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Improving Mental Health in India

Mental Health in India
The COVID-19 pandemic has brought the crisis regarding mental health in India to the forefront. COVID-19 has led to various versions of isolation and insecurities for many Indian citizens.

Amid this crisis, the Indian Psychiatric Society’s survey has noted a significant increase in reported mental illness since the lockdown. This is an opportunity for the country to rework its mental healthcare system for its diverse population. The pandemic has affected the poor the most. The World Health Organization (WHO) has stated that mental health illness and poverty have a cyclical relationship in that extreme poverty triggers mental illness, which leads to further financial crises.

Government Initiatives

The government of India launched the National Mental Health Programme (NMHP) in 1982 and the Mental Health Care Act in 2017. The National Mental Health Programme focused mainly on increasing the reach of minimum mental health services for the poor. This encourages social development in general healthcare. After a gap of more than 20 years, the Mental Health Care Act mandated affordable mental health care, the right to make decisions and informed consent, the right to live in a community and the right to confidentiality. This Act more importantly decriminalized suicide.

The Mental Health Care Act is a step in the right direction with the aim of bringing mental healthcare to those who cannot afford it. Yet, almost 14% of the population still suffers from mental health disorders. While stigma and social stereotypes play a major role in the aggravation of these numbers, the nation’s budget invests very little into mental health. India as a developing country, spends only 0.05% of its subtotal health care budget on mental health.

De-stigmatizing Awareness

A study from 2017 suggested that 87% of the population was aware of mental illness and that 71% inculcated terms that propagate stigma. In 2015, Bollywood and Hollywood actress Deepika Padukone talked about her battle with depression on Indian television. By speaking about her struggles, she started a conversation about mental health in the nation. She also founded the Live Love Laugh Foundation which facilitates research and outreach on various levels. The Live Love Laugh Foundation provides free mental health care to the rural poor, educates caregivers and creates a community of awareness in rural Karnataka and Orissa. As of now, close to 3,000 direct beneficiaries have received treatment through the Foundation.

Organizations like The MINDS Foundation, Manas Foundation, The Banyan and Aasra along with many others are key in de-stigmatizing mental health in India. They often work as gap-fillers in a system that is out of reach for many. The World Health Organization (WHO) noted in a report in 2017 that there are less than two mental health professionals for every 100,000 people in the country. The Banyan, with its branches in Kerala, Tami Nadu and Maharashtra is an NGO that focuses on holistic mental health solutions for those who live in poverty in these states. It has over 16 centers and has reached a population of over 100,000.

Tele-health Initiatives

Universities, nonprofits and several hospitals have facilitated workshops, online counseling sessions and helplines. Tele-health calls have helped to bridge the gap between those who would normally shy away from in-person visits. However, it has been detrimental to those who lack access to these online facilities. The rural poor in India do not own the technology to be able to access facilities like e-prescriptions or telehealth calls. The transition of online healthcare into rural areas in India is a promising developmental venture.

Community-based Approaches

India’s allocated mental healthcare budget and prevalent social stigma surrounding it have emerged as the two major problem areas. Encouraging studies have paved the way for a community-oriented approach to practicing psychosocial therapy in the country. This will entail training community-based healthcare workers to serve as supervised non-specialist mental healthcare workers by following standard protocols. Sangath, an NGO based in Goa, New Delhi and Bhopal, is implementing this model through its programs. Sangath provides affordable mental healthcare by strengthening state and private sector services by training the community. Sangath is also working with policymakers to further develop as well as implement this model of care.

Resources During COVID-19

The India Research Center of the Harvard T.H. Chan School of Public Health has recounted a few tips for mental well-being during the pandemic. Mindfulness, breathing exercises, meditation, limiting news consumption, generosity and empathy are practices that are effective along with other useful resources that the school emphasizes. Here is a list of numbers one can contact during a mental health emergency in India.

In a country as plural as India, innovative approaches are essential factors of growth. The nation has a long way to go in order to climb up on the mental health and well-being ladder. However, NGOs and foundations are paving the way toward improved mental health in India.

– Anuja Mukherjee
Photo: Flickr

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What You Need to Know about Mental Health in India

Mental Health in IndiaIndia is home to more than one billion citizens. According to a 2015 World Health Organization (WHO) report, of that billion, 56 million suffer from depression and 38 million have anxiety disorders. When adjusted for population size, India is the country with the greatest burden of mental and behavioral disorders, leading some to call the lack of mental health care in India a burgeoning crisis.

Although India is working to improve the mental health of its citizens, initiatives have been slow going. Some roadblocks to improving mental health are the social stigma, its low priority in the healthcare budget and a shortage of mental health professionals.

Stigma

One major barrier to improving mental health in India is the social stigma around mental illness. According to a survey by the Live Laugh Love Foundation, of the 3,556 respondents, 47 percent could be considered judgmental of people with mental illnesses while 26 percent were categorized as being afraid of the mentally ill. This study looked at people between the ages of 18 and 45 from different socio-economic backgrounds. Surprisingly, most of the respondents in those categories were well educated and from higher social classes. When asked to describe the mentally ill, many used derogatory terms or harmful stereotypes.

However, 26 percent of the respondents were categorized as supportive of people with mental illnesses. These respondents tended to be younger—between the ages of 18 and 24—and from a relatively lower educational and socio-economic background.

Advocates and activists are also working to destigmatize mental health in India. Recently, India passed the Mental Health Care Act of 2017, which protects the rights of people with mental illnesses so that they are treated without discrimination.

Low Priority

According to a 2015-16 survey by the Bengaluru-based National Institute of Mental Health and Neuroscience, 150 million Indians are in need of mental health care, but only 30 million have access to the care they need. Although India began implementing its National Mental Health Program in 1982 with the goal of integrating mental health care with general care, the rollout has been slow. As of 2015, only 27 percent of the 630 districts intended to have a mental health program had created one. The District Mental Health programs have also struggled with inaccessible funding and administrative issues like an inability to fulfill the required number of professionals for each district.

While this program has struggled, the government has been working on other means of improving mental health in India. In 2014, it began implementing its first National Mental Health Policy, which aims to increase funding for training mental health professionals and universal access to mental healthcare.

A Need for Mental Health Professionals

Perhaps one of the biggest roadblocks to improving mental health, though, is the extreme shortage of mental health professionals. In 2014, the WHO found that there is on average only one mental health professional for every 100,000 citizens. These doctors, psychiatrists and psychologists tend to be overworked leading to misdiagnoses in too many cases.

One way the government of Karnataka in southwest India has been trying to fill in the gap is with community health workers called accredited social health activists or ASHA workers. Though they usually are women who council other women in their communities on pregnancy, breastfeeding and parenting, in 2016, they began training these workers to identify and deal with mental health issues. While ASHA workers can help fill some of the gaps, there remains a need for more specialized care. India’s National Mental Healthcare Policy and District Mental Healthcare Policy is a good start, but for it to be successful, the Indian Government has to be proactive in training mental health professionals.

While people with mental illnesses are still struggling, the topic of mental health in India is gaining traction. Activists are working to destigmatize and protect people with mental illness while the government is working to increase accessibility to mental health professionals.

– Katharine Hanifen
Photo: Flickr