“It is health that is real wealth and not pieces of gold and silver” – Mahatma Gandhi
By and large, physical health is still more straightforward and more tangible than mental health, but over the course of the past decade, there’s been increased willingness to recognize mental health as an essential part of one’s well-being. But whenever we observing today’s era such willingness and awareness towards mental health finds no place in 24/7 running and earning policy and such awareness about mental health is limited in mere words only. The current scenario is, in the race of earning money and becoming the richest or chasing the dream for gaining supreme position in the business or profession, people are not even hesitate to put his health in danger. What is meaning of earning such wealth which permanently damage our perfect health?
According to Ayurveda, perfect health is defined as “a balance between body, mind, spirit, and social wellbeing.”
Whenever “Health” is referred it is important to take note that it not only include physical health but also include “Mental Health”. However if the Primary Importance as to health is in question then it should be given to mental health since mental health is an integral and essential component of health. Even though person has gained the best physical fitness but if he is undergoing any mental illness, such fitness is of no use if person is not mentally fit. But, if person is mentally fit then even though he is facing toughest time he will overcome such situation.
As per World Health Organisation, “Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”.
When it comes to physical health, people are so conscious and aware that what super-foods eat and what the most cutting-edge workouts to stay fit and how to monitor every aspect of their health with state-of fitness bands. But when it comes to mental health, the awareness just isn’t there. Mental illnesses constitute one-sixth of all health-related disorders. India accounts for nearly 15% of the global mental, neurological and substance abuse disorder burden. Mental Health in India is still a fairly new topic and the mental health myths and taboos attached to this subject are prevalent till date. Many people aren’t even aware that they may be suffering from a mental health concern. Educating people about mental wellbeing, however, is a battle in itself.
As per nationwide Statistics, 1 in every 5 individuals suffers from some form of mental illness symptoms. Close to 60 to 70 million people in the country suffer from common and severe mental disorders. 50% of mental health conditions begin by age 14 and 75% of mental health conditions develop by age 24. Mental illness can be triggered by a multiple factors. Some of the factors are long term acute stress, biological factors, drug overdose, constant negative thoughts, low on energy etc.
Indian Laws on Mental Health
The age-old legislations of the Indian Lunatic Asylum Act of 1858, and the Indian Lunacy Act of 1912 were mainly centred around custodial issues. Later, the Mental Health Act replaced the Indian Lunacy Act of 1912, which had largely focused on custodial care and “protecting” the public from patients. Under the new act, patients could be treated at general hospitals. In 1996, the NMHP was expanded to the district level. The new District Mental Health Programme was supposed to install a team of mental-health professionals to run outpatient services and manage a ten-bed inpatient facility in each of India’s 630 districts by 2025.
But the DMHP has faced several challenges. Because healthcare is the responsibility of individual state governments, the quality of DMHP facilities vary from state to state. By 2016, according to government statistics, only 241 districts had been covered under the scheme and this act too did not see the light of day.
The Mental Healthcare Act, 2017 ensures that every person with a ‘mental illness’ has access to mental healthcare services. It guarantees the right to affordable, good quality and geographically accessible mental health services. It says that the central or state governments must provide for or fund these services. It ensures that these persons have a right to live life with dignity by not being discriminated against or harassed. It decriminalizes suicide attempt by a mentally ill person. A person with mental illness shall not be subjected to (ECT) therapy without the use of muscle relaxants and anesthesia.
Another highlight of this act is to include the mental illness under insurance. However, till date it has been not cover even after clearly mentioned under Mental Healthcare Act, 2017. Similarly, petition is filed by Mental Health Activist before Hon’ble Supreme Court on the ground that apex authority had failed to ensure that insurance companies provide insurance cover to mental illnesses despite a law providing for it.
Factors responsible behind Mental Illness
Ignorance and Social Stigma-
Ignorance and Social Stigma are two negative sides that gives the brutal blow to mental health. Ignorance is most dangerous than actual illness since after getting diagnosed with illness, it can be eliminated by immediate treatment. However, if the person is not aware about illness then how to save that person from illness is the biggest task and in such situation chances of getting cured is reduced day by day.
In our country, the discovery of a mental illness is often followed by denial and hesitation to seek help. Despite its enormous social burden, mental health remains a taboo subject that is susceptible to age-old stigmas, prejudices and fears. Even though mental disorders can be cured or controlled, most people tend to sweep their issues under the carpet and suffer in silence. Approach of society plays the major role towards person undergoing mental illness if positive attitude is adopted by society then society is going to witness positive change in such person.
The foremost reason for India to lose its mental health is the lack of awareness and sensitivity about the issue. There is a big stigma around people suffering from any kind of mental health issues. They are often tagged as ‘lunatics’ by the society. This leads to a vicious cycle of shame, suffering isolation of the patients. One of the most effective ways to overcome such situation is to educate and sensitise more people about the nitty-gritty surrounding mental Health.
Depression-
Depression and mental health problems are something that can strike anyone and everyone. Now-a-days, it is as normal as catching a cold, or suffering from fever. If depression is not diagnosed at the earliest it shall proceed towards mental and psychological disorder which in some cases ended into committing suicide. Multiple factors are responsible behind Depression i.e. Loss in Business or Profession, Breakdown of Marriage, dysfunction of family life etc. The major element behind increasing cases of depression is the person suffering from depression find it difficult to come forward, and those around them find it difficult to recognise it. Many in India still don’t recognise depression as an ailment that can be treated and controlled.
In India, more than 58 million people (or 4.5 per cent) people suffer from depression. Globally, the total number of people suffering from depression was estimated to exceed 300 million. This is about 4.4 per cent of the world’s population. This is an 18 per cent increase between 2005 and 2015.
Untreated depression is the leading cause of more than 7,88,000 suicides that occur worldwide every year, roughly corresponding to one death in every 45 seconds. Due to COVID-19 Pandemic, the rate is even higher. According to recent survey, 43 per cent Indians suffering from depression as lockdown & job loss left huge impact on mental health.
There were some Bollywood celebrities as well who undergone the depression . However, some of them overcome the depression and become the superstars and in remaining cases, depression overtake to some celebrities and they become the shining star of galaxy.
Cricket too is no more exception of mental illness. In October 2019, Australian all-rounder Maxwell proceeded towards “Mental break” on ground of deep mental stress. Even Virat Kohli too undergone similar kind of mental stress on India tour of England 2014.
Financial Crisis-
Financial crisis is huge blow in anyone’s life. If the person is not competent to tackle the shock of financial loss it resulted into breakdown of mental health and in some cases it will extend to some serious mental disorder as well. Apart from it, loss of job or employment too break down the mental health especially at the time where rate of unemployment is much higher. Due to the Nationwide Lockdown to prevent the transmission of Corona Virus, such lockdown almost affected the people of entire nation engaging in different businesses and professions. Using the savings to met basic necessity instead on using it on future plans keep the future dreams under the cloud of darkness. As per recent survey, almost 61% Indians are facing mental health issues in Covid-19 Pandemic. Such Situation is marked as ‘Worst period of the Decade’
Dysfunctional of family life-
Specific to mental health, family plays a very significant role in development of positive mental health. Chances of occurring of psychological problems could be lessened if family climate is maintained as healthy and supportive to family members.
A dysfunctional family is a family, in which conflict, misbehaviour and even abuse on the part of individual members of the family occur continuously. Dysfunctional families are most often a result of the alcoholism, substance abuse, or parents’ untreated mental illnesses/defects or personality disorders, and dysfunctional family experiences. Violence and verbal abuse are typical outcomes. Harsh behaviour to the family members especially to the children badly affect their mental health. Child is very easily affected from such instances and gradually, such harsh behaviour too noticed in child since for any child his parents is biggest ideal and primarily he learn whatever his parents teach him or either by following the practices followed by his parents. That’s why it is always quoted that , “Happy Family is Healthy Family”
Treatment Gap:-
Treatment Gap is equally contributed towards cases of mental health. If person undergone any mental distress attended with proper treatment the outcome shall be different. There are certain elements that resulted into treatment gap such as, negligence on the part of doctor or medical staff, expensive treatment, lapse of time as if the patient is not treated on the time agreed earlier resulted into gap in treatment. According to the WHO study, the treatment gap (the number of people with disease who are not in treatment) of mental disorders in developing countries was 76%–85%.
According to the recently conducted National Mental Health Survey (NMHS), the treatment gap of any mental disorder in India was reported to be as high as 83%. Further, it was reported that despite three out of four persons experiencing severe mental disorders, there are huge gaps in treatment. This has been reported due to the stigma associated with mental disorders, and nearly 80 per cent of those with mental disorders had not received any treatment despite being ill for over 12 months.
Mental Illness and Suicide
The most dangerous decision taken by any person undergoing mental illness or stress in relation with mental health is to end his life by way of suicide. The Social stigma surrounding mental health is believed to be one of the major causes of the high suicide rates in India. People suffering from any kind of mental illness constantly face social judgement. Mental health conditions like depression and anxiety don’t even show apparent symptoms at times. Hence, people living with such conditions often end up committing suicide.
The U.S. National Centre for Biotechnology information noted on its report that most suicides are related to psychiatric disease, with depression, substance disorders and psychosis being the most relevant risk factors.
The National Crime Records Bureau 2015 Report shows that out of the 3,800 illness-related suicides in India, about 1,280 occurred due to some sort of mental illness.
According to the World Health Statistics 2019 published by WHO, India’s suicide rate stood at 17.8 suicides per 1,00,000 people in 2016, much higher than the global suicide rate of 10.5. The report presented suicide rates for countries and regions using data from the WHO Global Health Estimates for 2016. According to the data, there were 2,15,872 suicides in the country.
According to another study by The Lancet, suicide deaths in India increased from 1,64,404 in 1990 to 2,30,314 in 2016, an increase of 40.1%. If no steps in respect of preventing mental illness shall taken, this ratio will be even higher.
Is India capable to deal with mental health crisis?
Although India is world’s fifth-largest economy, the amount spent by India on mental health budget over the last few years are much lower than average spending of low-income countries, which comes to about 0.5 percent of their healthcare budgets.
According to the WHO’s 2017 Mental Health Atlas, mental health made up just 1.3 percent of the government’s total health expenditure—amounting to four rupees per citizen.
India’s healthcare budget in 2018, was 528 billion rupees (roughly $7 billion), out of which 500 million rupees (about $6.6 million) was for mental health. However, India has actually spent only 50 million rupees annually on mental health.
The amount spent on mental health comes about to 33 paisa ($0.004) per mental health patient if we take into account the 150 million people requiring urgent care.
The budget allocated to the National Mental Health Programme (NMHP) in 2019 was decreased to Rs 40 crore from Rs 50 crore in the previous year. This, in turn, was estimated to be only 0.05 percent of the total healthcare budget. The average allocation for mental health in developed countries is at least five percent. Even in 2020, the mental health budget did not see a rise.
The impact of the mental-health crisis is astronomical. Between 2012 and 2030, the WHO estimates, it will cost India over a trillion dollars in lost productivity.
Another saddest part is India had only 1.93 mental-health workers for every 100,000 people. (The global average is nine, while higher-income countries average close to seventy) Counting both the public and private sectors, there were just 25,312 mental-health professionals in India. There were fewer than four thousand psychiatrists in the country, and the total number of child psychiatrists was 49.The desirable number of psychiatrists is three for every 100,000 people. This means India has a shortage of 18,000 mental health doctors.
After going through laws and policies, it is clear that there is long way to go to control mental illness.
Conclusion and Suggestions:-
After studying the concept of mental health its factors and India’s scenario on mental health conditions, following views are suggested for better application of laws on mental health and it’s policies in order to give the maximum benefits for welfare of mental health conditions in India.
1. There is strong need to come up with more updated laws instead of sticking with age-old laws that has been outdated in current scenario. Laws are required to change from time to time with change in society so that ambiguity in law can easily resolved and our country shall proceed towards the beginning era of “free from mental illness”
2. If we need to achieve mental and physical health parity in India, the law and regulatory and statutory bodies should work together to keep up with advancements in making mental health resources more accessible and affordable.
3. India can appoint a minister with a Cabinet rank as head of mental health and well-being, and create an emergency task force of public health experts in creating and executing evidence-based interventions.
4. The chain of Depression and suicide need to be broken. Life is all about how person manage his good days and bad days. Up and Down are part of every person’s life. Suicide is not solution in any situation and in the absence of such person entire family has to face highest pain and burden which will sufficient enough to create more problems and complications in respect of mental health.
5. Mental health and suicide should be treated as a public health crisis that needs immediate fixing. Mainstream media and social media giants can be roped in to create and spread awareness. Apart from it, suicide prevention policy should be introduced. Many countries, including China, have been able to significantly reduce suicides after they implemented a suicide prevention policy.
6. Priority should be given to Counselling as it plays vital role to overcome mental illness. Along with counselling, open space environment should be created where person can share all thoughts going around in mind with assurance of strict confidentiality. Sometime, Instead of treatment people just need support, someone to listen to them. It is duty of family and friends to support that person instead of leaving him alone. Such support at crucial time is working more than any therapy or treatment.
7. The bridge of understanding is required to be develop between society and person suffering from mental illness then only stigmas attached to mental health shall be successfully eradicated. There is need to shift in attitudes surrounding mental health, particularly as India’s mental healthcare capabilities are still emerging and the stigma associated with mental health conditions needs to be replaced with empathy and support.
8. Lastly, I just want to quote what Buddha quoted on health.
“The secret of health for both mind and body is not to mourn for the past, not to worry about the future, or not to anticipate troubles, but to live in the present moment wisely and earnestly”
This article is authored Adv. Rudra.M.Dani, BLS/LLB from KES J.H. Patel Law College.
Also Read – Human Rights And Mental illness In The Contemporary Era.
