“What mental health needs is more sunlight, more candor, and more unashamed conversation.” – Glenn Close.
The aforementioned line highlights that the first and foremost reason for India to lose its mental health is the lack of awareness and sensitivity about the issue. There is a big stigma around people suffering from any kind of mental health issue. They are often tagged as ‘lunatics’ by society. This leads to a vicious cycle of shame, suffering, and isolation of the patients. In a country where everything is loud, from protests to festivals, from celebrations to sorrow, it is mental health that is hushed down and mentioned in whispers. A voice so low that the one suffering from it also struggles in silence and doesn’t know the extent to which it is harming him.
A report by the World Health Organisation (WHO) revealed that 7.5 percent of the Indian population suffers from some form of mental disorder. Mental illnesses constitute one-sixth of all health-related disorders and India accounted for nearly 15% of the global mental, neurological, and substance abuse disorder burden. The treatment gap, which is defined as the prevalence of mental illnesses and the proportion of patients that get treatment, is over 70 percent. A 2019 study by a British charity, Mental Health Research UK, found that 42.5 percent of the employees in India’s corporate sector suffer from depression or an anxiety disorder – almost every second employee. Nearly 35 percent of India’s population is between the ages of 15 and 34 years, according to the government’s statistics. And suicide was the leading cause of death among young people – aged 15 to 39 – in 2016, according to Lancet Global Health Study. Without anticipating a coronavirus pandemic, the WHO earlier predicted that by 2020, roughly 20 percent of the population will suffer from mental illnesses. That means, today, more than 200 million Indians may have mental illnesses, and the situation is likely to worsen.
These figures speak volumes about the trauma and stigma associated with mental health and how difficult it is for society to accept it as an illness. The biggest issue is about awareness, where physical health is celebrated and superfoods and fad diets are followed for the same, a decent conversation regarding mental health is stigmatized. In our country, the discovery of a mental illness is often followed by denial and hesitation to seek help. Despite its enormous social burden, mental health remains a taboo subject that is susceptible to age-old stigmas, prejudices, and fears. Even though mental disorders can be cured or controlled, most people tend to sweep their issues under the carpet and suffer in silence. Not only do we need to actively foster awareness about mental health, but we also need to create awareness about the absurdity of the stigmas attached to mental health, to eradicate them.
Although the world’s fifth-largest economy, India has spent only 0.05 percent of its health budget annually on mental health over the last few years, much lower than even the average spending of low-income countries, which comes to about 0.5 percent of their healthcare budgets. India’s healthcare budget in 2018, was 528 billion rupees (roughly $7 billion), out of which 500 million rupees (about $6.6 million) were for mental health, which was reduced to 400 million (approximately $5.7 million) in the following year. However, India has spent only 50 million rupees (roughly $650,000) annually on mental health. The amount spent on mental health comes to about 33 paise ($0.004) per mental health patient if we take into account the 150 million people requiring urgent care.
The mental health situation in India demands active policy interventions and resource allocation by the government. To reduce the stigma around mental health, we need measures to train and sensitize the community/society. The way charity begins at home, so does the awareness about mental health. Emotions aren’t supposed to be bottled up and put on display but should be shared without the fear of being judged at least by the near and dear ones. This can happen only when we have a persistent nationwide effort to educate society about mental diseases. We also need steps to connect the patients by forming a peer network, so that they could listen and support each other. Moreover, people experiencing mental health problems should get the same access to safe and effective care as those with physical health problems. Additionally, mental illness must mandatorily be put under the ambit of life insurance. This will help people to see mental illness with the same lens as they use for physical diseases.
Mental health may not be an issue in any election and has rarely found mention in the election manifesto of any political party in India but providing good health to its citizens is a fundamental right guaranteed by the constitution. The “Right to Life” has been interpreted by the Supreme Court as not just safeguarding the mere act of breathing or existing but ensuring the quality of life and human dignity. In 2017, India acknowledged this by enacting the National Mental Healthcare Act “to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services.” We need to break the stigma associated with mental health and speak about it as freely as we do about any physical ailment. Only then would we be able to accept and grow inclusively.
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