Acknowledging mental health as a principally impactful driver of individual and national development, the Economic Survey 2023-24 extensively highlights this health issue, and its significance and implications on policy recommendations for the first time.
The Survey mentions that at an aggregate economic level, mental health disorders are associated with significant productivity losses due to absenteeism, decreased productivity, disability, increased healthcare costs, and so on.
MENTAL HEALTH SITUATION IN INDIA:
WHO defines Mental Health as 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 part of health and well being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in.
WHO calls Mental Health as a basic Human right. According to the WHO, mental illness makes about 15% of the total disease conditions around the world.
According to the National Mental Health Survey (NMHS) 2015-16, 10.6% adults in India suffered from mental disorders.
The treatment gap for mental disorders ranged between 70% and 92% for different disorders.
The prevalence of mental morbidity was higher in urban metropolitan regions (13.5%) compared with rural areas (6.9%) and urban non-metro areas (4.3%).
Citing the National Council of Educational Research and Training’s (NCERT) Mental Health and Well-being of School Students Survey, the Economic Survey highlights an increasing prevalence of poor mental health among adolescents exacerbated by the COVID-19 pandemic, with 11% of students reported as feeling anxious, 14% feeling extreme emotion, and 43% experiencing mood swings.
In 2019, India’s suicide rate was at 12.9 per 1,00,000 persons. This was higher than the regional average of 10.2 and the global average of 9.0. Suicide has become the leading cause of death among those aged 15–29 in India.
REASONS FOR MENTAL HEALTH DETERIORATION IN INDIA:
The deterioration of mental health in India can be attributed to a combination of social, economic, and cultural factors.
SOCIO CULTURAL FACTORS:
Stigma and Lack of Awareness: Mental health issues are often stigmatized in Indian society, leading to discrimination and reluctance to seek help. There is a lack of awareness about mental health disorders and their treatment options.
A survey by the National Institute of Mental Health and Neurosciences (NIMHANS) found that 70-80% of people with mental illnesses do not receive treatment due to stigma and lack of awareness.
Rapid Urbanisation and lifestyle changes: Rapid urbanization has led to increased stress, unhealthy lifestyles, and social isolation.
The World Health Organization (WHO) has reported that urban populations in India have higher rates of anxiety and depression compared to rural areas.
Substance Abuse: Including alcohol and drug use, is a growing problem that exacerbates mental health issues.
he NMHS found that approximately 22.4% of the population in urban areas and 23.3% in rural areas have issues related to substance abuse, contributing to mental health deterioration.
Family Dynamics: Strained relationships, domestic violence, and family pressures can lead to mental health issues.
The NMHS reported that family-related stress is a common cause of mental health problems, particularly among women.
Gender Disparities: Women and LGBTQ+ individuals often face gender-based violence and discrimination, leading to mental health issues.
According to the NMHS, women are more likely to suffer from depression and anxiety due to societal pressures and violence. Increase in activities of exorcism, counselling especially faced by LGBTQ community.
Role of media: Online abuse, body shaming, beauty standards and other stereotyping has been on the rise and children susceptible to such abuse are also increasing as more social media users are now identified underage.
ECONOMIC FACTORS:
Unemployment and Poverty: Economic stress, unemployment, and poverty are significant contributors to mental health issues.
According to a report by the National Mental Health Survey (NMHS), 31% of urban and 22% of rural populations suffer from mental health problems due to financial stress.
Workplace stress: The competitive nature of the job market and high-pressure work environments contribute significantly to stress and anxiety.
A study by the ASSOCHAM found that 42.5% of employees in the private sector in India suffer from depression or anxiety due to work stress.
Poor Mental Health infrastructure: There is a severe shortage of mental health professionals and facilities.
According to WHO, India has only 0.3 psychiatrists and 0.07 psychologists per 100,000 people, far below the recommended levels.
Academic Stress: Students face immense pressure to perform well academically, leading to stress, anxiety, and depression.
The National Crime Records Bureau (NCRB) reported that in 2019, over 10,000 students died by suicide due to academic pressure. Events that occur every year in Kota, Rajasthan
Low budget Allocation: Developed countries allocate 5-18% of their annual healthcare budget on mental healthcare, while India allocates roughly 0.05% (Organization for Economic Co-operation and Development, 2014) of its healthcare budget. This is the lowest among all G20 countries. Despite a rise in mental illness issues, the Union Ministry of Health allocated less than 1% of its budget to directly deal with psychological illnesses in 2022.
STEPS TAKEN BY INDIA TO ADDRESS MENTAL HEALTH ISSUE:
The Mental Healthcare Act, 2017: The Act rescinds the Mental Healthcare Act, 1987 which was criticised for failing to recognise the rights and agency of those with mental illness.
The Act seeks to ensure rights of the person with mental illness to receive care and to live a life with dignity. It provides the Right to Access to Healthcare
The Act decriminalised suicide stating that whoever attempts suicide will be presumed to be under severe stress, and shall not be punished for it.
Right of Persons with Disabilities Act, 2017: Acknowledges mental illness as a disability and seeks to enhance the Rights and Entitlements of the Disabled and provide an effective mechanism for ensuring their empowerment and inclusion in society.
National Mental Health Programme: Keeping WHO recommendations, it was introduced in 1982 to provide mental healthcare as a part of general healthcare system
National Tele Mental Health Programme
Rashtriya Kishor Swasthya Karyakram- Adolescent friendly health clinics
Central government’s efforts to raise the number of psychiatrists from 0.75 per lakh population in 2021 to the World Health Organization’s norm of three psychiatrists per lakh population.
Kiran – a 24/7 toll free helpline by Ministry of Social Justice and Empowerment
Manodarpan: Students will receive psychosocial help as part of an effort under the Atmanirbhar Bharat Abhiyan, with the goal of improving the students’ mental health and overall well-being.
WHAT MEASURES CAN BE TAKEN FOR MORE INCLUSIVITY:
The WHO has recommended Three Paths to transformation towards better Mental Health.
Standardising guidelines for mental health services across the government and private sectors, and bringing effective pathways for integrating mental health interventions in schools
Developing an age appropriate mental health curriculum for teachers and students, encouraging early intervention and positive language in schools, promoting community-level interactions
Balancing the role of technology in providing mental health awareness and celebrating diversities and differences.
Careful mapping and research needs to be undertaken to produce quality data, that is essential to understand the size of the problem. This in turn should be utilised to implement a comprehensive approach, supported by heightened political commitment, scientific understanding and a citizen driven movement.
CASE STUDIES:
Sleep consultants for Olympic participants to manage their stress
Japan’s special ministry dealing with suicides
PRACTICE QUESTION:
Q. Discuss the mental health situation in India and analyze the reasons for its deterioration. Suggest measures that can be taken to address mental health issues effectively. (15 marks, 250 words)