Mental health is an important and integral part of human health. Currently, mental illness has become a global health concern, and there is little doubt that the pandemic has exacerbated the problem. Let us take a look at one of the most underserved areas of healthcare in India during the pandemic. One out of every five people in India suffers from some form of mental illness. Between 2012 and 2030, the economic cost of mental illness in India is expected to be $1.03 trillion. Ram Nath Kovind, India’s president, warned that India is facing a “mental health epidemic.” However, India spends a pittance on mental healthcare, at roughly 0.6 percent of the total health budget, compared to the world average of more than 5% on mental health research, infrastructure, and related activities.

Mental illness in India

According to a survey by the National Institute of Mental Health and Neurosciences (NIMHANS), at least 13.7% of the Indian population suffers from some sort of mental disorder, with approximately 10.6% of Indians requiring immediate treatment. Additionally, it has been discovered that over 42% of the private sector employees of corporate India suffer from depression or some form of anxiety disorder.

In this regard, there is also a significant rural-urban divide. Mental illness is more prevalent in cities than in rural areas. Urban people mostly suffer from schizophrenia, mood disorders, neurotic, and stress-related illness, which can be ascribed to stress, a fast-paced lifestyle, the difficulties of daily life, and a collapse of social support systems, amongst other factors.

Today, roughly one in every twenty people suffers from depression, particularly females between the ages of 40 and 49. Individuals in this age bracket are also more prone to suicide, especially those residing in metro cities. Income may also play a role in the development of mental disorders. Some studies have associated low levels of household income with mental disorders and suicide attempts.

Stigma with a lack of awareness

While the treatment gap is a significant factor in the persistence of these diseases, which is primarily due to financial constraints, negligence, a lack of awareness, a scarcity of mental health specialists (including neurologists, psychiatrists, psychologists, nurses, and social workers) throughout the country are also significant factors.

Additionally, there is no denying that social stigma linked with mental illness remains entrenched in India. Even today, mental health issues are rarely discussed publicly, and persons who suffer from a mental disease typically face discrimination and exclusion. Sometimes these push the depressed towards committing suicide. According to the study by NIMHANS, around 150 million Indians require mental health care services, yet fewer than 30 million seek medical treatment.

Mental Healthcare Act 2017

Recognizing the importance of mental health, the government of India formulated a National Mental Health Programme in 1982, and Mental Healthcare Act was passed in 1987. But even after nearly forty years, not much progress has been made in educating the public and eradicating the stigma associated with mental illness. This prompted the Indian government to introduce the Mental Healthcare Bill 2016 and the accompanying 2017 act, which repealed the 1987 Mental Health Act. This new Mental Healthcare Act also decriminalizes suicide attempts and ensures that every person challenged with mental illness gets easy and affordable access to good quality medical treatments funded by the government. Mentally challenged people should now get the right to equal treatment and be protected from inhuman treatments. The new act also protects and restores their property rights, which no doubt is a big achievement.

What is to be done?

However, little has changed in the country five years after the law was passed. Progress in the delivery of mental healthcare services has been sluggish, and there is great difficulty in allocating the weight of health problems, with mental healthcare issues typically being overlooked. Mental health cases have risen sharply since the start of the pandemic and the countrywide lockdown in 2020, and the pandemic is wreaking havoc on the population’s mental health, owing to fears of infection, social isolation, and the death of family members, all of which are exacerbated by the stress caused by unemployment and loss of income.

In addition, given the acute shortage of psychiatrists in the mental healthcare sector (approximately 3.5 psychiatrists per million people versus the Commonwealth average of 56 psychiatrists per million people), it would be impossible to sustain any significant leap without additional investment. More mental health specialists are desperately needed, including neurologists, psychiatrists, psychologists, nurses, and social workers. At the same time, it must be ensured that all people receive equal coverage for mental illnesses as well as other physical illnesses at a reasonable cost. Finally, our society needs to raise mental health awareness. The massive loss of human capabilities cannot be sustained indefinitely.

Soumik Sarkar is an Assistant Professor of Economics at Adamas University, India. He is a former Economist with the Indian Chamber of Commerce.