Mental Health in India: An overview

According to a WHO report, 2018, India tops the list of countries with the highest depression. The global happiness index report 2019, published by United Nations reports that India’s rank has gone down 7 places to be at 140 among the 156 nations included in the survey. All these statistics point to an alarming trend of declining mental health and well-being in India. With more than 50 per cent of the population below the age of 25, such a trend points out at the necessity to address the mental health issues, especially among young adults.

Why is mental health suddenly a huge issue?

The talk regarding mental health, of course, boomed very recently as it was largely unheard in the yesteryears. Naturally, it is common to look at it with scepticism for people who are acquainted with mental illnesses through roadside vagabonds, or grossly distorted and comical representations of mental illnesses in films and media. But today, more important than ever, a discussion on mental health and stringent actions to enhance it has become imperative due to several reasons like the following:

Changing times, changing demands: Increased pace of life, work and other forms of stress, environmental factors like noise and crowding, changing culture and attitudes and related issues like acculturation, identity confusion and trouble in relationships
Taking over by technology: Reduced face to face interactions, technology-based lives where we feel our lives and we ourselves are inadequate based on Facebook feeds and Instagram stories. We fail to remember, as the great French philosopher quotes “Kings and philosophers shit and so do ladies.”
Loneliness: One of the most severe epidemics in human history, loneliness, with its sublime effects is killing us, while we remain blind to it. It is not being alone, but as Carl Jung puts it an inability to connect, a feeling where you can do nothing but simply stare at your world collapsing before you. Increasingly nuclear families with decreasing communication have facilitated loneliness in our lives
Broken families
Substance abuse
Stress and reduced efficiency
Increasing suicides
Increasing crime rates and violence

How to know if someone is having mental trouble?

This “someone” could be you and I and It is often very difficult to pick up signs and symptoms of mental illness. Unlike in physical illness, in mental health, often you won't understand the situation or you would fail to realise that you need help. Even worse, you would be surrounded by confused people, not knowing what to do and their attempts to help may accidentally cause more damage which aggravates the situation. But doing nothing is not a good choice either as it might cost you the person itself. Nevertheless, there are certain signs subtly emanating from a tormented mind that call for help. These can be picked up if you could closely pay attention.

Lack of appetite and sleep.
Unusual mood swings.
Excessive, often unusual expressions of anger.
Withdrawal, apathy, and anhedonia.
Socio-occupational dysfunction.
Physical symptoms without definite underlying causes.
Excessive anxiety.
Extensive substance abuse.

What to do if you find someone like that?

Pay attention to those signs, but don't peer into their privacy or stalk them.
Ask them if they would like to talk and if they are ready to talk, listen.
Encourage them to take professional help.
Help them find recognised, reputed and reliable mental health services. In India, the sad fate of mental health services is the huge number of unqualified and hoax professionals, providing such services. This might lead to faulty diagnosis and worsen the situation.
Be constant support. Text them, help them get involved in activities they enjoy, use the strength of your relationship to make them feel loved and enhance your relationship through the process.

Mental illnesses are diverse and have a huge complicated array. ICD, in its upcoming 11^th version and DSM in its 5^th version, are two major global classification systems of mental illnesses, the former being a WHO publication and the latter published by APA. Unlike the popular notions of a few neurological and psychological illnesses like depression, anxiety, schizophrenia, there are several other types and classes of disorders, some of which, like personality disorders are strange in the fact that people with such disorders are less affected by the disorder when compared to the people around. When people do not have an insight regarding their problem, they naturally do not feel the need to go for treatment. An example of such disorders is the antisocial personality, commonly extrapolated as the psychopaths.

Even in such cases, psychological interventions can help a great deal. Even if some disorders are incurable, psychological interventions have been proved to definitely improve the situation and enhance the quality of lives for such individuals and their social circles. Hence, it is imperative to understand the significance of mental health services and to fight against the stigma surrounding it. With celebrities opening up about their mental struggles, and media trying to atone for the horrible mockery of mental illnesses in the past by sensitizing the public towards mental health, an active dialogue has been initiated on this topic.

Mental health, however, is still an overlooked aspect of health and overall wellbeing. Mental illness, due to several reasons seems obscure and subtle and is often prone to misunderstanding. In addition, the stigma surrounding mental health has worsened the situation regarding mental health. The condition of mental health in India is appalling.

According to a study published by World Health Organisation in 2018, mental health workforce in India (per 100,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07) which is grossly insufficient to cater to the 13.7% of Indian population suffering from mental illness as per the NMHS-2015-16. Despite encouraging dialogue about mental health, stigmatized attitudes towards mental illnesses persist as indicated in the TLLLF report 2018. However, in the modern age, mental health and related illnesses are one of the major crippling issues that not only have its effect on an individual level but also have pervasive effects across a community and a broader social context, and certainly call for immediate attention and efforts.

- Ananda Krishnan

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