Address Stigma and Discrimination in Mental Health

Context: The Lancet recently released a new report calling for radical action to end stigma and discrimination in mental health. The World Mental Health Day was also celebrated on October 10th.

About new Lancet Commission:

• It is a grouping of over 50 contributors across the world, including people, academics, policymakers with lived experience of mental health.

Highlights of the report:

• The report indicated that 90% of people living with mental health conditions feel negatively impacted by stigma and discrimination.
• Further, 80% said stigma and discrimination can be worse than the condition itself.
• Additionally, 90% of those surveyed felt that media could play a major role in reducing stigma.
• On ‘stigma’ associated with mental health:
  • As per the commission, stigma can cause social exclusion and disempowerment of people with mental health conditions leading to discrimination and human rights violations, including problems in accessing healthcare, challenges in securing employment, and increased likelihood of health complications leading to early death.
  • Women with a diagnosis of severe mental disorder and their family members do face more stigma which has ramifications for marriage and employment preventing social inclusion.

Report recommendations:

• Putting the involvement or participation of people with mental illness at the centre of the matrix, the commission has urged governments, international organisations, schools, employers, healthcare, civil society and media to act immediately.
• For instance, it has been recommended that all countries take action to decriminalise suicide, therefore reducing the stigma around suicide and leading to fewer occurrences.

Determinants of Mental Health:

• Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time.
• For example, violence and persistent socio-economic pressures are recognized risks to mental health. The clearest evidence is associated with sexual violence.
• Poor mental health is also associated with: rapid social change, stressful work conditions, gender discrimination, social exclusion, unhealthy lifestyle, physical ill-health and human rights violations.
• There are specific psychological and personality factors that make people vulnerable to mental health problems. Biological risks include genetic factors.

Status of mental health in India:

• WHO estimates that about 7.5 percent of Indians suffer from some mental disorder and predicts that by the end of this year roughly 20 percent of India will suffer from mental illnesses.
• WHO states that there is a huge shortage of psychiatrists and psychologists in India.
• According to the numbers, 56 million Indians suffer from depression and another 38 million Indians suffer from anxiety disorders. India also accounts for 36.6 percent of suicides globally.
• A report published in The Lancet Psychiatry in February 2020 indicates that in 2017, there were 197.3 million people with mental disorders in India.

Various Government of India Initiatives:

Constitution and Legal Provisions:

• Article 21: The right to a dignified life extends to the right to seek Mental Health care.
• Article 47: Duty of the state to raise the level of nutrition and the standard of living and to improve public health.

National Mental Health Programme (NMHP) in 1982:

• To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of the population.

Mental Healthcare Act, 2017:

• It was passed in 2017, came into effect in May 2018 and replaced the Mental Health Act of 1987.
• To the joy of most Indian medical practitioners and advocates of mental health, the act decriminalised suicide attempts in India.
• It also included WHO guidelines in the categorisation of mental illnesses.
• The most significant provision in the act was “advanced directives”, which allowed individuals with mental illnesses to decide the course of their treatment and also appoint someone to be their representative.
• It also restricted the use of electro-convulsive therapy (ECT), and banned its use on minors, finally introducing measures to tackle stigma in Indian society.

Rights of Persons with Disabilities Act, 2017:

• The Act acknowledges mental illness as a disability and seeks to enhance the Rights and Entitlements of the Disabled and provide an effective mechanism for ensuring their empowerment and inclusion in society

Mano Darpan Initiative:

• An initiative under Aatmanirbhar Bharat Abhiyan aims to provide psycho-social support to students for their mental health and well-being.

Kiran Helpline:

• The helpline is a giant step towards suicide prevention and can help with support and crisis management.
• The helpline aims to provide early screening, first-aid, psychological support, distress management, mental well-being, and psychological crisis management and will be managed by the Department of Empowerment of Persons with Disabilities (DEPwD).

SAATHI:

• It is a South-Asian Mental Health Outreach Program of ASHA International that aims to:
• Promote awareness about mental health and emotional wellbeing Improve access to care.

Way Forward:

• There is a need for more promotive programs & campaigns on mental health.
• The government should press more on allocating more funds in Mental Health Organisations.

Source: The Hindu