Skip to main content

Mental healthcare: India faces treatment gap of 50-70%

By Moin Qazi*
According to an India Spend report, the number of Indians suffering from mental illness exceeds that of the population of South Africa. At present, the mentally ill account for nearly 6.5 percent of the country’s population and it is estimated that by 2020 this number will increase to a staggering 20 percent. Further, the World Health Organisation estimates that nearly 56 million Indians — or 4.5% of India’s population — suffer from depression. Another 38 million Indians –or 3% of India’s population -suffer from anxiety disorders. Many of these people live with both. . Many of these illnesses can be treated, but access to treatment is often difficult, and stigma continues to scare individuals away from seeking diagnosis and appropriate treatments even when they are available.
As the world observed World Mental Health Day on 10th October, it is time India renews its efforts to improve the mental health services. The abysmal state of mental health care in the country is a cause for great concern and India cannot afford to ignore some of the stark realities. Most government-run hospitals do not have psychiatric drugs, and visiting a private shrink and sustaining the treatment — usually a long drawn out affair — is an expensive proposition for most families.
According to the Ministry of Health and Family Welfare report, India faces a treatment gap of 50-70 percent for mental healthcare, implying that more than half of the population does not get the required treatment and medical facilities. The government data highlights the dismal number of mental healthcare professionals in India — 3,800 psychiatrists, 898 clinical psychologists, 850 psychiatric social workers, and 1,500 psychiatric nurses nationwide. The WHO reports that there are only three psychiatrists per million people in India, while in other Commonwealth countries, the ratio is 5.6 psychiatrists for the same.
By this estimate, India is short of 66,200 psychiatrists. Similarly, based on the global average of 21.7 psychiatric nurses per 100,000 people, India needs 269,750 nurses
Mental health accounts for 0.16 percent of the total Union Health Budget, which is less than that of Bangladesh, which spends 0.44 percent .The developed nations’ expenditure amounts to an average of 4 percent."
A National Institute of Mental Health and Neurosciences (NIMHANS) survey estimates that 13.7 percent of the Indian population above the age of 18 suffers from mental morbidity, requiring active intervention. It also suggests that one in every 20 Indians suffers from depression. Nearly 1 percent of Indians suffer from high suicidal risks. Almost 9.8 million children in the age group of 13-17 years are suffering from mental health concerns and require an active intervention.
The World Bank has recently identified mental health as a Global Development Priority which recognizes the critical impact mental health has on economic development and well-being. The economic consequences of poor mental health are equally significant. .A World Economic Forum/Harvard School of Public Health study estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to $16.3 trillion between 2011 and 2030. In India, mental illness is estimated to cost $1.03 trillion (22% of economic output) between 2012-2030.
A majority of those with these illnesses can recover and lead fulfilling lives such as going to school, working, raising a family, and being productive citizens in their communities. Although mental illness is experienced by a significant proportion of the population it is still seen as a taboo issue. These barriers deprive people of their dignity. To make dignity in mental health a reality requires every member of society to work and take action together
.A field-based research study in the prestigious medical journal The Lancet (by Pandit et al) concludes, “Most Indians do not have community or support services for the prevention of suicide and have restricted access to care for mental illnesses associated with suicide, especially access to treatment for depression, which has been shown to reduce suicidal behaviours.” Counseling has a great role to play in alleviating stress and helping depressed people improve their self-esteem and their ability to cope with despair.
There have been some encouraging innovations in India led by voluntary organizations that are both impactful and replicable. Dr. Vikram Patel, who is a professor at the London School of Hygiene and Tropical Medicine and co-founder of Goa-based mental health research nonprofit Sangath, is in the forefront of community mental health programmes in Central India.
The programme is designed to establish a sustainable rural mental health support to address issues relating to stress and tension that abet suicides alcohol abuse and depression in the rural community .It deploys health workers from within the community, some with no background in mental health. These workers are trained to raise mental health awareness and provide “psychological first-aid”. The program also includes counselors who are imparted mental health literacy. The third line of workers consists of expert psychiatrists, who are qualified to provide medications for more serious mental health disorders. The programme uses Primary Health Centres for screening and feeding people with mental illnesses.
Dr. Patel’s vision has been the provision of superior mental healthcare to low-resource communities. He argues that 90 per cent of people affected by mental illnesses go untreated owing to the paucity of psychiatrists. Importantly, his research has effectively demonstrated that evidence-based treatments for mental illnesses can be delivered in low-income countries by non-specialist healthcare workers. His work has been applauded by TIME magazine which featured him in its annual list of annual list of the 100 most influential people in the world.
Dr. Patel feels that mental health problems are still perceived by many as rich man’s diseases. It is assumed that if you are poor, then the symptoms of depression are simply an expression of the misery of your life. Contrary to public belief, mental suffering is not a natural consequence of poverty and those who are poor and depressed deserve, if anything, even more attention than the rich.
A lot of good programmes got their start when one individual looked at a familiar landscape in a fresh way. These creative and passionate individuals saw possibilities where others saw only hopelessness, and imagined a way forward when others saw none. We increasingly have the tools; but we need to summon the will the way game changers like Dr. Patel are doing. People like him have shown there are solutions if we think out of the box. And don’t accept limits to how the world works.

*Author of the bestselling book, “Village Diary of a Heretic Banker”, has worked in the development finance sector for almost four decades

Comments

TRENDING

Crucial to revisit roots, embrace core Hindu principles: love, compassion, harmony

A note on religious leaders'  Satya Dharam Samvad in Haridwar: *** In a groundbreaking gathering, more than 25 religious leaders including Swamis, Acharyas, Pujaris, Gurus, and Sadhvis from all over India convened to discuss the tenets of Hinduism on September 16th, 2023, in Haridwar, to discuss and discern the current trajectory of Hinduism. This brand new initiative, the Satya Dharam Samvad, was inspired to organize its first assembly in response to the December 2021 Dharma Sansad, where hate speech and calls for violence against the Muslim community contravened the essential principles of Hinduism. Religion is being used to incite riots among Hindus, Muslims, Christians, Buddhists, Jains, etc. In the face of such hatred, Swami Raghavendra felt that something meaningful should be done in the present climate. 

Maoist tendency of mechanically adhering to Chinese path ignores Indian conditions

By Harsh Thakor  The C.P.I. (Maoist) formed in 2004 with merger of the C.P.I. (M.L) Peoples War and the Maoist Communist Centre has demonstrated courage in intensity compared to any great revolutionary struggle in the history of the world. It leads the largest armed movement of a Peoples Guerrilla Army in the world today and proved themselves as the true torch bearers of the Indian Communist movement.

Significant step towards empowering and particularly engaging with informal workers

ActionAid note on drive to empower informal sector workers Odisha with the support of District Labour Department: *** The Odisha Unorganised Workers Social Security Board (OUWSSB) facilitated an Unorganized Workers Awareness Camp at the Red Cross Bhawan in Bhubaneswar, Odisha. The event took place in collaboration with the District Labour Department at Khordha, Centre for Child and Women Development and ActionAid Association. This informative event aimed at empowering informal sector workers by disseminating crucial information regarding their eligibility for various social security schemes provided by the Government of Odisha.

We need to resurrect Neruda, give birth to poets of his kind amidst neofascist rampage

By Harsh Thakor  On 23rd September we commemorate the 50th death anniversary of Pablo Neruda, whose contribution to revolutionary poetry was path breaking. Pablo Neruda’s poetry manifested the spiritual essence of revolutionary poetry and how poetry was a weapon for a revolutionary struggle. The story of his life illustrated the spiritual transformation undergone a human being to transform him into a revolutionary and how environment shapes the lie of revolutionary.

Dev Anand ably acted as westernised, urban educated, modern hero, as also anti-hero

By Harsh Thakor  On September 26th we celebrated the birth centenary of legendary actor Dev Anand. Dev Saab carved out a new epoch or made a path breaking contribution in portraying romanticism and action in Bollywood cinema, giving his style or mannerisms a new colour. Arguably no Bollywood star manifested glamour in such a dignified or serene manner or struck the core of an audience’s soul in romantic melodies. Possibly we missed this evergreen star being cast in a Hollywood film. Dev Anand is like an inextinguishable soul of Bollywood. Although not as artistic or intense as Dilip Kumar, Raj Kapoor or Ashok Kumar ,Dev Anand surpassed them all for liveliness or flamboyance, with his performances radiating g energy on the screen, in realms rarely transcended. In his own right, Dev Saab, was a craftsman, like his classical contemporaries, with a characteristic composure. Perhaps never was a Bollywood star so suave, bubbling or charming as Dev Anand, who often looked like an Indian versi

Grassroots NGO enlightens people of Kupwara with intricacies of Right to Information

J&K RTI Foundation and Founder Civil Rights Movement Kupwara note on how RTI Pend is empowering Kupwara with insights on Right to Information Act: *** RTI Pend, the grassroots initiative aimed at democratizing access to information, hosted its 2nd event in Kupwara. On the request of the Civil Rights Movement Kupwara, this event was tailored to enlighten the people of Kupwara with the intricacies of the Right to Information Act, presented in their local language and dialects. The event successfully bridged both offline and online participation, addressing queries on the spot and offering applicants practical solutions.

Abrogation of Art 370: Increasing alienation, relentless repression, simmering conflict

One year after the abrogation by the Central Government of Art. 370 in Kashmir, what is the situation in the Valley. Have the promises of peace, normalcy and development been realised? What is the current status in the Valley? Here is a detailed note by the People’s Union for Civil Liberties , “Jammu & Kashmir: One Year after Abrogation of Art. 370: Increasing Alienation, Relentless Repression, Simmering Conflict”:

Agro-biodiversity through seed identification, conservation, replication, crop selection

By Kuntal Mukherjee, Basant Yadav, Shivnath Yadav* This article is mainly based on a journey of the three of us since 2010 based on field experience, study of different articles, reflective journeys with local community based organisations, villagers and practitioners in Chhattisgarh. The slow growth of Agriculture in India with near stagnation in productivity since mid ‘80s in contrast to the remarkable growth during the green revolution period has come to the front as a great concern. In post WTO era Indian Agriculture has been witnessing structural changes, uncontrolled influx of agriculture goods and commodities from foreign countries due to open market nature. The gradual reduction in subsidies from internal production leads to increasing cost of production of agriculture produces at the farm gate. It causes gradual decrease in internal production as well as productivity and posing threats to small farm and stakeholders. 

Indian youth can choose political career which offers tremendous opportunities

By Sudhansu R Das  The Indian political sector is growing faster than any other sector in the world. This sector has been fully liberalised. Political career in India is open to any age group starting from 25 plus to 90 plus; people with any educational background, even an illiterate person can contest election in India. An old man or woman with multiple organ failure can become leader of a political party; they can control party workers from the hospital bed also. Social status, physical and mental ability seldom stand in the way of a political leader. Advanced age is not an issue which can be reversed with effortless ease. 

Commodification of road accident deaths: The hidden health hazard of motonormativity

By Chandra Vikash*  Jahnavi Kandula, an Indian student from Andhra Pradesh, studying in America was killed in a road accident by a police motor car in January 2023. Now, 8 months after the accident, a bodycam video of Daniel Orderer, who is the vice president of the Seattle Police Officers Guild, has gone viral on social media. He was laughing at her death and saying that “she was 26 years old, anyway… she had limited value… just give her $11,000 (ie Rs 9.13 lakh)”.