It is past time to prioritise mental health

When compared to other countries at the same socioeconomic level, India has one of the highest suicide rates. According to the World Health Organization, India’s suicide rate in 2019 was 12.9/1,000,000, which was higher than the regional average of 10.2 and the global average of 9.0. Suicide has surpassed car accidents as the leading cause of death among people aged 15 to 29 in India.

Background: Mental Health

  • While every precious life lost due to suicide is one too many, it is only the tip of the iceberg in terms of mental health in the country, particularly among young adults. Women are more likely to suffer.
  • Across the globe, the prevalence of certain mental health disorders is consistently higher in women than in men.

Mental Illness Prevalence

  • The pandemic has exacerbated the situation: According to a study published in the Lancet, it could have increased the prevalence of depression by 28% and anxiety by 26% globally in just one year between 2020 and 2021.
  • Rising among younger age groups: Again, large increases have been observed among younger age groups, owing to virus uncertainty and fear, financial and job losses, grief, increased childcare burdens, school closures, and social isolation.
  • Stress is being exacerbated by increased use of certain types of social media: Increased use of certain types of social media is also exacerbating stress in young people. Social media detracts from healthier face-to-face relationships and reduces investment in meaningful activities. More importantly, it undermines self-esteem through negative social comparison.

The socioeconomic consequences of mental illness

  • People living in poverty are more vulnerable: Mental illness is a leading cause of disability worldwide, and it is inextricably linked to poverty, creating a vicious cycle of disadvantage. People living in poverty are more likely to suffer from such conditions.
  • People suffering from mental illnesses are more likely to fall into poverty: People with severe mental health conditions, on the other hand, are more likely to fall into poverty due to job loss and increased health-care costs.
  • Stigma and discrimination: Stigma and discrimination frequently erode social support structures. This feeds the vicious cycle of poverty and mental illness.
  • Higher income inequality is associated with a higher prevalence of mental illness: Unsurprisingly, countries with greater income inequality and social polarisation have a higher prevalence.

Approach to protecting, promoting, and caring for people’s mental health?

  • Eliminating the deep stigma associated with mental health issues: The first step should be to eradicate the deep stigma that prevents patients from seeking treatment on time and makes them feel ashamed, isolated, and weak. Stigma grows in the dark and disperses in the light. To cut through the darkness and shine a light, we need a mission.
  • Making mental health an integral part of public health programmes: There is a need to incorporate mental health into public health programmes in order to reduce stress, promote a healthy lifestyle, screen and identify high-risk groups, and strengthen interventions such as counselling services. Special attention must be paid to schools.
  • Paying special attention to the most vulnerable: We should also pay special attention to groups that are particularly vulnerable due to issues, such as victims of domestic or sexual violence, unemployed youth, marginal farmers, armed forces personnel, and personnel working in hazardous conditions.
  • Developing a strong mental health care and treatment infrastructure: Inadequate treatment and stigma exacerbate each other. Only 20-30% of people with such disorders are currently receiving adequate treatment.
  • Everyone should be able to afford mental health services: Inequitable service uptake and outcomes will result from improved coverage without corresponding financial protection. All government health-care schemes, including Ayushman Bharat, should cover the broadest possible range of services.

Why is the wide treatment gap?

  • One major reason for a large treatment gap is a lack of resources.
  • Mental health issues receive less than 2% of the government health budget, which is the lowest among all G20 countries.
  • There is a severe shortage of professionals, with one estimate claiming that the country has fewer psychiatrists than New York City.
  • To close the gaps in health infrastructure and human resources, significant investments will be required.
  • Currently, most private health insurance policies cover only a subset of mental health conditions. Similarly, only a small number of WHO-prescribed medications are included in the list of essential medicines.

@the end

We need an urgent and well-resourced whole-of-society approach to protecting, promoting, and caring for our people’s mental health, just as we did with the Covid pandemic. “There is no health without mental health,” said Brock Chisholm, WHO’s first Director General.

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