Mental health in India

When it comes to physical health, people are so conscious and aware these days. They are up to date with the latest on: what super-foods eat and what not to eat, what the latest diet fads are, which workout to do and which activities to perform. They are constantly monitoring themselves through fitness bands and smart watches. However when it comes to their emotional and mental health people are a tad bit causal. Many people aren't even aware that they are suffering from a mental health issue. In India, 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 obsolete stigmas and fears. Even though most mental health problems can easily be addressed and cured most people tend to ignore them and suffer.

The Basic Numbers of Mental Health

A report by the World Health Organisation (WHO) in October 2019 revealed that 7.5 per cent of the Indian population suffers from some form of mental disorder. Mental illnesses constitutes about 1/6 of all health-related disorders and India accounted for nearly 15% of the global mental 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 per cent. At present, India spends around 0.06 per cent of its health budget on mental health. This percentage is even less than what Bangladesh (0.44 per cent) spends on mental health. According to a 2011 World Health Organisation (WHO) report, most developed nations spend over 4 per cent of their budgets on mental-health research, infrastructure, frameworks and talent pool.

How many professionals are avaiable to support?

The National Mental Health Survery which was conducted in late 2018 puts the number of psychiatrists at 2052. According to them "The availability of psychiatrists in the NMHS states varied from 0.05 per lakh population in Madhya Pradesh to 1.2 per 100,000 population in Kerala. Data available for some of the high-income countries indicate this number to be between 1 and 2 per 100,000 populations. Except for Kerala, all the other states fell short of this requirement.” However these numbers are a little too much on the lower side. However according to the Indian Psychiatric Society, if we take into account the number of students under psychiatric courses during this time and also consider the figures from other sources like pharma companies etc, the figure should be somewhere around 9000 psychiatrists. This is still 0.75 psychiatrists per 100000 people. This ratio is quite bad. According to experts this ratio should be somewhere around 3 per 100000. There has to be much more awareness to increase the inflow of professional psychiatrists in next few years. Increasing the intake in courses is one way. Maintaining and updating details of practicing psychiatrists – a unified and fool proof method of regularly updating the number of psychiatrists needs to come in place.

Another very important number is that of professional psychologists and therapists. Most people who suffer from emotional or mental health issues require help from a qualified psychologist or counsellor. According to the 2015 report by the National Institute of Health, there were only 900 psychologists in India. Also according to National Crime Records Bureau, 2015 (the latest data available), the entire mental health workforce, comprising clinical psychiatrists, psychologists, psychiatric social workers and psychiatric nurses stands at 7,000, while the actual requirement is 54,750. We can say that the number would be a little higher today but the fact remains that it is still quite abysmally low. Psychologists and Counsellors form a very integral part of the mental health ecosystem and as such India is suffering from a massive shortage of these professionals.

To bridge this gap between demand and supply, the number of psychology seats should be increased. However, it should be kept in mind that merely increasing seats would not make a difference as it takes more than five years to become an expert in the field of psychiatry. Also, we are witnessing a trend of misrepresentation as today, many with just good command over the language claim to be psychologists. They don’t have the adequate qualification to be one.

Due to all these factors the treatment for mental health disorders is quite high on average in India. It would cost approximately 20-50 thousand rupees to complete one cycle of treatment. Thus people often tend to find alternatives like pseudo counsellors and online reading material to feel better. This is not effective at all and can worsen the prevalent problem as well.

How bad are the prevalent conditions like stress, depression etc ?

Nearly 9 in 10 Indians suffer from stress. In fact, the recently-released findings of the 2018 survey conducted by Cigna TTK Health Insurance, show that stress levels are higher in Indian compared with other developed and emerging countries, including the United States, the UK, Germany, France, China, Brazil and Indonesia. The survey further revealed that 95 per cent of Indian millennials between the age group of 18-34 are stressed compared to the global average of 86 per cent.

Nearly 50% of all working employees suffer from high levels of stress according to multiple surveys including one by leading healthcare provider Optum. Work, money and family are the most common sources of stress, the surveys found. Other factors include parenting, pregnancy, change, caregiving and social isolation.In addition, there is intensifying peer pressure, thanks to social media, to match up to a certain lifestyle-—such as going on a fancy holiday— that is adding to the anxiety and leading to stress and depression.

In conclusion we can say that India lacks far behind than other developed nations in terms of a good mental health ecosystem. The burden is high and the support available is too less. There have to be new innovations and platforms which can be used to increase the reach of mental health services for people.