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Mental Healthcare in India: Where do We Stand, and How to Improve the Landscape?

Dr. Ishita Mukerji

The Covid-19 pandemic has offered a unique opportunity to broaden the national mental health agenda with a focus on reducing the treatment gap for people affected by mental disorders to the betterment of mental health for the whole population, observes Dr Ishita Mukerji, Clinical Director and Senior Psychologist at Kaleidoscope, A unit of Global Excellence Group.

Health is overall perceived majorly as the wellbeing of the physical aspect, bypassing the aspect of mental health. The consequences of mental disorders impact both mental and physical health. It can also lead to the creation of social, human rights, and economic consequences across the world.

Globally, 20% of young people experience mental disorders. In India, more than 14% of the total population suffers from variations of mental disorders i.e one in every seven Indians is affected by mental disorders. Unfortunately, the treatment gap, between the number of people suffering and the number of patients that get treatment, is over 70%. Though one thing that equally contributes to the rising percentage of mental disorders is the stigma around them. It is a key barrier to a successful treatment, which includes seeking and sustaining participation in services. The roots of stigma are widespread, but it often manifests in several different forms. Mental health stigma discreetly operates in society and is internalised by individuals. The public stigma associated with mental health problems not only particularly affects help-seeking among young people, but this ethics-laden issue also acts as a barrier to individuals who may seek or engage in treatment services as well. The extent of stigma among young people in India is boundless so it is no exaggeration to suggest that the country is under a mental health epidemic.

There are several potential reasons for why, despite the high prevalence of mental health and drug use conditions, there is much less participation in treatment. One of the foremost reasons for India to be behind mental health recovery is also the shortage of the mental healthcare workforce in India. WHO states that in India, per 100,000 population there are 0.3 psychiatrists, 0.12 nurses, 0.07 psychologists, and 0.07 social workers, while the desirable number is anything above 3 psychiatrists and psychologists per 100,000 population. Issues like these mount up the scale of the problem and needs to be addressed immediately. As per the Indian Union Ministry of Health and Family Welfare reports, the country needs around 13,000 psychiatrists, to achieve an ideal ratio of psychiatrists to the population is about 1: 8000 to 10,000 but currently has just about 3,500 which is about one psychiatrist for over 2 lakh people.

Another reason attributed to the wide treatment gap is the problem of inadequate resources. Inadequacy exists in our infrastructure and in human resources that is why despite improvements in various health sectors, India still lacks marginally in addressing the issue and contributes disproportionately to the global burden of disease. In the fifth largest economy of the world, a big chunk of the population still ends up impoverished because of high out-of-pocket healthcare expenditures and suffers the adverse consequences of the poor quality of care. Given the dire shortage in numbers of psychiatrists, psychologists, psychiatric nurses, and social workers; investing in primary care systems and employing innovative force multipliers are future courses of action.

The important task at hand is to address the mental health of Indians more effectively by creating awareness and picking up the momentum and widening the scope of activities that can lead to the better mental health of the citizens. The Covid-19 pandemic has provided a unique opportunity to broaden the national mental health agenda with a focus on reducing the treatment gap for people affected by mental disorders to the betterment of mental health for the whole population.

Timely intervention, awareness about the issue, availability of professional help, and appropriate policies are the only way to improve the situation. It becomes imperative to believe and propagate that people with mental illness deserve to live their lives with dignity and confidence. All it requires is a collaborative public-private-social partnership to change things considerably.

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