations in emotional states and diagnosable mental health disorders. Experiencing occasional sadness, hopelessness, or anxiety is a universal human phenomenon and does not invariably signify the presence of a mental health disorder.
A mental health disorder is restricted by the intensity and persistence of these emotional states, which substantially disrupt an individual’s daily life. Recognizing and seeking intervention for these conditions is imperative, rather than relegating them to oblivion through insensitive comments such as “I observed them smile.” Nevertheless, it is also essential to comprehend that mental health is not analogous to physical disorders. Mental health issues are frequently categorized as disorders, as opposed to diseases. Unlike infectious diseases, which are amenable to antibiotic treatment to eliminate the causative agent, mental health problems necessitate a more intricate and multifaceted approach. The spectrum of treatment options encompasses medication, therapeutic interventions, lifestyle modifications, or a combination thereof. Notably, therapy involves the guidance of trained professionals who assist individuals in reevaluating their thought processes and approaches to life. Identifying the underlying causes of mental health conditions, such as toxic work environments or strained interpersonal relationships, can serve as a compass for therapeutic measures. Medications, while productive, are not without potential side effects and must be administered under the purview of medical oversight.
Some Statical Facts towards Mental Health:
The World Health Organization’s estimate that 56 million Indians grapple with depression, along with 38 million suffering from anxiety disorders, highlights the nation’s pressing mental health challenges. Encouragingly, there is a growing awareness of mental health concerns, particularly in urban India. A study conducted by UnivDatos Market Insights (UMI) reveals that the mental health industry is projected to experience substantial growth, with an annual rate of 15% expected from 2022 to 2028. This upward trend indicates the increasing recognition of the importance of mental well-being. The COVID-19 pandemic and its economic repercussions have further exacerbated these issues, causing a surge in mental health problems. It is crucial now, more than ever, to combat the stigma surrounding mental health, fostering an environment where individuals can openly discuss their struggles and seek the help they need to address these growing concerns.
The Wellcome Global Monitor report “Mental Health, the most extensive worldwide survey addressing anxiety and depression, provides a comprehensive view of public perceptions regarding mental health. Spanning across 113 countries, this study underscores that 92% of global respondents regard mental health as equal to or even more vital than physical health. Nonetheless, it illuminates a notable perceptual disparity, whereby individuals tend to ascribe greater relevance to science in elucidating the intricacies of human physiology in comparison to the understanding of emotions and sentiments. This perspective extends to the belief that scientific endeavours demonstrate higher efficacy in combating infectious diseases or cancer than their effectiveness in ameliorating anxiety or depression. From a context-specific vantage point centred on India, the survey reveals that prevailing attitudes within the Indian populace towards mental health exhibit a positive trajectory. Impressively, 42% of respondents in India express a high level of comfort in engaging in discussions about anxiety and depression within their local community, a statistic significantly surpassing the global average of 19%. However, it concurrently underscores the globally prevalent sentiment that while science may offer insights into the aetiology of mental illnesses, its therapeutic efficacy in addressing such conditions may face inherent limitations.
The amalgamation of findings from these studies collectively underscores a burgeoning awareness in India concerning the critical importance of mental health, coupled with a progressively open and accepting attitude towards this topic. This transformation can be attributed, in part, to the improved educational infrastructure and enhanced accessibility to information. Nevertheless, it is incumbent upon stakeholders to recognize that effectively tackling the multifaceted mental health challenges in India necessitates systemic support. Progress in this domain should encompass not only the generation of novel scientific insights but also the dissemination of this knowledge to heterogeneous audiences. Policymakers, service providers, and educators ought to synergize their efforts to construct resilient systems capable of addressing India’s underserved mental health requirements, all while accommodating individual idiosyncrasies and endorsing respective agencies in managing mental health.
India is grappling with an unparalleled mental health crisis that requires immediate attention and action. According to a recent National Institute of Mental Health and Neurosciences (NIMHANS) survey, nearly 150 million Indians need mental health care services, yet fewer than 30 million actively seek help. This stark discrepancy highlights the pressing issues surrounding mental health in the country. As Pratima Murthy, director of NIMHANS, emphasized, “Mental health is a critical issue, and treatment for mental disorders is not a luxury but a necessity.” To fully grasp the gravity of the situation, we must examine the factors contributing to this crisis, including inadequate awareness, insufficient access to mental health professionals, and the profound economic impact of untreated mental health issues.
Challenges in Mental Health Tracking and Perception:
Tracking progress in mental health is challenging, particularly in a diverse and culturally rich country like India. A severe shortage of mental health professionals and pervasive social stigma compound the issue. Live Love Laugh, a prominent mental health organization, has conducted studies that shed light on changing perceptions and attitudes towards mental health. Although there have been positive shifts in public opinion, significant gaps in understanding and access to mental health interventions persist. Bridging these gaps is crucial to ensuring proper mental health support for all.
Government Allocation and Prioritization:
Despite the increasing prevalence of mental health issues in India, allocating resources for mental health remains alarmingly low. In 2022, India’s Health Ministry gave less than 1% of its budget to address psychological illnesses. There is an urgent need for a more decentralized mental health approach involving the government and private initiatives. Nelson Vinod Moses of the Suicide Prevention India Foundation stressed the importance of offering subsidies, grants, and support for clinics, hospitals, research, and public health campaigns. Making mental health treatment a national priority would not only alleviate the financial burden of mental illness but also positively affect the management of other medical conditions linked to mental health. The Indian government has made commendable efforts towards mental healthcare in recent years, with growing support for mental health initiatives witnessed in recent Union Budgets. In 2017, the Union Finance Minister allocated approximately Rs. 670 Crore, representing around 1.4% of the total budget outlay exceeding Rs. 86,000 Crore, for mental healthcare. This is a positive development, and it is notable that a substantial portion of these funds, Rs. 630 Crore, was designated for NIMHANS, Bangalore, and Assam’s Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, recognizing the pressing need to bolster mental health services in the country.
India has implemented various initiatives and policies to address mental health challenges. The National Mental Health Program (NMHP), launched in 1982, was a significant step in recognizing the prevalence of mental disorders and the shortage of mental health professionals in the country. The Mental Health Act of 2017 played a pivotal role by ensuring that every affected person is entitled to mental healthcare and treatment from government institutions, marking a crucial development in promoting mental health services as a fundamental right. The introduction of the ‘Kiran’ helpline, the MANAS (Mental Health and Normalcy Augmentation System) Mobile App, and the Tele Mental Health Assistance and Networking Across States (Tele-MANAS) service are significant steps towards providing much-needed mental health support to those in need.
However, several challenges continue to impact mental health in India. The widespread use of specific social media platforms has been linked to increased stress and mental health issues among young people. The COVID-19 pandemic has also exacerbated mental health problems globally, particularly among younger age groups. Additionally, poverty and mental health have a concerning link, with individuals living in poverty at a higher risk of developing mental health conditions and mental health issues, pushing individuals into poverty through job loss and increased healthcare expenses. Inadequate mental health infrastructure is also a pressing challenge, with only a fraction of individuals with mental illnesses receiving adequate treatment due to insufficient resources, including funding and access to essential medications.
Economic Impact: The economic consequences of untreated mental health issues are substantial. During the COVID-19 pandemic, mental health problems surged globally, with India no exception. A Deloitte survey found that workplace-related stress significantly affected mental health for 47% of professionals surveyed in India. The economic cost of mental health issues to Indian employers was estimated at approximately $14 billion annually due to absenteeism, lower productivity, and attrition. The World Health Organization estimates that mental health issues cost the economy $1 trillion annually in lost productivity. The impact on the workforce undeniably underscores the urgent need for comprehensive mental health support in workplaces.
Social Work Intervention: In order to address these challenges constructively, India must continue to reimagine mental healthcare. It is crucial to overcome mental health’s deep-rooted stigma to encourage patients to seek timely treatment and reduce feelings of shame and isolation. Integrating mental health into public health programs can reduce stress, promote healthy lifestyles, identify high-risk groups, and strengthen mental health interventions, especially in schools. Significant investments are needed to enhance mental health infrastructure and human resources to bridge gaps. Mental health services must become affordable, ensuring that government health assurance schemes, including Ayushman Bharat, cover many mental health conditions. With a comprehensive and holistic approach, India can address mental health issues and improve the lives of many individuals. Social workers are indispensable in addressing the pressing issues of depression and related mental health challenges. They are at the forefront of efforts to destigmatize mental health problems, raise awareness, and support needy individuals. Indian Social workers can employ a range of impactful interventions to make a meaningful difference; here are a few points highlighted by the author:
Community Education Programs: Social workers can lead in organizing community-based mental health awareness programs. These initiatives can involve educating local communities about the signs and symptoms of mental health disorders, reducing stereotypes, and highlighting the importance of seeking help when needed. By engaging with communities directly, social workers can break down barriers to understanding and encourage open conversations about mental well-being.
School-Based Initiatives: Schools are vital spaces where young minds can be nurtured, and social workers can implement programs that promote positive thinking and emotional well-being among students. By collaborating with educational institutions, social workers can introduce mental health curricula, conduct workshops, and create safe spaces for students to discuss their feelings and concerns. Early intervention and education in schools can go a long way in preventing mental health issues among the youth.
Support Groups: Facilitating support groups for individuals with depression is another crucial role for social workers. These groups offer a safe and non-judgmental environment where individuals can share their experiences, emotions, and coping strategies. Social workers can guide these sessions, providing emotional support and connecting participants with appropriate mental health services, reinforcing that they are not alone in their struggles.
Crisis Intervention: Social workers can actively participate in crisis intervention teams that respond promptly to individuals in acute distress or at risk of self-harm or suicide. Their expertise in assessing and addressing immediate mental health crises can be a lifeline for those in dire need. By being on the front lines, social workers can help save lives and ensure that individuals receive the timely care and attention they require.
Advocacy and Policy: Advocacy is a powerful tool, and social workers can use their voices to champion mental health policy reforms in India. They can engage with policymakers, raise awareness about the critical need for increased funding and resources for mental health services, and advocate for reducing social stigma associated with mental illness. By actively participating in policy discussions, social workers can influence positive changes in the mental health landscape, ultimately benefiting countless individuals and families nationwide.
In a nutshell, Mental health challenges often go unnoticed or unaddressed in India due to social stigma and limited resources. Fortunately, social workers are on the front lines of the fight against depression and other related mental health issues. They act as advocates, educators, and supporters, working tirelessly to build awareness and provide crucial support to those in need. Their dedication and tireless efforts foster a more compassionate and mentally healthy society. To address India’s mental health crisis, a comprehensive approach is needed. This approach should address destigmatization, inclusion in public health programs, strengthening infrastructure, and affordability. By prioritizing mental well-being and providing much-needed support to those facing mental health challenges, India can foster a society that values mental health as much as physical health. It is imperative to act now, recognizing that mental health is as crucial as physical health for the well-being of the nation’s citizens. By addressing challenges such as destigmatization, inclusion in public health programs, strengthening infrastructure, and ensuring affordability, India can foster a society prioritizing mental well-being and providing much-needed support to those facing mental health challenges. The time to act is now, recognizing that mental health is as crucial as physical health for the well-being of the nation’s citizens.
References:
- Dhyani A, Gaidhane A, Choudhari SG, Dave S, Choudhary S. Strengthening Response Toward Promoting Mental Health in India: A Narrative Review.
- https://www.weforum.org/agenda/2022/02/india-mental-health/
- https://www.who.int/india/health-topics/depression
- https://thewire.in/society/why-many-indians-dont-trust-mental-health-advice
- https://timesofindia.indiatimes.com/blogs/The-underage-optimist/indians-are-still-living-in-denial-about-mental-health-issues/
- https://timesofindia.indiatimes.com/blogs/voices/why-mental-health-needs-a-big-boost-in-budget-2023/
- https://www.hindustantimes.com/lifestyle/health/india-fails-to-address-growing-mental-health-problem-101667038300362.html
- https://www.thelivelovelaughfoundation.org/blog/self-care-support/cultural-barriers-to-seeking-counselling-in-india