In 2017, President Ram Nath Kovind said that "India was facing a possible mental health epidemic" and stressed the need to provide access to treatment facilities to those suffering from mental disorders by 2022. What made things even more alarming was a report by the Ministry of Health and ICMR in December 2019 that stated that 1/7 Indians were mentally ill. That means that a staggering 20 crore Indians are battling mental health issues.
Status of Mental Health facilities
There are approximately 9000 Psychiatrists and not enough Psychologists, Medical Social Workers, Counselors and others. There has been a lot of enthusiasm to build IIMs, IITs, AIIMS across India with the belief that the country needs more management graduates, engineers and medical facilities. Building a trillion-dollar economy is important, but in an era of massive angst due to globalisation and rapid social change, we need more graduates in mental health. Somewhere the stigma and poor awareness is not only among the ordinary Indian but also among policymakers and politicians ruling the country.
The National Mental Health Policy of India, October 2014, states, "The vision is to promote mental health, prevent mental illness, promote destigmatisation, desegregation and ensure socio-economic inclusion of persons affected by mental illness by providing accessible. affordable and quality health and social care to all persons across their lifespan within a rights-based framework." This needs to be implemented, and the words need to translate into action!
Health workers are important
The country does not need a top-heavy mental health system. A couple of decades ago, when I asked the Executive Health Officer of BMC why our health workers are not trained to screen families for mental disorders and suicide, the answer I got was, "We are more interested in the treatment of malaria and dengue among the poor, and mental illness exists among the rich." Things have not changed much. The zeal to identify covid +ve cases has been path-breaking, but the strategy to screen those affected by the mental health pandemic has been dismal across the country.
The poor are more affected
The NCRB 2019 figures clearly show that nearly 1/4 who die of suicide are daily wage labourers. Mental health is not about feelings alone but also about food. As the centre rolls out the Swachh Bharat Mission 2 across the country, money and food to the poor, a program for mental health awareness needs to be initiated all over with the same intensity and magnitude. To quell the epidemic, one needs a mental health movement and massive programs. This needs political will, which is in abundance.
Identifying Early Signs
Just as early signs of covid, malaria and dengue are publicised similarly, early signs of mental illness such as a change in behaviour, appetite, sleep, lack of interest in work, sadness, crying spells, hearing imaginary voices also need attention. A massive social media blitzkrieg is important. Unfortunately, chats of Chief Ministers across states to the people at large are devoid of any mental health input. This blindness is shocking.
The Road Ahead
India achieved a reduction of 83.34 per cent in malaria morbidity and 92 per cent in malaria mortality between the years 2000 to 2019. TB deaths in India in 2019 were 79,000, whereas deaths due to suicide in the same year were 1,39,123. While there are massive TB treatment and prevention programs across the country that W.H.O has lauded, the same can't be said about suicide. There is still no 'Suicide Prevention Policy' in the country.
India can do it if it wills! Posters by the MCGM across housing complexes against dengue made their appearance when cases increased but not for mental health. We need a Mental Health Minister both at the centre and the states as well as commissioners in Districts to bring focus and strategy in fighting mental illness. On this World Mental health Day, let us pledge to build a mental health movement across the country. A robust economy can never survive alongside fractured minds and sad hearts!
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