On par with ‘per capita income’ of Indians, not more than 10% of total population (130 crore) can afford mental health assistance. When the annual health expenditure of India’s GDP is 1.15%, despite the staggering rate of suicide rates in the world, Indians are respectively eligible for .33 paisa (less than one dollar) in the space of mental health assistance. The amount spent on mental health assistance is comparable with what Indian billionaire Mukesh Ambani makes in just 3 hours, or a day’s expense of a trip abroad by Indian Prime Minister Narendra Modi.
India is home to an estimated 56 million people suffering from depression and 38 million more from anxiety disorders, according to the World Health Organization (WHO) report in 2015–16. To add woes, in this lockdown period since March 2020, there’s an increment of 20% sufferers (other than the cases of domestic violence, sexual abuse and suicidal rates) but however the predicament has always been persisting before the covid-19 outbreak.
Talking about ‘sex’ in public sphere or with family members, despite overly populated, is still a taboo and anti-sanskaari. The brouhaha of 21st century is merely conspicuous, it seems? On the same lines, discussions over ‘mental health’ is yet to find its space, normalcy and acceptance. No matter how loudly and passionately they chant ‘Jai Shri Ram’ but mental health is still finding itself in the records of stigmatic books.
To bring to your notice, the plight in “rural India” is far worse because of triggering environments that increase an individual’s susceptibility to contract a mental illness; a lack of awareness on the subject and widespread superstition shrouded around mental illness; and a dearth of resources and facilities, at the same time. The cases of farmers’ suicides are fair enough to prelude the unfair treatment meted out to the ‘shudra’ (working class) of rural India, while there’s a complete blackout on the subject of mental health issues experienced by Dalits and Queer community in India.
The year 2016 which witnessed the chest-thumping demonetization movement, also saw the highest suicide rates (17 for every 100K Indians). The mainstream media has not mustered the courage to talk about the issue ‘yet’. According to the 2016 National Mental Health Survey, 83% of people suffering mental health problems in India did not have access to adequate mental health treatment. The same year, India had three psychiatrists for every million people and even fewer psychologists, according to the World Health Organization (WHO). If we keep aside ‘what about Pakistan?’ for a while, the same year tells that the US had 100 psychiatrists and almost 300 psychologists for every million people.
India currently has 9000 psychiatrists, 2000 psychiatric nurses, 1000 clinical psychologists, and 1000 psychiatric social workers. The country would need an additional 30,000 psychiatrists, 37,000 psychiatric nurses, 38,000 psychiatric social worker and 38,000 clinical psychologists. According to a study published in the Indian Journal of Psychiatry, it will take 42 years to meet the requirement for psychiatrists, 74 years for psychiatric nurses, 76 years for the psychiatric social worker, and 76 years for clinical psychologists, for providing care for the total population. The same goes for the hospital beds as well.
India has to pick up promptly before ‘we are sorry for each other’.
On May 16, 2020, the Supreme Court issued a notice to the insurance regulator (IRDAI) seeking the latter’s response on coverage of mental health ailments in policies. Though it is mandated, covers are still not widely available. SC was responding to a petition where it was stated that insurers were refusing to cover mental health treatment.
Under the Mental Healthcare Act 2017, offering insurance for mental health ailments has been made mandatory by law. The Act says that every insurer has to offer medical insurance for treatment of mental illness on the same lines as insurance for physical illness treatment.
The Section 18 of the Mental Healthcare Act, 2017 says that every person shall have a right to access mental health care and treatment from mental health services run or funded by the government. If the government fails to provide the right to access mental health care to everyone, then it is the responsibility of the government to reimburse the costs of treatment.
In reality, this never happens.
Cost estimation for the implementation of the Mental Healthcare Act 2017 http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2019;volume=61;issue=10;spage=650;epage=659;aulast=Math
Over 5 crore people suffer from depression in India: WHO https://www.livemint.com/Specials/Ysja8QtaVqjRpKg7eAFJfL/Over-5-crore-people-suffer-from-depression-in-India-WHO.html
The conversation around mental health in India forsakes 69% of the population https://www.moneycontrol.com/news/india/the-conversation-around-mental-health-in-india-forsakes-69-of-the-population-4577731.html
As India’s lockdown ends, a mental health crisis is looming https://www.weforum.org/agenda/2020/05/indias-lockdown-ends-mental-health-crisis-beginning/
Mental Health Series Part 2: At up to Rs 19,000 for therapy, how many in India can afford treatment? https://www.moneycontrol.com/news/business/economy/mental-health-series-part-2-at-upto-rs-19000-for-therapy-how-many-in-india-can-afford-mental-healthcare-facilities-5414271.html