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Syllabus
- GS-II- Government policies and interventions for development in Health sectors and issues arising out of their design and implementation.
- GS-II- Health & Governance
Context: Children have spent the past two years in the grip of a pandemic that has played havoc with lives across the globe. This has impacted their mental health.
- The impact of the pandemic on the mental health and well-being of populations is gaining attention worldwide.
- Several experts, including the World Health Organization (WHO), have been expressing concerns that this is a global crisis to be reckoned with.
What is mental health and why it is important?
- Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It has intrinsic and instrumental value and is integral to our well-being.
- Mental also helps determine how we handle stress, relate to others, and make healthy choices. It underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in.
- Mental health is important at every stage of life, from childhood and adolescence through adulthood.
- Mental and physical health are equally important components of overall health. For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes, heart disease, and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness.
- Mental health is determined by a complex interplay of individual, social and structural stresses and vulnerabilities.
- Positive mental health allows people to:
- Realize their full potential
- Cope with the stresses of life
- Work productively
- Make meaningful contributions to their communities
- Mental illnesses are among the most common health conditions across world. There is no single cause for mental illness. A number of factors can contribute to risk for mental illness, such as
- Early adverse life experiences, such as trauma or a history of abuse (for example, child abuse, sexual assault, witnessing violence, etc.)
- Experiences related to other ongoing (chronic) medical conditions, such as cancer or diabetes
- Biological factors or chemical imbalances in the brain
- Use of alcohol or drugs
- Having feelings of loneliness or isolation
What is mental health and why it is important?
- Neglected Area: Mental health which forms the core of our personhood is often neglected which impeded the development of an individual to full potential.
- Stigmatised: Mental health illness is often considered as Taboo that leads to reluctance on part of family members to seek diagnosis & treatment for the patient
- Burden of Demography: According to WHO, the burden of mental disorders is maximal in young adults. India being a young country (nearly 50% of its population below the age of 25) will face increased burden of mental illness in short term
- Major contributor to the burden of illness: An estimated 150 million people across India are in need of mental health care interventions, according to India’s latest National Mental Health Survey 2015-16.
- Disproportionate impact: It is the poor, dispossessed and marginalised who bear the greatest burden of mental health problems, but historically their sufferings are dismissed as a natural extension of their social and economic conditions
- Post-Treatment gap: There is need for proper rehabilitation of the mentally ill persons post his/her treatment which is currently not present.
- Lack of Specialists: Low proportion of mental health workforce in India (per 100,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07).
- Dangers of increase in post-COVID order: Mental health problems, tend to increase during economic distress leading to reduction in life-expectancy. This has been described by Nobel prize winning economist, Angus Deaton, as “Deaths of Despair”
- Prone to abuse: Mentally ill patients are vulnerable to and usually suffer from drug abuse, wrongful confinement, even at homes and mental healthcare facilities which is a cause of concern and a gross human right violation.
- Affordability issues: Due to inadequate number of mental health caretakers, such service if often concentrated in Urban areas and are also expensive
- Needs Unique approach: There is no one-size-fits-all prescription for mental health issues as they are intimately intertwined with unique, personal life stories.
How measures do WHO recommend to tackle mental health?
- WHO’s “World mental health report: transforming mental health for all” calls on all countries to accelerate implementation of the action plan.
- WHO argues that all countries can achieve meaningful progress towards better mental health for their populations by focusing on three “paths to transformation”:
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- deepen the value given to mental health by individuals, communities and governments; and matching that value with commitment, engagement and investment by all stakeholders, across all sectors;
- reshape the physical, social and economic characteristics of environments – in homes, schools, workplaces and the wider community – to better protect mental health and prevent mental health conditions; and
- strengthen mental health care so that the full spectrum of mental health needs is met through a community-based network of accessible, affordable and quality services and supports.
- WHO gives particular emphasis to protecting and promoting human rights, empowering people with lived experience and ensuring a multisectoral and multistakeholder approach.
What is the status of Mental Health in India?
- In India, according to National Institute of Mental Health and Neuro-Sciences data, more than 80% of people do not have access to mental healthcare services for a multitude of reasons.
- As per the National Mental Health Survey conducted by the National Institute of Mental Health and Neurosciences (NIMHANS):
- The prevalence of mental morbidity is high in urban metropolitan areas.
- Mental disorders are closely linked to both causation and consequences of several non-communicable disorders (NCD).
- Nearly 1 in 40 and 1 in 20 persons suffer from past and current depression, respectively.
- Neurosis and stress related disorders affect 3.5% of the population and was reported to be higher among females (nearly twice as much in males).
- Data indicate that 0.9 % of the survey population were at high risk of suicide.
- Nearly 50% of persons with major depressive disorders reported difficulties in carrying out their daily activities.
What are the initiatives taken by India to deal with mental health?
- National Mental Health Program (NMHP): The National Mental Health Program (NMHP) was adopted by the government in 1982 in response to the large number of mental disorders and shortage of mental health professionals.
- To generate awareness among masses about mental illnesses Information, Education and Communication (IEC) activities are an integral part of the NMHP.
- District Mental Health Programme (DMHP), 1996 was also launched to provide community mental health services at the primary health care level.
- Facilities made available under DMHP at the Community Health Centre (CHC) and Primary Health Centre (PHC) levels, include outpatient services, assessment, counselling/ psycho-social interventions, continuing care and support to persons with severe mental disorders, drugs, outreach services, ambulance services etc.
- Mental Health Care Act 2017: Under this legislation, every affected person has access to mental healthcare and treatment from government institutions.
- It has significantly reduced the significance of Section 309 IPC and attempts to commit suicide are punishable only as exceptions.
- Kiran Helpline: In 2020, the Ministry of Social Justice and Empowerment launched a 24/7 toll-free helpline ‘Kiran’ to provide mental health support.
- Manodarpan Initiative: It aimed at providing psychosocial support to students, teachers, and family members during the Covid-19 pandemic.
- MANAS Mobile App: To promote mental wellbeing across age groups, the Government of India launched MANAS (Mental Health and Normalcy Augmentation System) in 2021.
- National Tele Mental Health Programme: This programme was announced in the Budget of 2022-23, to further improve access to quality mental health counselling and care services in the country.
So, what is the way forward?
- Awareness: People should be made aware of significance of mental health, as much as that of physical health.
- Destigmatising the issue: Sharing one’s story about mental health (through media campaigns) is the most effective strategy to reduce stigma attached with mental illness
- Community Approach: There is need to deploy community health workers who, with appropriate training and supervision, effectively deliver psychosocial interventions for the needy
- Increase Funding: State governments need to scale up its psychosocial interventions through community health workers
- Broadening the scope: Mental health care must embrace the diversity of experiences and strategies which work, well beyond the narrow confines of traditional biomedicine with its emphasis on “doctors, diagnoses and drugs”
- Digital initiatives: To help improve rural India’s mental health through telemedicine, initiatives like Schizophrenia Research India’s (SCARF) mobile bus clinic is being run by an NGO. There is need for scaling up such initiatives through public-private collaboration to bridge the rural-urban divide
- Measures that can be taken at individual level by people who are suffering from mental illness
- Reminding oneself that all of humanity is goes through tough times
- Doing something for others, for science has shown that care-giving and community service makes life more meaningful & rewarding
- Discussing with friends & families about the issues being faced
Main Practice Question: What interventions are taken by the government to address the rising mental health problems in India?
Note: Write answer his question in the comment section.
