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Elderly Mental Health Care

Why is it in the news?

  • According to a study
  • , the global elderly population is increasing rapidly, with 1.1 billion people aged 60 and above in 2022 (13.9% of the population), expected to reach 2.1 billion (22%) by 2050.
  • Further, India’s elderly population is also growing significantly, with 149 million older adults (10.5%) in 2022 projected to increase to 347 million (20.8%) by 2050.
  • Despite the aging population, there is limited understanding of healthy aging and elderly mental health, leading to misconceptions and fears regarding issues like depression, anxiety, and dementia in older individuals.

More about the Study

  • Ageing can be categorized into physical, social, and psychological domains, and these aspects are interconnected, influenced by genetics, lifestyle, environment, and diseases.
  • Social challenges faced by elders include increased dependency, social isolation, poverty, ageism, and abuse (emotional, physical, sexual, financial), often perpetrated by family members.
  • Many Indian towns and cities are not “elder-friendly,” lacking accessible infrastructure and public services, including healthcare.
  • Psychologically, elders are expected to achieve ego integrity and acceptance of aging, but many struggle with these concepts, leading to emotional challenges.
  • Developing diverse interests throughout life, such as music, sports, social work, or domestic responsibilities, can help prevent a sense of purposelessness after retirement and reduce the risk of depression.

 

Mental illness and Care

  • Approximately 15% of elders in India (22 million individuals) experience serious mental illness, including depression, anxiety, dementia, and substance use disorders.
  • The “treatment gap” for elder mental illness in India is as high as 90%, primarily due to lack of awareness among the public and healthcare professionals.
  • Stigma associated with ageing and mental illness compounds the challenges faced by elderly individuals and their families in seeking treatment.
  • Poverty and limited access to healthcare services further hinder access to mental health interventions for elderly individuals, particularly in rural areas.
  • Initiatives like the partnership between the Schizophrenia Research Foundation (SCARF) and Azim Premji Foundation aim to raise awareness about elder mental health in rural communities and create support networks.
  • Traditional joint family systems in India, although rare today, provided important social interactions and care for elders, which are increasingly scarce due to migration and smaller family sizes.
  • Festivals and rituals play a role in socializing and keeping elders mentally active, highlighting the importance of preserving these traditions.
  • Future planning for elderly care should involve financial savings, lifestyle adjustments, and community-level services for mental health support.
  • Incorporating healthy ageing concepts into school curricula can raise awareness and preparedness for old age.
  • Urban planning should consider elder-friendly designs to improve mobility and reduce dependency, while addressing the specific needs of elders with mental illness is essential.
  • Government policies, resource allocation, and service implementation are crucial for addressing the mental health needs of the ageing population, and caring for elders should be a collective responsibility.

 

About Mental Health
  • The WHO defines Mental Health as, “Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in’’.
  • The WHO calls Mental health as a basic human right as it is crucial to personal, community and socio-economic development.

 

Reasons for Poor Mental Health in India

 

Lack of Awareness and Sensitivity:

  • Mental health issues are often stigmatized, leading to shame, suffering, and isolation for individuals.
  • Stigma and discrimination hinder social support structures.

Lack of Mental Healthcare Personnel:

  • Severe shortage of mental healthcare professionals in India.
  • Low psychiatrist and psychologist-to-patient ratios compared to developed countries.

Gap in Treatment:

  • Only 20-30% of people with mental illnesses receive adequate treatment.
  • Inadequate resources contribute to the wide treatment gap.

Low Budget Allocation:

  • India allocates a minimal portion of its healthcare budget to mental healthcare, the lowest among G20 countries.

Changed Lifestyle:

  • Increased use of certain social media exacerbates stress and mental illness.
  • Shift to nuclear families reduces emotional support.

Income Inequalities:

  • Poverty and mental health are closely linked.
  • Poverty increases the risk of mental health conditions, and mental illness can lead to job loss and increased healthcare expenses.

Steps to improve Mental Health in India

 

Legal Measures:

  • The Mental Healthcare Act, 2017, ensures the rights and dignity of individuals with mental illness.
  • The Rights of Persons with Disabilities Act, 2017, recognizes mental illness as a disability.

Schemes and Initiatives:

  • National Mental Health Program (NMHP) provides mental health services in the general healthcare system.
  • National Tele Mental Health Program offers tele-counselling services.
  • Helplines like Kiran provide support for mental health issues.
  • Manodarpan focuses on students’ mental well-being.
  • Issuance of Guidelines/Advisories: Government issues guidelines on mental illness management and awareness.

Global Initiatives

 

Further Steps Needed

  • Address stigma surrounding mental health.
  • Integrate mental health into public health programs.
  • Improve mental healthcare infrastructure and human resources.
  • Allocate a higher budget for mental healthcare.
  • Conduct research for quality data on mental health.
  • Follow WHO’s Three Paths to transformation for better mental health.

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