Mental Health Scenario in India today
09 Sep 2016
Mental illness is a recognized, medically diagnosable illness that results in the significant impairment of an individual’s cognitive, affective or relational abilities. Mental disorders result from biological, developmental and/or psychosocial factors and can be managed using approaches comparable to those applied to physical disease (i.e., prevention, diagnosis, treatment and rehabilitation).
In India, it is estimated that 6-7 % of population suffers from mental disorders. Nearly 10 million-20 million Indians (1%-2% of the population) suffered from severe mental disorders such as schizophrenia and bipolar disorder, and nearly 50 million (5% of the population) suffered from common mental disorders such as depression and anxiety at the end of 2005, Health and Family Welfare Minister JP Nadda informed the Lok Sabha in May 2016, quoting data from the National Commission on Macroeconomics and Health, 2005, the last report available.
The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuropsychiatric disorder is much higher than diarrhea, malaria, worm infestations and tuberculosis if taken individually. Together these disorders account for 12% of the global burden of disease (GBD) and an analysis of trends indicates this will increase to 15% by 2020 (World Health Report, 2001). One in four families is likely to have at least one member with a behavioral or mental disorder (WHO 2001). These families not only provide physical and emotional support, but also bear the negative impact of stigma and discrimination. Most of them (>90%) remain un-treated. Poor awareness about symptoms of mental illness, myths & stigma related to it, lack of knowledge on the treatment availability & potential benefits of seeking treatment are important causes for the high treatment gap.
At least 60 million Indians – a number greater than the population of South Africa – suffer from mental disorders, even as the country lags the world in medical professionals and spending on mental-health issues. India spends 0.06% of its health budget on mental healthcare. This is less than Bangladesh (0.44%). Most developed nations spend above 4% of their budgets on mental-health research, infrastructure, frameworks and talent pool, according to this 2011 World Health Organisation report.
While suicides caused by insanity declined from 7% in 2010 to 5.4% in 2014, more than 7,000 people killed themselves as a result of mental disorders. The National Crime Records Bureau (NCRB) statistics reveal that a total of 1,35,445 people committed suicide in 2012 which amounts to a an average of 15 suicides an hour or 371 suicides daily. Maharashtra ranked second on the suicide index with Tamil Nadu topping it.
The government has commissioned a national mental health survey through the National Institute of Mental Health and Neuro Sciences, Bengaluru, to estimate the number of mental patients and utilization patterns of mental health services. Starting on June 1, 2015, the study interviewed 27,000 respondents by April 5, 2016 and got back the following results.
India is short of health professionals to address mental issues, particularly at the district and sub-district level.
There are 3,800 psychiatrists, 898 clinical psychologists, 850 psychiatric social workers and 1,500 psychiatric nurses nationwide as per the Ministry of Health and Family Welfare in the Lok Sabha in December 2015.
This means there were three psychiatrists per million people, according to data from the WHO, 18 times fewer than the Commonwealth norm of 5.6 psychiatrists per 100,000 people.
By this estimate, India is short of 66,200 psychiatrists.
Similarly, based on the global average of 21.7 psychiatric nurses per 100,000 people, India needs 269,750 nurses.
What have we done so far?
The Government of India has launched the National Mental Health Programme (NMHP) in 1982, with the following objectives:
To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of the population;
To encourage the application of mental health knowledge in general healthcare and in social development;
To promote community participation in the mental health service development and to stimulate efforts towards self-help in the community.
The need of the hour is in addressing major challenges such as lack of mental health manpower, financial aid and stigma, which are the major threats to developing comprehensive psychiatric services in the community.
In spite of best efforts, the ratio between psychiatrist and population is worsening day-by-day. Feeble attempts to address the issue of development of manpower in the area of mental health are far from reality. Adding to this, natural and manmade disasters are also placing an enormous challenge on the available meager resources.
Increase in invisible mental health problems such as suicidal attempts, aggression and violence, widespread use of tobacco, alcohol and other drugs, increasing marital discord and divorce rates emphasize the need to prioritize and make a paradigm shift in the strategies to promote and provide appropriate mental health services.
Tags: mental health, health care, indian mental health, suicide,