Economic Survey 2023-24: Addressing Mental Health at the Economic Level for the first time ever

For the first time ever, the Economic Survey 2023-24, tabled in Parliament discusses extensively about mental health, its significance, and its implications on policy recommendations.

Mental Well-Being

• Concept: Mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community. 
  • It is an integral component of health and a basic human right. 
  • Mental health is more than the absence of mental disorders.
• Interconnected Aspects: Mental well-being is intertwined with physical, social, and emotional health.
• Range of Mental Health Conditions: Mental health conditions include mental disorders, psychosocial disabilities, and mental states associated with significant distress, impairment in functioning, or risk of self-harm.
• Impact of Mental Health Concerns: Mental health concerns, from minor stressors to severe disorders, can have an impact throughout an individual’s lifetime.

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Mental Health Issues through the lens of Economics

• Productivity Losses: The Economic Survey points out that at an aggregate economic level, mental health disorders are associated with significant productivity losses due to 
  • Absenteeism, 
  • Decreased productivity, 
  • Disability,
  • Increased healthcare costs, etc. 
• Poverty and Mental Health: There is also evidence of poverty affecting the risk of mental health via stressful living conditions, financial instability, and a lack of opportunities for upward mobility, which contribute to heightened psychological distress.

National Prevalence of Mental Health

• Mental health is recognized as a significant driver of both individual and national development 
• As per the National Mental Health Survey (NMHS) 2015-16.
  • 10.6% of adults in India suffer from mental disorders.
  • Treatment gap for mental disorders ranges between 70% and 92%, depending on the disorder.
• Urban vs. Rural Disparities: Mental morbidity prevalence is higher in urban metro regions (13.5%) compared to:
  • Rural areas (6.9%)
  • Urban non-metro areas (4.3%)
• Adolescent Mental Health: As per the NCERT’s Mental Health and Well-being of School Students Survey, there is an increasing prevalence of poor mental health among adolescents, exacerbated by the COVID-19 pandemic.
  • 11% of students report feeling anxious.
  • 14% report experiencing extreme emotions.
  • 43% experience mood swings.

Key initiatives and Policies Taken by the Government for Mental Health

Recognizing mental health as a fundamental aspect of overall well-being, the Survey underscores key initiatives and policies taken by the Government in this regard:

• National Mental Health Programme: Under this programme, Central funds to districts under the national health mission for integrating mental health at primary healthcare level and improving mental health infrastructure.
  • Under the District Mental Health Programme of this scheme,  more than 1.73 lakh Sub Health Centres, Primary Health Centres, Urban PHCs and Urban Health and Wellness Centres were upgraded to Ayushman Arogya Mandirs providing mental health services.
• Manodarpan (Counselling during COVID-19) : It is a Web Page and national toll-free helpline for seeking psychological support for students.
• National Tele Mental Health Programme: This programme aims to provide Universal Access to mental health counselling through Toll-free number.
• Increasing Mental Health Personnel: 
  • 25 Centres of Excellence were sanctioned to increase PG students’ intake,
  • Mental health services provisioned for 22 AIIMS, 
  • Three Digital Academies providing online training courses to general healthcare medical and paramedical professionals set up.
• Rashtriya Kishor Swasthya Karyakram: This programme was designed for the Holistic development of the adolescent population.
  • Adolescent Friendly Health Clinics (AFHC) and Peer education programmes were conducted across the country.
• Ayushman Bharat School  Health & Wellness  Programme: For the Sensitising and training Health and Wellness Ambassadors (teachers).
• Use of ICT: Live interactive sessions SAHYOG through PM eVidya DTH channels, yoga sessions, etc. for providing support to the children of our country.

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Global Initiatives on Mental Health

• Mental Health as a Human Right: The UN Human Rights Office has recognised Mental health as a fundamental human right.
• World Mental Health Day: It is observed on 10th October every year for raising awareness of mental health issues around the world and mobilising efforts and resources in support of mental health.
• WHO’s Comprehensive Mental Action Plan 2013-2020: This Plan was adopted by the 66th World Health Assembly.
  • The action plan recognizes the essential role of mental health in achieving health for all people. 
  • It is based on a life-course approach, aims to achieve equity through universal health coverage and stresses the importance of prevention.
• Mental Health Atlas: The Mental Health Atlas was launched by WHO in 2017 and is released every three years.
• • It is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability and utilisation of services and data collection systems.
• Sustainable Development Goals (SDG’s): Suicide prevention is included in the Sustainable Development Goals 3.

Policy Recommendations on Mental Health

The Economic Survey of 2024 stresses on proper implementation of the programmes to accelerate the improvements made in mental healthcare on the ground and address gaps in the existing programmes to maximise their effectiveness.

Some of the important policy recommendations included in the latest Economic Survey are as follows:

• Increasing Mental Health Professionals: Redoubling efforts to increase the number of psychiatrists, from 0.75 psychiatrists per lakh population in 2021 to the WHO norm of 3 per lakh population
• Developing comprehensive guidelines for the excellence centres’ services: alongside mental healthcare professionals and users to understand their needs.
• Program Evaluation and Feedback: Assessing the effectiveness of the programmes by gathering feedback from the users, professionals, and stakeholders to make necessary changes and meet the needs of a wider population.
• Community Support and De-stigmatization: Nurturing peer support networks, self-help groups, and community-based rehabilitation programmes can help de-stigmatization of mental disorders and develop a sense of belonging.
• Collaboration and Partnerships: Partnering with NGOs to scale up efforts, share knowledge, and leverage resources to enhance future policies, to aid in identifying areas of improvement.
• Person-Centric and Recovery-Oriented Services: Involving individuals with personal experience with mental health problems in decision-making, service planning, and advocacy efforts can increase the person-centricity and recovery orientation of mental healthcare services
• Early Identification and School-Based Interventions: Sensitization of mental health at the preschool, Anganwadi level to provide precious early identification of disorders.
• Public Health Approaches: 
  • Standardisation of guidelines for mental-health services across government and private sector
  • A bottom-up, whole-of-community approach in addressing the topic of mental health and breaking the stigma.

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