In 2017, the Indian government introduced the Mental Healthcare Act intending to make mental health services accessible to all of its citizens. The government brought this act so that every individual would be able to practice their right to get complete mental health treatment from proper government-funded services. This was a very crucial step in the field of mental health as with this act, the government officially declared that mental health is as serious a concern as any other public health issue in India. It was the government’s attempt to show its people that mental health was not a myth but a serious issue that needs to be addressed immediately.
While at that time, it was a moment of great joy for the mental health community of India, the sad part is that it didn’t work as well as we thought. The common man of India still goes to work in the morning with an unhealthy level of stress and emotional issues on his back. There are many reasons why the Mental Healthcare Act of 2017 did not cause much positive change in the mental health condition of our country. Let’s understand them in detail.
What’s the scenario right now?
Let us say a middle-class man suffering from depression and anxiety decides to take mental health help in India. But with his income of say Rs 30,000 and his family to take care of, it would be extremely difficult for him to take enough mental health therapy sessions to see even a minute improvement in his condition. And it’s not just that, one doesn’t just need therapy to treat his/her mental health, therapy would be useless unless the person has enough time to take care of one’s overall health. This is usually the case with most middle-class people who work 10 to 7 seven jobs, 6 days a week, and then go home to give time to their family.
If we talk about the cost of mental healthcare services in India, a single therapy session costs around 1000 to 4000 rupees, which leads people to discontinue taking therapy sessions before they see any results, as they cannot afford treatments this expensive. Mental health treatments are so expensive in India that they can cost an individual 30 to 40 of his/her total monthly income. This is probably the reason why a 2019 survey found that only 7% of Indians are able to afford treatment for mental health issues and 44% depend on private insurance for it. The noteworthy point here is that this percentage is out of the people who get access to these mental health services and not all those people who are in need. It is the need of the hour to get seriously concerned about these issues as it is estimated in a study by Lancet Commission on Global Mental Health and Sustainable Development, that bad mental health could be the major reason why India’s total loss from 2012 to 2030 is adding up to $1.03 trillion.
Why do most Indians refrain from asking for mental health help?
In a mental health survey in 2016, it was found that around 14% of the Indian population has some kind of mental health issue. Section 18 of the Mental Healthcare Act, of 2017, states that it is the responsibility of the Indian government to make mental health services accessible and affordable to all its citizens, and individuals who are not able to get help, should be provided with proper compensation.
Unfortunately, the real scenario is completely different as most of the mental health facilities provided by the government lack even the basic resources and capable staff. There are many reasons why a large population of India does not get access to the required mental health help. Let’s discuss them in detail:
Belief system and stigma: One of the biggest reasons why people refrain themselves from seeking mental health help is because of the fear of supposed disgrace or discrimination they would have to face in society. Besides, often families of the suffering individuals also withhold them from admitting that they are suffering from any kind of mental illness because of the fear that society would treat them differently. A large population of India lacks the necessary awareness and knowledge regarding mental health issues which is why for many people, having no mental illness is equivalent to normal mental health. They do not associate problems like emotional issues, suicidal thoughts, and sleep issues with a bad mental condition.
Shortage of competent mental health professionals: Even if people somehow gather the courage to come out with their mental health problems to seek treatment, they face another hurdle which is the lack of required healthcare professionals. Indian Journal of Psychiatry tells us that India has only 0.75 psychiatrists for every 1,00,000 individuals in need when the required number for the same population is at least three psychiatrists. MHP 2017, NMHP, and DMHP have clearly stated in their policies that it is mandatory for psychiatric hospitals to not just have psychiatrists, but also other kinds of mental health professionals like counselors, PSWs, and CPs. Despite this, many mental health hospitals are operating only with psychiatrists who are often just interested in prescribing medications to the clients regardless of requirements.”
Bad quality of mental health facilities provided by the government: While rich people can afford to go to expensive private hospitals and take the necessary number of therapy sessions without worrying about the expenses, the only affordable option for poor people is to get treatment from the government hospitals. But because these government facilities often lack the necessary resources and medication, People do not get quality help.
Poor financial condition: When the government facilities are incapable of helping, people have no other option than to turn to expensive private hospitals and clinics. Most of the Indian population that’s suffering from mental illnesses is poor and live in rural areas. This means, in order to seek treatment, they have to make long commutes which adds to the already high expenses of their treatment. Additionally, the transport facilities are also limited for them to travel to district hospitals and clinics.
Not completing the treatment: Another big problem is that mental health patients stop taking therapy sessions and medications as soon as their symptoms go away. They do not understand that, unlike physical illnesses, they cannot measure their improving mental health based on the symptoms. The reason behind such recklessness is the lack of appropriate psychoeducation. It is the responsibility of the therapists to explain to their patients the difference between mental and physical illnesses.
There is an extreme need for educating the Indian population about mental health problems. We need to understand that mental illnesses if left untreated, could lead to much bigger problems including physiological issues like cardiovascular diseases and diabetes. The government also needs to take solid steps to fight this mental health pandemic as bad mental health results in reduced productivity which could eventually cause great damage to our country’s economy and slow down its growth. We are always concerned about our physical health which is why we put so much effort into making good diet plans and workout routines, but little do we know that the best way to stay physically fit is to first keep ourselves mentally healthy.
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