Why India’s mental health care needs to get better

TL;DR, 0.05% of the health budget allocated for mental health care is peanuts, considering the amount of people that need it.

When we talk about our health being our true wealth, we often assume that being physically fit is what makes us ‘healthy’ overall, whereas we tend to forget that being healthy goes way beyond that. As the WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” We’ve all been in a place where we have often and actively looked after our health in terms of the former aspect of this definition while neglecting the latter.

 

But why must we treat our mental health with such importance? Because in doing so we are indeed taking care of our bodies. Our brain is also a part of our body and it is in fact correct when they say that ‘a healthy mind is a healthy body’. Issues in the mind can lead to the cropping up of psychosomatic symptoms, which are basically physical pains and ailments that have no biological reason to be there, like unexplained aches and pains. Better mental health also leads to better immunity, (there’s a whole field of research on this!) and a longer lifespan. 

That’s not the only reason, though. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Since all of these form the crux of human existence, it becomes all the more essential that we look after it. When a person’s mental hygiene is neglected and left untreated, they become more susceptible to mental illnesses and disorders. With rising stressors due to the current global situations, it becomes relevant to open a discussion around mental well-being and its need for inclusion in our future healthcare plans. Pain is pain, and just because it can’t be seen, doesn’t make it any less important.

Mental health in India 

Progress in mental health service delivery has been slow in most low- and middle-income countries. 

The suicide rate in India in 2015 at 15.7/1,00,000 was higher than the regional average of 12.9 and the global average of 10.6. Suicide is the leading cause of death among those aged 15–29 in India. Reports like this one by NIMHANS (National Institute of Mental Health and Neuro Sciences)  shed light on what mental health looks like in India, and the situation is dire.  The treatment gap, as measured by the absolute difference between the prevalence of mental illnesses and the treated proportion, has been found to be 76%–85% in less-developed countries, the reason being the inadequacy in human resources and infrastructure. Most of the people are discouraged while availing these facilities and end up suffering through adverse consequences of poor quality of care. Thus, India adds negatively to the global burden of disease. 

In addition to that there is stigma and ignorance that hinders India’s progression towards a better mental healthcare. Many people are even dismissive of mental illnesses by shunning it and calling it an ‘act’ for attention. To eliminate these shortcomings, the need of the hour is to sensitise and educate individuals about the importance of mental well-being and treatment of illnesses and disorders. A way to ensure this is by government intervention, funding of mental health organisations, open discussions and extension of support by citizens towards their loved ones for seeking professional help in time of need. 

So, what now?

Awareness, however, is only half the battle. You’ve read up on mental health, on how it is integral to well-being, and how it doesn’t make anyone any less for focusing on it. You’ve decided to see a therapist, or recommend one to your struggling friend. But there are no arrows or boards pointing out psychiatric clinics in bold, like, say, your local Dr. Naidu’s Family Clinic, so where do you go?

One of the most common issues people face is accessibility. India has only 9000 psychiatrists for every 1,00,000 people, which means that there aren’t enough doctors to tend to the country’s psychological needs. Studies may show mental health risks to be increased in urban areas, but there are also more mental health resources available in such areas, as opposed to rural sections.  However, because it’s hard to find good therapists nearby, people may consider seeking mental health care as “too much effort” and not obtain it.

Then there’s the accompanied issue of cost. Mental health care is costly enough for those who live in cities at close proximity to centres, where transportation isn’t an issue, for those who live further away, it becomes simply impractical. Sessions with a therapist seem like a luxury only the rich can afford, especially for an ailment that seems to be ‘all in the head’. The trivialisation of the issue, however, helps to justify not taking out the effort and funds to seek the required help, leading to the problem getting worse in the future. 

All hope is not lost, though. Humans are social creatures, and availability of better mental health care is a battle that we can win, together. A basic step is to create a support system around the afflicted individual by checking in on them, and using encouraging and positive language. Talking more about mental health and sharing resources, dispelling myths when you hear them, are also essential to promoting normalisation of the topic. Mental health is just like our physical health, and we should aim to get to a point when we feel as comfortable talking about it as we would be when talking about a fever, or a cold. 

The internet is also full of resources we can use to educate ourselves about mental health, as well as seek help. Yellow Club is one such resource, where mental health care is affordable and accessible— with online therapy sessions, workshops and resources for awareness, this can be a starting point for a journey to better mental health. There are communities like Yellow Club with therapists that offer online therapy, that bridge the issues of accessibility and affordability. Students can access free counselling facilities on college campuses, and demand for them if they aren’t available— they often tend to be quite popular, showing just how helpful it can be, when made available.

 However, not everyone has access to an internet connection and there are some aspects of face-to-face therapy that online therapy cannot replicate, making it ever- important to ensure that there are enough trained mental health professionals located in regions around the country. It’s also imperative that we have higher allocation of government funds in mental healthcare, as the current numbers are appallingly low, with only 0.05% of the health budget spent on mental health, annually, over the last few years. The high expenses involved when trying to get effective mental health care could be reduced with additional government investment. If we become advocates for our own mental health care, then we can begin to create a change.

Above all, know that it’s okay to ask for help, because the moment you do, you’re making that crucial decision to change your life— for the better.  While keeping your health in mind, ensure to lift up others, and aid in making your surroundings a safe space to keep the conversation going. 

We’re here for you, so let’s talk about it. 

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