India’s stigmatized mental healthcare cries for prioritisation

In India's close-knit communities, mental health struggles often face a deafening silence. According to a study by Deloitte, over 70 per cent of Indians use derogatory terms for mental disorders and nearly 40 per cent voice fear of a neighbour seeking help for mental health issues.

Avani Rara Jan 12, 2024
Image
Representational Photo (Photo: Twitter)

In India's diverse healthcare system, it seems societal misconceptions do contribute a ‘fair’ share of mental health challenges. According to Statista, a German data archive platform, 30 per cent of adults in India identify mental health as the primary concern, yet the issue remains inadequately addressed by the government. Mental well-being encompasses emotional, psychological, and social balances, impacting one’s thoughts, feelings and actions. When disruptions occur, they pose significant hurdles, demanding comprehensive support and attention.

Despite the economic growth, recent news reports suggest that India bears a heavy burden of mental health issues, with nearly 200 million people affected, including 56 million with depression and 38 million with anxiety disorders. Alarmingly, three-quarters of them experience these issues by age 24, with half showing signs by age 14. The mental health infrastructure also falls short, with only 46 dedicated mental health institutes and around 9,000 psychiatrists.

High suicide rate 

India grapples with a severe shortage of mental health professionals, with only 0.75 psychiatrists per 1,00,000 people, far below the WHO recommendation of 3 per 100,000. This shortage is particularly acute in rural areas and contributes significantly to India's high suicide rate of 12.70 per 100,000 individuals annually, placing India among the nations with the highest rates of depression and suicide worldwide.  Lancet Journal reports India has an 80 per cent treatment gap for mental disorders, which will cost $1.03 trillion to the economy by 2030.

According to a survey, in India, only 7 per cent can afford mental health treatment directly, with 44 per cent relying on private insurance. Shockingly, mental health care costs can eat up 30-40 per cent of monthly income on average, as per Lancet Psychiatry. In cities, counselling sessions cost around Rs 1500 per hour. While free digital teleservices handle many cases, severe ones need expensive additional support.

In India's close-knit communities, mental health struggles often face a deafening silence. According to a study by Deloitte, over 70 per cent of Indians use derogatory terms for mental disorders and nearly 40 per cent voice fear of a neighbour seeking help for mental health issues. ETactics, in a study among 90,000 people worldwide, found that 12.6 per cent of people with mental health disorders delay treatment due to fear of stigma. Hurtful labels like "crazy" or "attention-seeking" cling to mental health conversations, perpetuating this isolation. This silence bleeds into workplaces and social lives, with 9 per cent choosing secrecy over seeking help. While the 2017 Mental Healthcare Act aimed to break down these barriers, the Government of India allocates only 1 per cent of GDP towards its implementation.

A World Health Organization (WHO) study found that nearly 90 per cent of individuals in middle-income countries like India lack access to essential mental health care. The government's Tele-MANAS initiative, launched in 2021 as a digital portal, aims to bridge this gap. However, accessibility and affordability remain a significant challenge. Despite Tele-MANAS receiving 2,00,000 calls in a year, physical and mental health services remain exclusive to a few, underscoring the persistent lack of accessibility and digital divide in the country.

Partnering with NGOs

In India's $3 billion mental health market, the growth of technology should also play a crucial role in enhancing accessibility. For instance, the increasing use of gadgets like online meetings and phones significantly lowers counselling costs by up to Rs 300-500 per hour, enabling companies to offer more accessible services. Many health startups in Mumbai, Bangalore, and Delhi curate YouTube videos, discussion forums, and other mediums to educate people on self-care and preventive measures. These platforms foster open discussions and make mental health support more affordable and accessible through innovative and passionate solutions. It promises an evolving and growing space for more people to invest in the widely untapped market, providing the perfect opportunity for growth in the sector.

India's sizable youth population could drive open conversations about therapy and peer support. Through collaboration with NGOs, national strategies can effectively reach communities via grassroots efforts and social support networks. This collaboration can benefit basic counselling training given to the healthcare personnel available at community hospitals and self-help groups. Primary counselling helplines created in rural areas through feasible and cost-effective plans implemented by these groups have already proven effective. Such strategies thus create an efficient solution to India's growing and demanding healthcare needs.

Mental healthcare ecosystem 

Partnering with local NGOs to train teachers in the early identification of mental health issues among children is pivotal. The coping mechanism must involve tailoring student-focused learning with social-emotional programs on stress tolerance and building resilience and vital life skills. Supporting such initiatives through community organisations and coordinated efforts across sectors are instrumental in enhancing our mental health care system.

Today, any practical solutions for mental health challenges in India require substantial government support, increased funding, recognition, and dedicated personnel. However, this effort hinges on the demand from the people. Self-awareness through education is an added advantage that helps society to evolve in its perception of mental health. It's everyone's responsibility—citizens, NGOs, healthcare professionals, and policymakers—to advocate for mental health prioritisation. Creating a comprehensive and sustainable mental health care ecosystem demands active participation from all stakeholders everywhere.

(The author is a research intern with the Centre for Social and Policy Research at CHRIST (Deemed to be University). Views are personal. She can be contacted at avani.rara@pseco.christuniversity.in )

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