How is India Responding to the Mental Health Burden?

Key Points:

• Approximately 15 per cent of Indian adults go through issues concerning their mental health. This affects more than 200 million population
• There is an 80% treatment gap in mental health care
• NMHP and DMHP programs are intended to incorporate mental healthcare services in the general healthcare system countrywide for wider outreach of services
• Tech-related measures that involve TeleMANAS offer teleconsultation-based psychological support for persons residing in such remote locations
• NGOs are the backbone of the Indian mental healthcare industry

There’s a growing need to cater to the mental health challenges of India. Mental health is as important as one’s physical health. It influences not just individual lives but also productivity, economic stability, public safety, and overall quality of life, contributing to the nation’s social and economic development. As the understanding of mental health evolves, so does the urgency to address the mental health crisis affecting millions worldwide.  

Nearly 15% of Indian adults, about 200 million, have mental disorders according to the National Mental Health Survey 2015-16 conducted by NMHS. The proportion of these among adults is 10.6%. COVID-19 had a huge impact on the portrayal of mental wellbeing. Lockdowns, isolation, and fear of infections all contributed to the escalation of mental illness. Governments play a pivotal role in implementing policies and initiatives to provide adequate mental health services and support for their populations.

Read More: COVID-19 AND MENTAL HEALTH : LANCET STUDY

Persisting Treatment Gaps

Mental health services in India today show a wide discrepancy between needs and what is available on the ground. The National Mental Health Survey (2015-16) estimates about 200 million Indians requiring mental health care services yet only 10-12% getting treated within or outside institutions each year. The country has approximately 47 government mental institutions as well as other private ones which do not meet the needs of such a vast population.

Key numbers underline the worrying lack of mental health workers: 0.3 psychiatrists, 0.07 clinical psychologists, and 0.07 mental health social workers per 100,000 people. Most public hospitals are overcrowded and lack basic amenities while private care is unaffordable due to high charges. Mental health disorders vary from minor conditions such as anxiety and depression to severe illnesses like manic-depressive psychosis, each of them needing specialised and varying types of services.

Government Initiatives

The National Mental Health Programme (NMHP) was launched in 1982. It aimed to integrate mental health services into primary healthcare as it acknowledged the need for bottom-up care. 

District Mental Health Programme (DMHP), which is an integral part of NMHP, is implemented in more than 700 districts. It covers the detection, management, and care of mental illnesses/diseases and also has other elements like work stress management programs, suicide prevention initiatives, life skills training, and guidance counseling for school/college students among other programs.

Read More: Understanding Stress: Types, Causes, and Coping Strategies

The Mental Healthcare Act (MHA) of 2017 marked a significant legislative reform, ensuring the rights of individuals with mental illnesses. It mandated the provision of affordable and accessible mental health care and protects patients’ rights to confidentiality and informed consent. 

The NMHP and DMHP are ambitious but face challenges and have been delayed by bureaucratic bureaucracy, and corruption and some states are not effectively implementing them. Even the Mental Healthcare Act of 2017, although revolutionary, is still not water-tight concerning the protection of patients’ rights. There have been differences in its execution among different states for instance due to lack of enough funds and infrastructure as some states have found it difficult.

Prevention-Based and Community Health Care Model

To reduce the burden of mental health issues, preventative strategies must be prioritized. Mental health screening programs should be established in schools, workplaces, and across communities to identify victims early, while campaigns working towards reducing the stigma will be effective in reducing the burden. 

A greater emphasis should be placed on establishing community-based multi-sectoral support systems, bridging the gap between a single consultation and various outpatient care options and lifestyle support, and ensuring continuous mental support.

The critical importance of prevention and the use of community-based models lies in the fact that they rely on early detection to halt the return of illness and increase the time during which it de-escalates. For instance, these techniques diminish the overall disease burden due to which the health system gets burdened. Therefore, they prevent severe sicknesses from general healthcare; and assure service accessibility, mutually helpful circumstances, test controls as well and cultural appropriateness favorable for prevention and management support.

Read More: How Culture Shapes Mental Health and Influences Our Well-being

Role of Technology and TeleMANAS 

In India, technology has been an important tool to bridge the mental health care gap. The aim of TeleMANAS (Tele Mental Health Assistance and Networking Across States) is to provide mental health support through teleconsultations. By using online platforms, TeleMANAS hopes to offer real-time counselling and psychiatric consultations which will especially benefit those who are in remote areas and other underserved regions.

Currently, there are 34 states/UTs with 46 Tele MANAS Cells offering mental health services, while more than five lakh calls have been received on the helpline. Most phone calls have dealt with issues such as exam stress and anxiety, sadness, or sleep disturbances. Callbacks have been made for nearly seven thousand of these calls to ensure all-around care. Such callers requiring further attention are linked up effectively with facilities like DMHP and nearby healthcare providers.

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Additionally, the inclusion of artificial intelligence and machine learning in mental health applications promises better diagnosis and management of mental disorders. The use of tools such as online meetings and smartphones helps reduce therapy costs by around Rs 300-500 per hour thus making them affordable and bringing them closer to people in need.

Introduction of inventive solutions through technology and affordable means takes leading positions in Delhi, Bangalore, and Mumbai-based startups. This portrays an ever-changing wide-open territory that provides room for capital gain and expansion in a spacious field.

Read More: Psychology and Artificial Intelligence

Role of NGOs and Youth 

Non-governmental organizations and youth-driven activities of utmost importance are addressing India’s mental health challenges. Some of these non-profit organizations are committed to promoting good mental health practices among the public through fighting discrimination against people living with different psychiatric disorders besides offering basic psychological services in rural communities. 

The involvement of the youth, through campaigns, workshops, and peer support groups, has been instrumental in driving conversations about mental health. Educational institutions are increasingly incorporating mental health awareness programs, fostering a supportive environment for young people.

With financial support and more nuanced regulatory laws on administrative policies for NGOs, these organizations can find increasing support and benefits to expand their services to more people.

Way Forward

While certainly commendable, India’s mental healthcare can improve in some areas as explained below.

Concentrated teaching and incentives are needed to deal with leadership and motivational challenges, hence improving service delivery and supporting high staff morale, particularly at mental health institutions. 

Fostering Community Participation is the key ingredient to promoting effective Information Education Communication (IEC) activities. Successful implementation of the National Mental Health Programme (NMHP) can be realized by the involvement of stakeholders such as caregivers.

Bolstering Human Resources can mobilize additional human resources for preventive and curative strategies. Existing resources need to be distributed rationally with gender-based responsibilities. Accredited Social Health Activists (ASHAs) can be trained in mental health screening while Community Mental Health Workers (CMHWs) should be assigned at the Primary Health Centre (PHC) level.

Read More: Understanding the Role of Psychiatric Social Workers

Increased Funding is needed to address fund flow & utilization problems. Further funds have to be mobilized towards meeting NMHP goals thus ensuring a minimum availability of mental healthcare services. States must commit themselves to financial responsibilities through consistent implementation.

Implementing Robust Monitoring for periodic evaluations and mid-course corrections is important. By addressing central support and database maintenance issues connectivity can be ensured in remote areas for regular information flow and adherence to monitoring guidelines.

By focusing on these areas, India can significantly improve its mental health care system and achieve better health outcomes for its population.