The Burden Of Mental Health Disorders In India: What Is Needed To Be Done?

This article talks about the prevalence of mental health disorders in India, challenges in tackling the problem, as well as strategies required to reduce the burden.

Mental wellness may seem like a personal problem, but it impacts society as a whole. NOT a thing to be proud of, but India tops the list of the prevalence of mental illness globally. Dr Navya Saluja, Consultant Psychiatrist and Medical Officer In-Charge at Sukoon Health discusses the burden of mental health disorders across the states of India.

According to the National Mental Health Survey 2016, close to 14 percent of India’s population required active mental health interventions. One in seven Indians were affected by mental disorders of varying severity in 2017 and the numbers have only risen since then. World Health Organisation (WHO) estimates that the burden of mental health problems in India is 2443 disability-adjusted life years (DALYs) per 100,00 population. The age-adjusted suicide rate per 100,000 population is 21.1 and the economic loss due to mental health conditions, between 2012-2030 is estimated at USD 1.03 trillion.

These are fairly alarming numbers and are telling of a more serious, underlying problem in society. Mental health disorder including anxiety/phobias, eating disorders, stress, and more serious ones like schizophrenia, bipolar disorder, depression, suicidal tendency, substance use disorders and personality disorders impacts the quality of life, throws challenges to the sufferer at school, college or workspace level, and reduces overall productivity. There could be social and financial implications, abuse vulnerability, and physical health concerns. The overall impact isn’t just personal, but it has major social repercussions too.

Delving deeper into the problem

One of the greater challenges of mental health discussion in India is the paucity of public mental health research in our country. The last sizeable study done to understand the state-specific trends of each mental disorder was The Burden of mental disorders across the States of India: The Global Burden of Disease Study 1990 2017. It showed that nearly 45 million people suffered from mental health disorders, and most Indian states that housed a large part of the population showed a low progress performance in the index. States like Maharashtra and several northeastern states bear a heavier burden of mental health issues amongst their citizens than the country’s central and northern states. The study reported that Kerala, Karnataka, Telangana, Tamil Nadu, Himachal Pradesh, Maharashtra, Andhra Pradesh, Manipur, and West Bengal have the highest prevalence of anxiety disorders. A state-specific study of trends of each mental disorder like this is important to guide appropriate policies and health system responses that can effectively address the burden of mental disorders across regions in India.

Change the narrative

Having said that, mental health is still a fairly new topic for us. Laced with myths and taboos, it is not a priority area for our policymakers even today. However, to tackle the burden of mental health disorders, it is imperative that policymakers, healthcare providers, and society at large work in tandem. Implementing the National Mental Health Act 2017 is a good place to start. A progressive act, unfortunately, its implementation and adoption have been restricted. A study done by Deloitte, Mind Matters: A perspective on the mental health landscape in India highlights the lack of mental health boards at the state and district level to drive the agenda. It also points to the fact that while the Act mandates insurance providers to cover mental health along the same lines as physical illness, the enactment has been flawed. One can also tap into digital solutions to tackle capacity issues, however currently, these are rudimentary, have operational issues, and are not scalable. The inadequate focus on mental health in medical curricula is also a pressing concern, and so is the dearth of institutions carrying out research on the subject, which could provide better evidence for correct initiatives. The lack of capacity (number of psychiatrists, psychologists, and social workers), especially in rural areas, is also a major crisis. So is the government and private sector long-term funding it affects the implementation of great initiatives.

A top concern

Mental health issues can cause homelessness, incarceration in prisons, and a lack of educational and income-generation opportunities. Often, the sufferers’ human rights are violated when they are subject to unhygienic and inhuman living conditions, physical and sexual abuse, and neglect. They are even denied rights (marriage, family, and leading normal life in public, etc.). All of these hinder economic development at a national level and if you do the math, the negative economic consequences of mental illness far exceed the costs of treatment. Coming to think of it, some of the costs due to the illnesses can be measured in monetary terms while many others cannot be quantified.

Policymakers and healthcare professionals must promote mental wellness, focusing on creating an environment that encourages healthy living and motivates people to adopt healthy lifestyles. Also, the treatment of mental health disorders calls for comprehensive strategies that must be publicised by highlighting the availability of and access to cost-effective treatment of common mental disorders even at the primary healthcare level. All of this could be a good start to eradicate a larger societal problem at hand.