Context:

• This article is based on the news “This article is based on the news “India’s Mental-health problem is obscured  by stigma, dearth of data” which was published in the Mint. Mental health-related issues are rising in India according to the Standing Committee on Health and Family Welfare, which tabled its 148th report on ‘Mental Health Care and Its Management in Contemporary Times’, in Parliament. 

Parliamentary Committee Report on Mental Health Care: Key Findings

• The Committee has  expressed its worry about the decrease in funding of tertiary care programs and noted that it feared that the reduced budgetary allocation would hamper the state of tertiary-level mental health institutions in the country.
• Despite one in every seven Indians suffering from mental disorders, with onset seen as early as age 14 (Global Burden of Disease Study, 1990-2017), the discourse around mental-health is insufficient. 
• World Mental Health Day 2023 was celebrated on (October 10) with the theme “Mental health is a universal human right” to promote  mental-health as a universal human right.

Also read: Spare a Thought for Psychiatric Caregivers too

What is Mental Health?

• The WHO defines mental health as a state of well-being in which a person realizes their abilities, copes with the normal stresses of life, works productively and makes a contribution to the community. 
• Researchers have identified:
• • poverty, childhood adversity, and violence as the three main risk factors for the onset and persistence of mental-health disorders.
  • Social Media detracts from face-to-face relationships, which are healthier, and reduces investment in meaningful activities.

What is the burden of mental health in India? 

• The National Mental Health Survey (NMHS) of 2015-2016 highlights 150 million adults live with a mental disorder and require access to care services, but the majority are unable to access treatment.
• According to WHO, India’s suicide rate in 2019, at 12.9/1,00,000, was higher than the regional average of 10.2 and the global average of 9.0. Suicide has become the leading cause of death among those aged 15–29 in India.
• Impact of COVID on mental health:  The Parliamentary Committee highlighted the adverse impact of the COVID-19 pandemic on the psycho-social well-being of all groups, especially children, adolescents, and caregivers. 
  • It noted the need for evidence-based intervention on developing infrastructure and other policies around mental-health.  

What are the major mental health challenges in India?

• Slower Implementation of Policies: The Rashtriya Kishor Swasthya Karyakram was rolled out in 2014. But despite having been in operation for nearly a decade, the mental-health strategies under this policy have been implemented painfully slowly.
• Underreporting of Mental-Health Issues: In India, mental health disorders are underreported due to poor awareness, lack of help-seeking behavior (stemming from stigma).
• Equity in Healthcare: Equity  remains a significant issue in India, and this also extends to mental-health. 
  • For example: Access to mental-healthcare services is often skewed along the same lines – wealth, caste, location, gender, etc.
• Understaffed Health Care:  India’s mental health care system faces a glaring challenge of severe understaffing. 
  • For example: As per WHO’s data there are merely three psychiatrists and psychologists for every 100,000 people in the country. This scarcity, exacerbated by the pandemic’s impact, is projected to worsen, potentially affecting up to 20 percent of the country’s population with mental disorders. 
• Poor Infrastructure: As per the paper published in the Indian Journal of Psychiatry around 56,600 public psychiatric beds existed for 130 crore people.
• Affordability: Experts have identified poverty and discrimination as key contributors to the treatment gap; affordability remains a major factor in availing treatment. 
  • For Example: A recent study published in the Indian Journal of Health Management found that spending on mental disorders pushed around 20% of Indian families into poverty. 

What are the Government initiatives on mental health?

• National Mental Health Policy(2014): It calls for a more accessible and holistic treatment of mental illnesses and advocates for the decriminalisation of attempted suicide. 
• Mental-Healthcare Act, 2017: It discourages the long-term institutionalization of patients and reaffirms the right of people to live independently and within communities.
• National Mental Health Programme (NMHP): It was re-strategize as the District Mental-Health Programme (DMHP) to decentralize mental care.
• Ayushman Bharat:The government has released operational guidelines on mental, neurological and substance use disorders at health and wellness centers (HWC).
• National Tele-Mental Health Programme (NTMHP): It aims to use digital technology to address growing mental-health challenges and improve access to quality mental-health counseling and care services in the country.

Way Forward

• Convergent model of Mental Health: Policymakers should endeavor to shift from the current “medical model” of mental-health to the convergent model of mental-health.
  • The latter recognises the complex interplay of behavioral, environmental, biological, and genetic factors throughout an individual’s life, especially during the crucial stages of childhood and adolescence. 
• Learning from Global Experiences: Programs like Rashtriya Kishor Swasthya Karyakram can learn from the experiences of other countries to better implement its vision.
  • For example, the successful implementation of the ‘Whole School, Whole Community, Whole Child’ model in the U.S. embraces a holistic approach to children’s well-being by considering factors such as nutrition, physical activity, and emotional health within the school environment.
• Strengthening of  mental health facilities: A recent Standing Committee report tabled in Parliament highlighted that the high treatment gap for most illnesses was due to a lack of mental-health professionals, poor infrastructure and stigma. 
  • The panel suggested the government strengthen mental health facilities at primary and secondary levels to improve overall availability and accessibility of mental-healthcare for all.
• Multi-Pronged Approach: The government should continue to make the improvement of school environments and health-promoting conditions a priority in parallel with efforts to combat pressing health concerns like malnutrition and anemia.
• Creation of Mental Health Cadre: A new cadre of community mental-health workers (CMHW) may also be created at the Primary Health Centre level for screening and facilitating treatment as recommended by policymakers.
• Public Figures, Raising Mental Health Awareness: When a celebrity speaks up about their mental-health struggles and encourages mental-health treatment, it can raise awareness on a wider scale and send the message that it’s okay to ask for help.
  • For Example: Actor Deepika Padukone is a role model that other public personalities with mental-health issues need to follow to show how they can lead productive lives for common man.

Conclusion:

In light of India’s escalating mental health challenges characterized by insufficient funds, societal stigma, and limited awareness, a holistic strategy with augmented funding, community-driven programs, and stigmatisation ndeavors is essential to establish mental well-being as a universal human right for every Indian.