Supreme Court has said the judiciary should not treat the mental health of a person with a “one-size-fits-all” approach.
Data on Mental health:
The top mental illnesses were depressive disorder and anxiety disorder, impacting 45.7 million and 44.9 million respectively.
The contribution of mental health disorders to the total Disability-Adjusted Life Years (DALYs) in India increased from 2.5% in 1990 to 4.7% in 2017.
The Southern states namely Tamil Nadu, Kerala, Telangana, Karnataka, and Andhra Pradesh accounted for a higher prevalence of mental disorders.
Range of Mental illnesses in society:
Mental illnesses include anxiety disorders, psychotic disorders, mood disorders, substance use disorders, personality disorders and eating disorders.
The majority of suicides in the world are related to psychiatric problems or to the illnesses listed above.
Death by suicide is a complex phenomenon and not fully reported.
Globally, the suicide rate was 10.6 per 1,00,000 population whereas in India, it was 16.3 per 1,00,000 in 2016. The suicide rate was higher among males compared to females.
Mental health may not be the primary concern in developing economies like India as there may be other communicable and non-communicable diseases which may be more prevalent.
There are also challenges regarding funding, delivery of mental health packages, lack of trained staff, etc.
However, these challenges need to be considered more seriously in the wake of COVID-19 as mental health issues are widely prevalent among the Indian population due to lockdowns and related issues.
Challenges related to Mental Health in India:
existing public-health priorities and its influence on funding; c
hallenges to delivery of mental health care in primary-care settings;
the low numbers of those trained in mental health care;
the lack of mental health perspective in public-health leadership.
In India, having a mental health disorder is perceived with a sense of judgement and there is stigma associated with those having mental health issues.
Mental disorders are also considered as being a consequence of a lack of self-discipline and willpower.
The stigma associated with mental health as well as lack of access, affordability, and awareness lead to significant gaps in treatment. The National Mental Health Survey (NMHS), 2015-16 found that nearly 80% of those suffering from mental disorders did not receive treatment for over a year.
There are a few studies which have measured mental health literacy in the Indian context. One study found mental health literacy among adolescents to be very low, i.e. depression was identified by 29.04% and schizophrenia/psychosis was recognized only by 1.31%. Stigma was noted to be present in help-seeking.
Initiatives to improve Mental Health:
National Mental Health Programme (NMHP): India launched NMHP in 1982 to improve the status of mental health in India. It has three important components. Such as Treatment of the Mentally ill, Rehabilitation and Prevention and promotion of positive mental health.
The Mental Health Care Act (MHCA) 2017: This Act repealed the Mental Health Act, 1987. The Act seeks to ensure the rights of the person with mental illness to receive care and to live a life with dignity. Few salient provisions of the Act are,
Central and State Mental Health Authorities: The Act established these authorities for regulation & coordination of mental health services in India.
Right to make an Advance Directive: Under this, every person can state how to be treated or not be treated for the illness during a future mental health situation.
Right to appoint a Nominated Representative: Every person also has the right to appoint a nominee to take, on his/her behalf, all health-related decisions.
Changes in Section 309 of the Indian Penal Code: This section of IPC criminalized the attempt to commit suicide. After the enactment of the Act, a person who attempts to commit suicide will be presumed as a person “suffering from severe stress’’. The person will also not subject to any investigation or prosecution.
KIRAN helpline: It is a 24/7 toll-free helpline launched by the Ministry of Social Justice and Empowerment. This helpline provides support to people facing anxiety, stress, depression, suicidal thoughts, and other mental health concerns.
Manodarpan Initiative: It is an initiative launched by the Ministry of Education under Atmanirbhar Bharat Abhiyan. The initiative provides psychosocial support to students, family members, and teachers for their mental health and well-being during the times of Covid-19.
RAAH app: It is a mobile application that provides free information to the public on mental health care professionals and mental healthcare centres. The National Institute of Mental Health and Neuro-Sciences(NIMHANS) has compiled a one-stop source online mental health care directory.
MANAS App: MANAS stands for Mental Health and Normalcy Augmentation System. It is a comprehensive, scalable, and national digital wellbeing platform. It has been developed to promote the mental well-being of Indian citizens.
Way Forward:
Urgent investment in child and adolescent mental health across sectors, not just in health, to support a whole-of-society approach to prevention, promotion and care.
Urgent investment in strategies to promote good mental health including prevention of gender-based and other forms of violence
Integrating interventions across health, education and social protection sectors - including parenting programmes and ensuring schools support mental health
Breaking the silence surrounding mental illness, through addressing stigma and promoting better understanding of mental health.
