Mental Healthcare Status in India, Government Schemes and Initiatives

What is Mental Health?

• The WHO defines mental health as “a state of mental well-being that empowers individuals to manage life’s challenges, recognize their abilities, learn and work effectively, and contribute to their community.
• Additionally, the WHO recognizes mental health as a basic human right, essential for personal, community, and socio-economic development.
• Research indicates that positive mental well-being can lower the risk of heart attacks and strokes.

Harmful Effects of Poor Mental Health

• Impacts on physical health and lead to harmful behaviours.
  • Example: Conditions like depression have been associated with chronic illnesses such as diabetes, asthma, cancer, cardiovascular disease, and arthritis.
• During adolescence and early adulthood can severely hinder the ability to form safe and healthy relationships with peers, parents, teachers, colleagues, and partners.
• Impairs a person’s ability to focus and engage in productive activities, affecting overall performance.
• Individuals with mental health conditions are vulnerable to stigma, discrimination, violence, marginalisation, and other human rights violations.

Prevalence of Mental Health Problems in India

• WHO Estimates:
  • India has a burden of 2,443 disability-adjusted life years (DALYs) per 100,000 population due to mental health problems.
  • The age-adjusted suicide rate in India is 1 per 100,000 population.

• Economic Impact: The economic loss in India due to psychological health conditions is projected to be USD 1.03 trillion between 2012 and 2030.
• Mental Health Burden (2017 Estimation): In 2017, it was estimated that 197.3 million people in India required care for mental health conditions.
  • This includes approximately 45.7 million people suffering from depressive disorders and 44.9 million from anxiety disorders.
• Impact of COVID-19 Pandemic: The COVID-19 pandemic has exacerbated mental health issues, making it a critical global concern.
• BRICS Nations Comparison:
  • India and Ethiopia have the lowest number of psychiatrists per capita.
  • Ethiopia employs 0.1 psychiatrists per 1 lakh population.

Reasons for Poor Mental Health Status in India

• Lack of Awareness and Sensitivity: In India, mental health issues are often not regarded as healthcare concerns.
  • Example:
• Shortage of Mental Healthcare Personnel: India faces a severe shortage of mental health professionals.
  • Example: National Mental Health Survey (2015-2016) highlighted that India has only 0.75 psychiatrists per 1 lakh population.

• Treatment Gap: The National Mental Health Survey 2015-16 showed that 10.6 per cent of adults suffered from mental disorders in India while the treatment gap for mental disorders ranged between 70 to 92 per cent for different disorders.
• Low Budget Allocation: While developed countries allocate 5-18% of their healthcare budget to mental health, India allocates just 1.11% (interim budget 203-24).
• Changed Lifestyle: The increased use of social media has heightened stress and mental illness, particularly among young people..
• Income Inequalities: Individuals living in poverty are at a higher risk of developing mental health conditions.
  • Conversely, those with severe mental health issues are more likely to fall into poverty due to job loss and increased healthcare costs.

Steps Taken to Improve Mental Health in India

Legal Measures

• Mental Healthcare Act, 2017: This replaced the outdated Mental Healthcare Act of 1987.
  • The Act grants the Right to Access Healthcare, ensuring that every person can access mental healthcare and treatment through government-run or funded services.
  • It also allows individuals to create an advance directive specifying their preferred treatment for mental illness.
  • Additionally, the Act decriminalized suicide, recognizing that those who attempt suicide are under severe stress and should not be punished.
• Rights of Persons with Disabilities Act, 2017: This Act recognizes mental illness as a disability and aims to enhance the rights and entitlements of individuals with disabilities, providing an effective mechanism for their empowerment and inclusion in society.

Schemes and Initiatives

• National Mental Health Programme (NMHP): Launched in 1982, the NMHP integrates mental health services into the general healthcare system, aligning with WHO recommendations.
• Generating Awareness: Information, Education, and Communication (IEC) activities are integral to NMHP to raise awareness about mental illnesses.
• Tele Mental Health Assistance and Networking Across States (Tele-MANAS) initiative: Announced in the 2022-23 Budget, this programme aims to improve access to quality mental health counselling and care services across the country.
• Kiran: A 24/7 toll-free helpline launched by the Ministry of Social Justice and Empowerment in 2020 to support individuals dealing with anxiety, stress, depression, suicidal thoughts, and other mental health issues.
• Manodarpan: Part of the Atmanirbhar Bharat Abhiyan, this initiative provides psychosocial support to students to improve their mental health and overall well-being.

Further Steps to Improve Mental Health

• Combat Stigma: Address the deep-rooted stigma surrounding mental health issues, which prevents individuals from seeking timely treatment and leads to feelings of shame, isolation, and weakness.
• Integrate Mental Health into Public Health Programs: Make mental health an integral part of public health initiatives to reduce stress, promote healthy lifestyles, and identify high-risk groups.
  • Strengthen interventions such as counselling services, with a special emphasis on schools.
  • Additionally, focus on vulnerable groups, including victims of domestic or sexual violence, unemployed youth, marginal farmers, armed forces personnel, and those working in difficult conditions.
• Enhance Infrastructure for Mental Health Care: Train community health workers (ASHAs) to educate and sensitise women and children about mental health issues and guide them to appropriate experts in their locality.
• Increase Budget Allocation for Mental Health: Substantially increase budget allocations for mental healthcare to address the wide treatment gap in health infrastructure and human resources.
• Undertake Careful Mapping and Research: Conduct thorough mapping and research to produce quality data, essential for understanding the scope of the problem.
• Follow WHO’s Three Paths to Transformation: Implement the WHO’s recommended three paths to transformation for improving mental health outcomes.

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