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Mental health crisis in India: Identifying the elephant in the room!

Gunajit Baishya. India had a gnawing problem with mental health even before the advent of this Pandemic. Mental disorders are among the leading causes of non-fatal disease burden in India. The Lancet study says, one in seven Indians were affected by mental disorders of varying severity in 2017. “197·3 million people had mental disorders in India, including 45·7 million with depressive disorders and 44·9 million with anxiety disorders.”

This post-Covid landscape in India will be a fertile breeding ground for an increase in chronic stress, anxiety, depression, alcohol dependence, and self-harm. The pandemic exposed the social and economic fissures in mass unemployment, depleted social safety nets, starvation, increase in gender-based violence, homelessness, alcoholism, loan defaults and millions slipping into poverty. People who already have mental health issues find it hardest to deal with the uncertainty created by the pandemic. And it has already started showing symptoms in society.

A leading suicide prevention advocate in India. Nelson Vinod Moses, says “At-risk populations include the 150 million with pre-existing mental health issues, Covid-19 survivors, frontline medical workers, young people, differently abled people, women, workers in the unorganized sector, and the elderly.”

Past incident tell us – After the stock market crash of 1929, the suicide rate in the United States (US) rose 50%; to 18.1 per 100,000 from the 12.1 per 100,000 from 1920 to 1928 and stayed at 15.4 per 100,000 between 1930 and 1940. In 2008, researchers from the University of Oxford and the London School of Hygiene & Tropical Medicine noted an extra 10,000 “economic suicides” across the US, Canada and Europe, due to the financial crisis. These suicides were attributed to the economic hardships post-recession.

A country like India with the highest number of poor and starved, and individuals with depression and anxiety, this pandemic is the perfect storm. In 2018, India reported 1,34,516 suicides. The World Health Organization (WHO) pegged 2016 suicides at 215,872, with a suicide rate of 16.5 suicides, against the global suicide rate of 10.5. History tells us that India should prepare for a large number of suicides or mental crises.

Suicides rise in India during Covid-19 crisis

320922 is the fearsome and huge number of COVID-19 cases with 9195 deaths being reported in India is complicating the situation. (As on 13 June 2020)

320922 is the fearsome and huge number of COVID-19 cases with 9195 deaths being reported in India is complicating the situation. (As on 13 June 2020). “From two-year-olds to teenagers, anxiety and stress rises among all age groups.”

In India due to distress triggered by the nationwide lockdown. A new set of data compiled by a group of researchers revealed that 338 deaths have occurred from March 19 till May 2 and they are related to lockdown. The group, comprising public interest technologist Thejesh GN, activist Kanika Sharma and assistant professor of legal practice at Jindal Global School of Law Aman.

According to the data, due to loneliness 80 people killed themselves and fear of being tested positive for the virus. The suicides are followed by migrants dying in accidents on their way back home (51), deaths associated with withdrawal symptoms (45), and those related to starvation and financial distress (36).

Recently, many suicide incidents are making news headlines including students, famous personalites, farmers, politician who have decided to end their life by suicide which is definitely a warning sign for India.

Free health centre and counselling during this crisis : To counter distress over COVID-19.

Coronavirus affects mental health in a dreadful manner and intensity throughout the world and also India at large. Furthermore, many psychologists across India offer counselling support during the COVID-19 or lockdown, round-the-clock and in many languages. Discussing uncertainty about their businesses and careers, interpersonal problems, Coronavirus infection, and even struggles to abstain from alcohol in many states.

Mastermind foundation has taken this initiative to extend COVID-19, “PAN INDIA FREE COUNSELING SERVICE” to the citizens of India. And many other organisations like National Institute of Mental Health and Neuro Sciences (NIMHANS), and Mumbai-based Arpan are also coming forward to helping people deal with mental wellbeing.s.

Mental Healthcare Act, 2017, (MHCA) :

  • An Act aims to provide for mental healthcare and services for persons with mental illness and to protect, promote, and fulfill the rights of such persons during the delivery of mental healthcare and services. The Act is progressive, patient-centric, and rights-based.
  • The Convention on Rights of Persons with Disabilities and its Optional Protocol was adopted on the 13th December 2006 at United Nations Headquarters in New York and came into force on the 3rd of May, 2008. Once the Government of India ratified the United Nations Convention on the Rights of Persons with Disabilities on the 1st day of October 2007.

The MHCA (Mental Health Care Act) guarantees every affected person access to mental healthcare and treatment from services run or funded by the government. The MHCA, 2017 that promises mental health care to all and introduce a suicide prevention policy. Countries like China, have been able to significantly reduce suicides after they implemented a suicide prevention policy.

How much India spends on healthcare, and in particular, mental healthcare, is it enough?

The annual health expenditure of India is 1.15% of the gross domestic product, and the mental health budget is <1% of India’s total health budget. In the 2020-21 Budget, India spend only 1.6 per cent, that is Rs 67,489 crore, of its total estimated budget expenditure on public health “which is not only very low in comparison to the average global public health expenditure but is miniscule even in comparison to the expenditure of low income countries”. If we look towards the other countries, the U.S. spends 17.5 percent of its GDP on healthcare, while Switzerland follows with a close second of 12.25 percent. France and Germany spend 11.45 and 11.27 percent respectively.

India’s investment in mental health — the last Union Budget slashed it by 20% from Rs 50 crore to Rs 40 crore. According to a study by the Indian Journal of Psychiatry “The conservative annual estimated cost on the government to implement the Mental Healthcare Act, 2017 would be Rs 94,073 crore.” Rs 94,073 crore compared to the allocated Rs 40 crore. It shows the lack of political will to address suicide prevention. Now it has to be seen how the government takes it forward.

Prevalence of depressive disorder state-wise in India :

Prevalence of depressive disorder state-wise in India
Source: The Hindu

Break the silence: A call to take action

India share of global number of suicide deaths has been rising every year because of emotional and economic burden on our society. India will need to do a lot more to prevent the maltifacted suicide death in the society. This is time to take pro-active steps and leadership roles in suicide prevention. By spreading message through films, making effective Mental health Plan, through campaigns to raise awareness, importance of suicide awareness and positive mental health to get it out in the open and Community engagement toolkit many lives can be saved. States like Assam have set up, till free centred to respond to mental health issues of quarantined and covid positive people and many states have provided access to free mental health counselling. But this should not be treated as a wave that tudes over rather an elephant in the room that everyone refuses to acknowledge.

“Mental health and suicide should be treated as a public health crisis that needs immediate fixing”

#Gunajit Baishya

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