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Saturday, November 26, 2022

De-Stigmatizing Mental Health

Good mental health is indispensable for the holistic well-being of people. Mental illnesses contribute 18.5% of the global disease burden including depression, anxiety and neuro-psychiatric disorders.

Covid-19 pandemic has highlighted that poor mental health incapacitates communities and erodes productivity of the nation besides imposing huge economic costs. The absence of adequate infrastructure, accessibility, and awareness is a major roadblock in the development of Mental Healthcare in India, that requires serious attention.

What is the Status of Mental Healthcare in India?

  • Mental health encompasses emotional, psychological, and social well-being. It influences cognition, perception, and behaviour. It also determines how an individual handles stress, interpersonal relationships, and decision-making.
    • Any disturbance in mental health affects the cognition, perception, and behaviour of a person to a greater extent.
    • In India, according to National Institute of Mental Health and Neuro-Sciences data, more than 80% of people do not have access to mental healthcare services for a multitude of reasons.
  • Initiatives by Government of India:
    • National Mental Health Program (NMHP): The National Mental Health Program (NMHP) was adopted by the government in 1982 in response to the large number of mental disorders and shortage of mental health professionals.
      • District Mental Health Programme (DMHP), 1996 was also launched to provide community mental health services at the primary health care level.
    • Mental Health Act: As part of the Mental Health Care Act 2017, every affected person has access to mental healthcare and treatment from government institutions.
      • It has significantly reduced the significance of Section 309 IPC and attempts to commit suicide are punishable only as exceptions.
    • Kiran Helpline: In 2020, the Ministry of Social Justice and Empowerment launched a 24/7 toll-free helpline ‘Kiran’ to provide mental health support.
    • Manodarpan Initiative: It aimed at providing psychosocial support to students, teachers, and family members during the Covid-19 pandemic.
    • MANAS Mobile App: To promote mental wellbeing across age groups, the Government of India launched MANAS (Mental Health and Normalcy Augmentation System) in 2021.

What are the Challenges Related to Mental Health in India?

  • Poverty Adding Vulnerability: Most strongly associated factors with mental disorders are deprivation and poverty. Individuals with lower levels of education, low household income, lack of access to basic amenities are at high risk of mental disorder.
  • Women at Spotlight: Due to a variety of social stigma and gender disparity, lack of access to education, limited mobility, added household responsibilities for working women, conditioning them into honed caregivers make them vulnerable to a variety of mental health issues.
    • Also, the National Family Health Survey of 2019-2021 showed that an overall 30% of women in India face gender based violence putting a third of all women in India at higher risk of developing anxiety disorders and depression.
  • Disaster, Climate Change and Mental Health: Disasters are potentially traumatic events which affect millions of people around the globe every year.
    • Many studies reported there were increased short term and long-term mental health consequences, such as depression, post-traumatic stress disorder (PTSD), anxiety and suicide among disaster survivors.
    • The Intergovernmental Panel on Climate Change (IPCC) revealed that rapidly increasing climate change is also posing a serious threat to mental health and psychosocial well-being, by amplifying disaster events.
  • Education System and Mental Health: Due to lack of stress on personalised and holistic educational structure in India, a large % of students show signs of mental disorders. Shockingly, every 1 hour a student commits suicide in India.
    • Children and young adults have complicated emotional eco-systems that are easily affected by surroundings, including parental pressure for good grades, social media engagements and relationship issues, which affect their mental health to a great extent.
  • Discrimination and Negligence: Mentally ill patients are vulnerable to discrimination, physical and sexual abuse, wrongful confinement, even at homes which is a cause of concern and a gross human right violation.
    • Specially, people with disabilities face a variety of structural and ideological challenges that have little to do with their actual limitations.
      • They experience abuse and neglect more often than the general population that further limits their participation in everyday life.
  • Lack of Awareness: Most of the mental health patients are not aware that it is actually a disease of concern and remain untreated. Poor awareness about symptoms of mental illness, myths & stigma related to it, lack of knowledge on the treatment availability & potential benefits of seeking treatment, makes a large number of patients deprived of care.
  • Lack of Mental Health Resources: Also, lack of low-cost diagnostic tests and lack of easily available treatment are the main hurdles in combating the problem of mental health in India.
    • There is a considerably low proportion of the mental health workforce in India (per 100,000 population) including psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07).
    • In addition, beliefs in supernatural powers for treatment in community delays diagnosis and treatment.

What Should be the Way Forward?

  • Inclusive and Resilient Healthcare Infrastructure: There is a need to build more inclusive and resilient healthcare infrastructure incorporating mental health aspects with emphasis on collective social health, access to affordable and quality care based on human rights and with psycho-social approach rather than following the traditional biomedical paradigm.
    • There is also a need to upgrade physical infrastructure and strengthen human resources by training more mental health professionals and skilled health workers especially for rural areas.
  • Mental Health Awareness: It is crucial to deconstruct the stigma related to mental disorder, through targeted awareness-raising and outreach through campaigns, utilising celebrities and social influencers.
    • There is also a need to mobilise support of NGOs to rural areas and deeper engagement of local communities and local governments.
  • Expansion of Yoga and Meditation Centres: Expansion of yoga and meditation would also provide enormous relief.
    • Their capacities can be built by civil society in collaboration with community-based organisations, but these initiatives have to be strongly supported by the Government.
  • Concerted Suicide Prevention Strategy: India needs a ‘Concerted Suicide Prevention Strategy’ at the national, state and local level.
    • At school level, Mentor-mentee programmes can be introduced to allow students to express themselves freely to their mentors and prevent them from falling into mental disorder pitfalls.
  • De-Stigmatizing Mental Health: This apathy can be mitigated if the focus shifts from viewing mental health as a negative concept to a social responsibility of improving health literacy, setting up self-help groups, and providing emotional support to the concerned.

For Prelims: National Mental Health Program (NMHP), Kiran Helpline, Mental HealthCare Act 2017, Mental Health and Normalcy Augmentation System, National Family Health Survey of 2019-2021, Climate Change and Mental Health.

For Mains: Status of Mental Healthcare in India, Challenges Related to Mental Health in India, De-Stigmatizing Mental Health.

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