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Mental Health Care in India

Why is it in the news?

  • Mental disorders are a major global cause of disability, with India significantly contributing to this burden.
  • Further, the COVID-19 pandemic has worsened the situation, impacting the psycho-social well-being of many.
  • However, access to mental healthcare is hindered by a lack of trained health workers, financial constraints, and poor coordination.

More about the news

Definition of Mental Health

  • Mental health encompasses psychological, emotional, and social well-being.
  • It is defined by the World Health Organization (WHO) as a state of well-being where individuals realize their abilities, cope with life’s stresses, work productively, and contribute to their communities.
  • Mental health disorders are characterized by significant disturbances in cognition, emotional regulation, or behavior, often associated with distress or impairment.

What data says

  • The National Mental Health Survey (NMHS) of 2015-2016 revealed that 150 million adults in India live with mental disorders, but the majority lack access to treatment.
  • A Lancet Psychiatry study showed that the contribution of mental disorders to India’s disease burden doubled between 1990 and 2017, affecting one in seven Indians.

Government Initiatives

  • India’s National Mental Health Program (NMHP) launched in 1982 aimed to provide affordable and accessible mental healthcare by integrating it with general care at primary health centers.
  • The program evolved into the District Mental Health Program (DMHP) to decentralize care and was integrated with the National Rural Health Mission.

(Human Resources for DMHP)

  • The Mental Healthcare Act, 2017, discourages long-term institutionalization, protects the autonomy and dignity of individuals with mental illness, and calls for holistic treatment.
  • Mental health services are also part of the Comprehensive Primary Health Care under Ayushman Bharat.
  • The National Tele-Mental Health Program (NTMHP) was launched in 2022 to use digital technology to improve mental health services.

Challenges and criticisms

Challenges in design and functioning

  • The mental health program has been credited for expanding community-level mental health services but criticized for its ineffective design and functioning.
  • The digital tele-mental health helpline, Tele-MANAS, has received over 3.5 lakh calls but faces barriers related to internet access and data privacy.
  • The Rashtriya Kishor Swasthya Karyakram (RKSK) has been unsatisfactory despite operating for nearly a decade.

Challenges in Accessibility and Affordability

  • Globally, there is a gap between those needing mental healthcare and those receiving it, with low access rates even when effective treatments are available.
  • In India, the treatment gap for mental disorders, except epilepsy, is over 60%, with some disorders like alcohol use disorders having an 86% treatment gap.
  • India faces a shortage of mental health professionals, including psychiatrists, psychologists, psychiatric social workers, and psychiatric nurses. For instance, India has only 0.75 psychiatrists per lakh people, far below the required number.
  • Financial barriers contribute to the treatment gap, with mental healthcare expenditure pushing 20% of Indian families into poverty.
  • Therapists in urban areas charge Rs 500-2,000 per session, making therapy unaffordable for many.

Challenges due to infrastructure gap

  • India has an insufficient number of public psychiatric beds, with only 56,600 beds available for a population of 130 crore (1.3 billion) people. The required number of psychiatric beds is estimated to be 6.5 lakh, highlighting a significant infrastructure gap.

Recommendations for improving Mental Healthcare in India

  • Allocate more resources to build mental healthcare institutions and associated infrastructure to enhance professional availability in the field.
  • Support organizations like “The Live Love Laugh Foundation” to transform perceptions of mental health, decrease stigma, and raise awareness.
  • Address the imbalance where one primary healthcare facility serves more than 51,000 individuals by increasing funding for quicker, cheaper, and easier access to healthcare services.
  • Provide training at the grassroots level for community health workers (ASHA, ANM, AWW center staff) to identify mild to severe mental health issues such as schizophrenia, anxiety, depression, and alcohol abuse.
  • Establish self-help groups of caregivers’ families and NGOs to engage the community and reduce the stigma associated with mental illness.
  • Continue to allocate funding for mental health awareness and address persistent issues related to mental health.
  • Encourage the public to overcome fear and resistance by not judging or labeling individuals with mental health issues. This can help them seek the support they need without hesitation.

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