INDIA'S MENTAL HEALTH CRISIS
As per the World Health Organization, mental illnesses constitute one-sixth of all health-related disorders and India, the most depressed country in the world, accounts for nearly 15% of the global mental, neurological and substance abuse disorder burden.
Figures from 2017 indicate that almost 200 million people had mental disorders in India, but even so only 12% of these sought aid for their mental health concerns. The challenges and causes for this include a lack of awareness, accessibility, infrastructure and medical health care professionals, added with the stigma attached to mental illnesses. With fewer than two psychiatrists for every 100,000 people, a drastically lower statistic than the global average of 9, it is no exaggeration to suggest that the country is under a mental health epidemic.
The situation is even worse in rural areas and tier 2/3 cities, where mental illness is still far for being acknowledged as an ailment. According to studies, out of those who opt for help for psychological ailments, majority are more likely to be located in urban areas, perched on top of the socioeconomic ladder, and have access to qualified psychologists, psychiatrists, appropriate medicines and both online and offline social networks that greatly de-stigmatize mental health. Thus, most people either tend to sweep their mental issues under the carpet and suffer in silence due to the stigma and discrimination attached to them or consult faith healers for such issues. What further adds to the woes of this segment of India's population is the dearth of health infrastructure. As indicated by a 2014 Human Rights Watch report, despite 70% of India’s population living in rural areas, these areas account for a mere 25% of the country’s health infrastructure.
With the ongoing COVID19 pandemic, these figures are only set to worsen. The lock down, which displaced millions of migrants, brought to surface multiple suicide reports. Even picturing the last thoughts of an impoverished migrant worker, walking thousands of miles in desperation to get home, is excruciatingly depressing.
The introduction of the new Mental Healthcare Act(2017), which mandates that every citizen has the right to adequate treatment and that insurance companies must cover mental health services, was seen as a major breakthrough in the area of mental healthcare. Sadly, even this had its own pitfalls. Experts agree that the first and foremost steps to conquer the existing crisis should be to increase the government spending (presently at INR 50 million annually, which can be equated with the cost of a Rolls Royce car) and create incentives for doctors to work in rural areas. Although multiple initiatives have been taken by non profit organizations which are certainly helpful, nonetheless to say that these measures are enough would be an overstatement.
HOW WE SOLVE IT
As the second most populous country in the world, addressal of this crisis through the efforts of doctors and philanthropic organisations alone is out of question. Hence, innovative and holistic ways must be adopted to reduce the treatment gap. Enabling community health workers in dealing with mental health issues, including local doctors and panchayats to steer people in the right direction and schooling rural communities and self help groups to provide basic care giving services are some steps that need to be taken. Although, a few such initiatives exist in this direction, they are restricted to only a few states in India.
Our approach at Nirvega thus, is to reduce the inequity in access to mental healthcare by equipping our young and budding psychologists with the necessary skills and resources to handle the huge demand and simultaneously empowering our underserved communities with awareness and community enablement.