The Forgotten And The Denied: The Status of Mental Health Facilities in India
By Arti Manchanda:
What do we do when an organ of our body is dysfunctional? Rather than detaching it from the body, we care for it to allow it to heal back and mingle with the other organs. We do it because we know the importance of life and how healthy we will be when all the body organs are in harmony with each other. My schooling happened in an all-girls missionary school where the children with special needs were made to study with other children. Although this concept came across as a little weird during my childhood, I now realize what it is like to be treated in the same manner as everyone. Recently, when I got a chance to attend a workshop at Sanjivini Society, a voluntary organization for mental health that also runs a rehab centre, I understood the pain people with mental disorders and their families have to go through.
India, the world’s biggest democracy and the second most populated nation with over a billion people, is a country of contrasts: the widening gap between the rich and the poor, the growing industrial hub that India is vis-à-vis the rising unemployment in the country and the migration of rural people into urban slums which creates many health and economic problems. In these times of contrasts, we often see people with mental disorders, which could be as common as depression and anxiety or people with the not-so-common schizophrenia and bipolar disorders. But does this mean that we ill-treat them and consider them rotten to forget all about them?
The pseudo-modernism that we have created for ourselves, i.e. we think we are becoming more civilized with times but are actually not, is apparent when challenged people in our society are considered to be a burden and are referred to using odd names. We leave no stone unturned to make these differently-able people feel out of place, neither are our systems friendly enough to provide them with the assurance that they are nothing but normal.
Our country is great when it comes to planning health services with major emphasis on primary health care but when it comes to actual implementation, things tend to fall flat. The infrastructure of primary healthcare is poor despite the importance given to it. There is only a small percentage of the total annual budget spent on health and mental health being a part of the general health services carries no separate budget. The National Mental Health Programme in India equates as the mental health policy. Compared to the previous years, the tenth plan saw an eight-fold increase in budget allocation for the National Mental Health Programme. The issues of stigma attached to mental illnesses and the rights of mentally ill people in the society are a matter of concern. Our country is well placed as far as trained manpower in general health services is concerned, but trained personnel for mental health are quite limited, mostly in urban areas.
Resolve for mental health:
Mental disorders account for thirteen per cent of the global burden of diseases. The World Health Organization (WHO) adopted a resolution, moved by India in the backdrop of the global burden of mental disorders which need a comprehensive, coordinated response from health and social sectors at the national level. The resolution recognizes that steps must be taken to promote mental health and empower people with mental disorders to lead a normal and productive life in the community. Even sensible people in our society react to a mental patient using derogatory terms such as ‘pagal’, ‘mental’ and ‘retarded’. Mental illnesses are ordinarily non fatal, not contagious, nor is their disability physically visible. Such patients are being systematically and continuously ignored and denied the social rights they deserve. Therefore, along with a change in mindset, there is a desperate need for a reform in the treatment of the differently-able in our country.
A lot needs to be done towards the several aspects of mental health care in India with special emphasis on training, research and provision of clinical services to promote mental health in all sections of the society.