In olden days, people believed that the brain of the mentally ill was possessed by demons or spirits, so they used to drill a hole into the skull of the person so that the demon possessing the brain might escape; this was done without anesthetics! Of course they were uneducated and ignorant about medical science, but how much advancement did we make in the field of such diseases today? Of course, medical science has made remarkable progress in the last few decades, but with regards to psychiatry, the progress is not enough when compared to other fields of medical science. The difference is that, today we don’t drill patients’ skulls! But many of us, even in the most developed countries of the world, still carry the belief that mental problems have something to do with demons or stigmatize these problems.
We tend to ignore the real cause of the problem, and since we become less able to face the symptoms, we give up. Dr. Brock Chisholm, the first Director General of the World Health Organization (WHO), in 1954, had presciently declared that “without mental health, there can be no true physical health” which is so true today. More than 60 years later, the scenario has not altered substantially. Recently, the Parliament’s nod for the revamped Mental Healthcare Bill is a positive step, but despite these efforts, the ground reality paints a shocking and bleak picture. Some of the alarming and shocking facts about mental health in India are as follows:
- About 14% of the global burden of disease is attributed to neuro-psychiatric disorders. Progress in mental health service delivery has been slow in most low and middle income countries. One among them is India.
- One out of every five Indians is suffering from a mental disorder.
- 50% of corporate India is under chronic stress.
- In terms of quality years of life lost due to disability or death- a widely adopted public health metric (by WHO) that measures the overall burden of disease – India ranked 2nd for uni-polar depressive disorders, just after China.
- India, China and the US are also the countries that are most affected by anxiety, schizophrenia and bipolar disorder, according to WHO.
- The report also lists suicide as the third largest cause of death in 15-35 year olds.
- In 2014, there were a total of 1,09, 456 official suicides reported.
- Only about 1 in 10 people with mental health disorders are thought to receive evidence-based treatment.
- Only 43 government institutions and less than 26,000 hospital beds are dedicated to mental health patients.
- At the moment, India spends 0.06% of its total health budget on mental healthcare.
Further to this,
- There are only 3 psychiatrists per 1 million people in India.
- As per a survey by WHO, mental illness will reduce economic growth in India and China by 11 trillion dollars.
These are a few facts and statistics about mental health in India that I have collected from different sources, but the scenario is almost the same all over the globe. Thus, it is evident that a mental health crisis is enveloping India as we speak – a crisis that is made worse by stigma, and a crippling lack of adequate mental healthcare infrastructure.
Let those stats sink in for just a minute. The question that begs to be answered is “Why don’t people get help?” The reasons that are very common are listed down, let’s have a look:
- Fear & Shame: One of the most common reasons for not seeking help is fear and shame. People recognize the negative stigma and discrimination associated with having a mental illness and don’t want to be labeled “mentally ill” or “crazy” which is very common in Indian societies. They also have concerns about how such a label could negatively impact their career, education, or other life goals.
- Lack of Insight: It is very common with the patients to say “there’s nothing wrong with me” or “I’m not sick” or “I don’t need help”, which signals a severe lack of insight. This is also known as ‘anosognosia’ seen in more than 50% of patients with schizophrenia or other mental illness.
- Limited Awareness: Many people are seen to acknowledge the problems but lack full awareness of the significance of the issue. In simple words, they do not take the symptoms seriously until it’s too late.
- Feelings Of Inadequacy: Often, people tend to believe that if they admit to being mentally ill, then it would make them inadequate or a failure. They are even ashamed of seeking help or assistance of others, and believe that they should be able to handle things themselves, which makes things even worse.
- Distrust: Well, this problem is common with patients of all departments of medical science. People are often ashamed and find it difficult revealing personal information to a stranger (doctors or counselor).
- Unavailability: Even if someone is interested in getting mental health treatment, they may not know how to find appropriate professional care. In India, in most of the rural or even some urban areas, there may be NO mental health professionals or institutions, those who provide treatment for more simple or complex issues.
- Practical Barriers: Financial hardship or lack of health insurance and not having reliable transportation can also prevent someone from engaging in getting treatment.
Any one of the above reasons can hinder or affect a patient getting help or treatment, moreover, to further complicate the matters, several of these issues can often be in play simultaneously.
Need Of The Hour!
- It is quite clear that the biggest barrier in fighting mental illness is acknowledging and accepting the illness rather than the medical techniques or developments in the fields. Government, along with the NGOs, needs to come out and create awareness among people; and it needs to be done now, because history of progress in the treatment of mental illness is shockingly horrible. Dr. Ala Alwan, Assistant Director-General of Non communicable Diseases and Mental Health at WHO, explains:
“Governments tend to spend most of their scarce mental health resources on long-term care at psychiatric hospitals. Today, nearly 70% of the meagre mental health spending goes to mental institutions. If countries spent more at the primary care level, they would be able to reach more people, and start to address problems early enough to reduce the need for expensive hospital care.”
Other than that, we as individuals need to reduce stigma related to mental health diseases and allow our friends or relatives to discuss their problems with us, because a person may function fairly well on the surface and can generally conceal their mental health concerns. If they can talk about their problems, they can be encouraged to seek care to relieve their distress. So, awareness should be created on every level so that it makes it ok to talk openly about mental health issues and ask for help. As Dr. Sigmund Freud said, “A layman will no doubt find it hard how pathological disorders of the body and the mind can be eliminated by ‘mere’ words. He will feel that he is asked to believe in magic.” Words have a healing power, from which also emerged a new field of study, ‘Neuro-Linguistic Programming’ or NLP, which teaches professionals how to use ‘talking’ as a means of healing among many other uses of it.
Further to this, government should ensure that more institutions are opened in every corner of the country and more mental health professionals are placed there, so that no patient goes untreated or unattended.
While, it’s a long way to go till all these issues are resolved, many NGOs like Ashadeep, NAMI India, Sanjivni Society for Mental Health, The Banyan, Vandrevala Foundation, etc. have taken the initiative to take care of mentally ill people or create awareness around mental health issues.
Many NGOs have offered helpline numbers for people or individuals who can reach out to them directly over phone and seek help. Some of them are:
- Samaritans Mumbai: (com) – 022-64643267, 022-65653267, 022-65653247 – 3:00 pm to 9:00 pm, all days or email to firstname.lastname@example.org
- AASRA (http://www.aasra.info/): 022-27546669 is a 24 hours a day, 7 days a week nationwide voluntary, professional and confidential services.
- Sneha India (http://www.snehaindia.org) : Available 24/7 044-24640050.
- Vandrevala Foundation – 1860-266-2345 (Delhi & others)
- Lifeline Foundation, Kolkata – +913324637401/7432 or email to email@example.com
- Kashmir Lifeline, Srinagar – 18001807020 (between 10:00 am and 5:00 pm-except Friday & Saturday) You can also check their Facebook page.
- Roshni Hyderabad – +914066202000/2001 (everyday 11:00 am to 9:00 pm) or email to firstname.lastname@example.org.
- Maithri, Kochi – 0484 2540530 (everyday 10:00 am to 7:00 pm) or email to email@example.com.
- iCall, Mumbai – 022 25521111 (8:00 am to 10:00 pm – Monday to Saturday) or email to firstname.lastname@example.org or contact via Facebook or Twitter.
- Jeevan, Jamshepur – 0657-6453841/6555555 (everyday 10:00 am to 6:00 pm) or email to email@example.com.
- Sahai, Bengaluru – +9180 25497777, Monday to Saturday between 10:00 am to 8:00 pm
- Ashadeep, Guwahati – +919435043308/ 0361-2456837