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Did You Know That There Are Only 3 Psychiatrists Per A Million People In India?

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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 samaritans.helpline@gmail.com
  • 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 reach@lifelinekolkata.org
  • 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 roshnihelp@gmail.com.
  • Maithri, Kochi – 0484 2540530 (everyday 10:00 am to 7:00 pm) or email to maithrihelp@gmail.com.
  • iCall, Mumbai – 022 25521111 (8:00 am to 10:00 pm – Monday to Saturday) or email to icall@tiss.edu or contact via Facebook or Twitter.
  • Jeevan, Jamshepur – 0657-6453841/6555555 (everyday 10:00 am to 6:00 pm) or email to jeevanjamshedpur@gmail.com.
  • Sahai, Bengaluru – +9180 25497777, Monday to Saturday between 10:00 am to 8:00 pm
  • Ashadeep, Guwahati – +919435043308/ 0361-2456837
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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