Mental health is defined as a condition of well-being in which a person recognises their ability to cope with various stressors in life and accordingly work to achieve success and productivity.
In India, there was already a mental health crisis before the pandemic broke out and now it has been brought to light, exposing flaws in existing mental health infrastructure and laws.
For instance, even though the WHO estimates that more than 90 million Indians, or 7.5% of the country’s 1.3 billion people, lives with mental illnesses, the country spends only ₹0.33, or approximately $0.5, on each mental health patient each year.
Further, according to a UNICEF report, only 41% of Indian youngsters think seeking treatment for mental health problems is a good idea. This should serve as a wake-up call, demonstrating that India’s mental health care system needs improvement and additional assistance from the government.
Mental health is influenced by the social, environmental and economic circumstances in which a person grew up, worked and aged. Early in infancy, inequalities in mental health arise, and they become more prominent as children get older. Exposure to abuse or home dysfunction, for example, leads to major mental health problems.
Further, people who belong to lower socio-economic status are prone to mental health issues and suffer severely due to a lack of resources. This can be explained by the demand-resource imbalance hypothesis, which states that people with low socio-economic status confront greater demands from exposures that risk their health and life but have fewer resources backed up to deal with them.
— Youth Ki Awaaz (@YouthKiAwaaz) March 1, 2020
As per a report, the pandemic has pushed 30 million Indians into poverty. It’s also worth mentioning that more than two-thirds of Indians are already impoverished, with 68.8% of the population living on less than $2 a day. As the number of individuals falling into poverty rises, it is critical to address the issue of mental health.
In many instances, people living with mental illnesses experience stigma and societal ostracisation. Moreover, sometimes family members eventually give up to deal with the situation. In addition, the lack of effective and inexpensive services for people in various places is a barrier. Then there is a lack of awareness and information on the nature and incidence of mental health care issues.
All these add up to a feeling of identity that has been passed down through generations in Indian culture. Adolescents are instructed what type of standards they must meet and who they must become as individuals by their families and others. As a result, people don’t get enough time to go out and discover who they want to be as persons and individuals. This then leads to a certain amount of dissonance.
With the spread of the internet throughout the world, there is also a homogenisation of culture. The sense of entitlement has grown, while the sense of sensitivity is dwindling. As the internet shapes the brain differently with a reduction in the ability to defer satisfaction because everything is just a click away, it results in a lack of empathy for one’s feelings as well as for others.
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Also, it gets difficult to share mental health problems in conservative societies like India, and people’s indifference further adds to the hardship for the person. If society perceives mental illnesses as a problem, then it would go unaddressed since the affected person would not reach out in fear of being labelled or judged.
Further, caring for the individual is not only emotionally and socially draining, but it is also financially costly for the family. In these situations, family members must be sensitised on how to carry out their caregiving responsibilities, which will be difficult for many to do.
There are insufficient numbers of specialists to staff mental health care in India. Primary care settings are better for providing initial mental health care, though specialists who can provide specific services are few.
Although, the Mental Health Act of 2017 recognises that everyone has a right to mental healthcare by requiring states to treat mental illnesses equally to physical illnesses and ensuring that everyone has access to mental health services at government institutions. However, its implementation has not been uniform across states, with only a few states creating rules and forming authorities under the 2017 Act.
The Borgen Project reported that only 10% of Indians suffering from mental health illnesses receive treatment.
Dr Tedros Ghebreyesus, head of the WHO, said:
“We must heed and act on this wake-up call, and dramatically accelerate the scale-up of investment in mental health.”
— Youth Ki Awaaz (@YouthKiAwaaz) October 11, 2021
For instance, a PIL was filed in the division bench of the Rajasthan High Court in 2020, stating that no measures have been taken to draught rules under the Mental Health Care Act of 2017. Further, despite several directives from the Supreme Court bench in Gaurav Kumar Bansal’s case, several states have failed to provide a progress report on the MHCA’s implementation.
Thus, there is a lack of willingness on the part of various state governments to create regulations and authorities in this respect, which must be established at the state level to resolve grievances and defend the rights of victims and their families.
Furthermore, it is unfortunate that none of the constitution’s articles expressly address mental health care or advocate for the state to promote mental health treatment. However, using the relevant articles of the constitution, the judiciary has given a broader meaning to the concept of health, ensuring the citizens’ right to a dignified life that includes both bodily and mental health.
For instance, Article 21 of the Indian Constitution guarantees the right to life and personal liberty, which includes the right to health.
It should be encouraged that the doctors return to rural areas and assist those who cannot afford pricey treatment. For instance, Doctor Gupta has been assisting people in rural Rajasthan, Punjab and Haryana to improve their mental health awareness for several years. Therefore, the government should incentivise such doctors so that other medical professionals also start these drives in the country.
In conclusion, spreading mental health awareness, which will generate its demand, is the best method to move forward and see the Mental Health Act being followed. It is believed that as public knowledge grows, so will access to treatment, and all the state governments will be pressured to create regulations for the benefit of the people.
It’s also reasonable to expect advocacy, political will, funding and cross-synergies will also follow.