*Dr Milind Deogaonkar  <[email protected]>*

*05 Feb 2012*

At its just concluded executive board meeting, the World Health
Organisation (WHO) adopted a resolution moved by India that focuses on the
global burden of mental disorders, and the need for a comprehensive,
coordinated response from health and social sectors at the country level.
India had also successfully argued for mental disorders being included in
the non-communicable disease list at the first Ministerial Conference on
Healthy Lifestyles and Non-commu­nicable Disease Control in Moscow last
year.

India’s initiative has been lauded, as the gap between the need for
treatment for mental disorders is wide all over the world. For example,
between 76 and 85 per cent of people with severe mental disorders receive
no treatment for their mental health problems, in low and middle-income
countries; the corresponding range for high-income countries is also
between 35 and 50 per cent.

It is internationally recognised that mental health is equally, if not
more, important for the health of any country. We need to do much more in
creating awareness, and governments too need to understand the implications
of mental illness and its ramifications on quality of life of citizens,
their families and society. While depression due to social factors is
leading people to commit suicides on one side, there is also a
bidirectional relationship between medical and mental illness. She points
out that cardiovascular diseases, cancer, stroke and Parkinson’s disease
also lead to prevalence of comorbid depression among those patients.

Yet it’s ironical then, that our mental healthcare scene is dismal,
bordering on the negligent. A note prepared by the ministry says, seven per
cent of India’s population suffers from mental disorders and over 90 per
cent remain untreated. There is less than one psychiatrist available for
every four lakh people.

The scene is worse in rural areas. This is not surprising considering
India’s allocation for mental health­care is less than 1 per cent of the
health budget. Translated into ground reality, these figures mean that a
huge percentage of the mentally ill are cared for by their families without
even getting a proper diagnosis.

The social stigma associated with being mentally sick means that families
can hardly hope for a support network outside the home. Even among the
educated and better-off sections, it is common to see the severely mentally
ill being hidden from the outside world, shunned by neighbours and
relatives, while those suffer­ing from less severe forms are accused of
being work-shirkers and malingerers. Women sufferers bear a heavier burden.
The mentally ill are also more prone to suffer violation of their human
rights, remain unemployed and poor, and more susceptible to the other
non-communicable diseases.

The strategies to fight mental illness call for a complex array that will
deal with its multifaceted effects, and civil society must do its part as
much as the government. Mental health and its ramifications affect every
country and section of society. Unfortunately, official recognition of the
incidence of the same in India has been more on paper than in practice. The
National Mental Health Programme (NMHP) was launched in 1982, while the
Mental Health Act (MHA), 1987, came into effect in the early 1990s. The
implementation of the programme has, however, not been satisfactory, the
most significant factor being the lack of priority given by the states to
it.

Psychiatrists and judicial activists have called for an overhauling of the
MHA to make it more patient-friendly and in tune with advances in the field
of mental healthcare. The draft MHA 2010 needs to be publicised and
discussed widely in the public domain.

One of their major demands is that the mental health programme should be
incorporated in the National Rural Health Mission, and care and counselling
should be available at primary health centres. There should be greater
attention to re­habilitation in severe illnesses like schizophrenia, which
is estimated to affect over 30 lakh patients in India.


*(Dr Deogaonkar is a US-based neurosurgeon of Indian origin. The opinions
expressed in this column are the author’s own)*
*
*
http://expressbuzz.com/voices/Dismal-mental-health-scenario-in-India/359525.html

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