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

mental health
The connection between poverty and mental health is not surprising. The severe emotional strain and stresses associated with making ends meet, poor nutrition and unfavorable living conditions can be extremely high. Depression can be up to two times more prevalent among low-income groups and people with the lowest socioeconomic status are eight times more at risk for schizophrenia.

Yet this problem does not receive adequate attention in many places, partly due to the societal stigmas sometimes associated with mental health issues. Only two percent of national health budgets is dedicated to mental health and up to 31 percent of countries do not have a mental health budget at all.

In India, a string of farmer suicides have been making headlines. Driven to depression by rising debt, small farmers who are unable to make a profit with the scarcity of rainfall and falling prices of crops commit suicide. According to a CNN report, in 2013, 11,722 farmers killed themselves across India. The suicides plunge families further into financial insecurity and hopelessness. Government interventions are crucial to curb these disturbing losses of life. Policies pertaining to land reform, industrialization, agriculture, poverty alleviation, availability of financing and compensation to farmers are all going to be needed to alleviate the burdens on small farmers.

Stigma and isolation complicate matters in treating mental health issues. People who suffer from mental health issues are often discriminated against or are discouraged from seeking treatment.

In some parts of the world, mental problems can be regarded as a sign of an evil spirit. Sufferers are seen by traditional or spiritual healers and are not treated by counselors or psychiatrists. Decades of superstitions and beliefs are hard to overcome, particularly when dealing with a delicate problem.

Many organizations and projects are trying out methods to provide mental healthcare to affected populations, including projects like the Zimbabwe based Friendship Bench Project, which provides counseling sessions, the international Programme for Improving Mental Health Care, which researches on methods to scale up delivery of mental healthcare and India based Sangath, which trains lay people in counseling and works with other nongovernmental and governmental organizations to evaluate and launch models for mental healthcare. Dr. Vikram Patel, co-founder of Sangath, was recently named one of TIME’s 100 most influential people. This might aid in bringing more attention to this urgent issue.

While the Millennium Development Goals can go a long way towards alleviating poverty, which will reduce many of the stressors, mental health issues need to be given importance as a public health issue and duly addressed.

Mithila Rajagopal

Sources: CNN, Prime, Sangath, SciDev, Times of India, World Health Organization
Photo: Flickr