Are We Failing The Mentally Ill?
Among the many challenges India faces, the most underappreciated is the ongoing mental health crisis. Mental illness is actually India’s ticking bomb. An estimated 56 million Indians suffer from depression and 38 million from anxiety disorders. For those who suffer from mental illness, life can seem like a terrible prison from which there is no hope of escape; they are left forlorn and abandoned, stigmatized, shunned and misunderstood.
Particularly worrying is the intensity of mental disorders in adolescents. Half of all mental illness starts by the age of 14, but most cases go undetected and untreated. Suicide is the second leading cause of death among 15-29-year-olds. Depression is the third leading item in the burden of diseases among adolescents Fortunately, there is a growth from the earliest ages, in order to cope with the challenges of today’s world.
The pathetic state of mental health care in the country coupled with the government’s apathy is a cause of great concern. A plausible reason is the sheer scale of the problem. Hence, nobody wants to discuss the elephant in the room. However, the nation cannot afford to ignore the stark reality. There are only about 43 mental hospitals in the country, and most of them are in disarray. Six states, mainly in the northern and eastern regions with a combined population of 56 million people, do not have a single mental hospital. Most government–run mental hospitals lack essential infrastructure, treatment facilities and have a sickening ambience. Visiting private clinics and sustaining the treatment, which is usually a long, drawn-out affair, is an expensive proposition for most families.
The fact is that poor mental health is just as bad as or maybe even worse than any kind of physical injury. Left untreated, it can lead to debilitating, life-altering conditions. Medical science has progressed enough to be able to cure, or at least control, nearly all of the mental-health problems with a combination of drugs, therapy and community support. Individuals can lead fulfilling and productive lives while performing day-to-day activities such as going to school, raising a family and pursuing a career.
Although mental illness is experienced by a significant portion of the population, it is still seen as a taboo. Depression is so deeply stigmatised that people adopt enforced silence and social isolation. In villages, there are dreadful, recorded cases of patients being locked up in homes during the day, being tied to trees or even being flogged to exorcise evil spirits. Stories of extreme barbarity abound in tribal cultures. In some societies, family honour is so paramount that the notion of seeking psychiatric help more regularly is considered to be anathema to them. Recognition and acknowledgement, rather than denial and ignorance are the need of the hour.
Many a time, mental-health problems are either looked down upon or trivialised. These man-made barriers deprive people of their dignity. We need to shift the paradigm of how we view and address mental illness at a systemic level. Tragically, support networks for the mentally ill are woefully inadequate. There is an urgent need for an ambience of empathy, awareness and acceptance of these people so that prejudices dissipate and patients are able to overcome the stigma and shame.
India’s Mental Health Care Act is very progressive legislation and is the equivalent of a bill of rights for people with mental disorders. Fundamentally, the Act treats mental disorders on the same plane as physical health problems thus stripping it of all stigmatizations. Mental health issues get the same priority as physical disorders Conceptually, it transforms the focus of mental health legislation from supposedly protecting society and families by relegating people with mental disorders to second-class citizens, to emphasizing the provision of affordable and quality care, financed by the government, through the primary care system.
Mental healthcare initiatives are presently focused on a narrow biomedical approach that tends to ignore socio-cultural contexts. Community mental-health services can offer a mix of clinical, psychological and social services to people with severe, moderate and mild mental illnesses. Also, counselling can make a profound difference and build resilience to cope with despair. Providing psychoeducation to the patients’ families can also help. Unfortunately, in recent decades, academic psychologists have largely forsaken psychoanalysis and made themselves over as biologists. There is a need for strengthening the cadre of behavioural health therapists.
Prevention must begin with people being made aware of the early warning signs and symptoms of mental illness. Parents and teachers can help build life skills of children and adolescents to help them cope with everyday challenges at home and at school. Psychosocial support can be provided in schools and other community settings
There is a need for more open discussion and dialogue on this subject with the general public, and not just expert ’s. This can help create a more inclusive environment for people with mental illness. With simple yet effective steps, we can turn the situation around and build a more accommodating environment for those struggling with mental distress.
Dr Moin Qazi is an author, researcher and development professional who has spent four decades in the development sector. He has been appointed a new member of the National Institution for Transforming India (NITI) Aayog Committee on Financial Inclusion for Women. He has worked for three decades with State Bank of India as a grassroots field officer, program manager, policymaker and researcher in development finance.
Views of the author are personal and do not necessarily represent the website’s views.
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