Q. According to the WHO, health is a state of complete physical, mental and social well being. In
this context, discuss emerging trends in mental health issues in India.
• Briefly, elaborate the statement in question.
• Discuss emerging trends in mental health issues in India.
• Identify the steps needed to address them.
• Conclude accordingly.
WHO defines Health as complete physical, mental and social well-being and not merely the absence of disease or infirmity. It depicts the wholesomeness of a human being understood as a composition of bodily, emotional, intellectual, and social as well as material parts.
In this context, the importance of mental health cannot be understated. According to a recent study in medical journal Lancet one in seven Indians were affected by mental disorders of varying severity in 2017. Following emerging trends in mental health issues in India can be observed:
-Increase in mental illness burden: The contribution of mental disorders to the total disease burden has doubled in India from 1990 to 2017. In 2017 there were 197.3 million people suffering from mental disorders in India, comprising 14.3% of the entire Indian population. WHO predicts that by 2020, roughly 20% of India will suffer from mental illnesses. Mental illnesses constitute one-sixth of all health-related disorders.
- Increase in depression and anxiety disorders: Among mental disorders, the most common are depression and anxiety disorders with 45 and 46 million people suffering from each respectively. Their prevalence is relatively higher in the southern states and in females. Further, the prevalence of depression is highest in older adults, which has significant implications for the ageing population of India. The positive association of these with suicide deaths makes the situation grave.
- Decrease in childhood onset mental disorders: The prevalence of childhood onset mental disorders such as idiopathic developmental intellectual disability, conduct disorders, and autism is higher in the northern states but has decreased across India in the period of 1990- 2017.
There is a shortage of mental health personnel in India, with two mental health workers and 0·3 psychiatrists per 1,00,000 population, which is much lower than the global average.
Thus, there is need to undertake following measures to address mental health issues:
• Increase funds allocation: The budget allocated for mental health is 0.05% of the total healthcare budget. Budget 2020 has not increased the allocation for the National Mental Health Programme (NMHP), even though the total healthcare budget saw a 7% increase. The government needs to increase funding to ensure access of mental health care and treatment from services run or funded by the government to every affected person under the Mental Health Care Act.
• Strengthening the role of communities and families in addressing mental health by reducing stigma and discrimination, raising awareness, and promoting inclusion. School-based mental health programmes can help improve mental health in children.
• Strengthening human resources: Task-sharing with non-specialists to raise awareness and appropriate training of community health workers to sensitise the patients and their families to the mental condition along with increasing seats in psychiatry could improve the mental health treatment.
• Telemedicine to provide mental health services in remote and inaccessible areas, internet- based and telephone-based helplines, and mental health mobile apps can reduce the burden on existing mental health services.
Mental health disorders are one of the highest contributors to productivity loss. It might not cause immediate death but it leads to morbidity. The cost incurred by the government due to such productivity loss is actually more than it would have to spend to kick-start the mental health sector. Thus, the above steps should be set in motion at the earliest