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Mental health treatment still out of reach

COVID-19 and the effects of the pandemic have plagued India’s health system. For those affected by mental health issues, treatment is a practical impossibility.

mental health, suicidal behaviour illustration Copyright: silentgunman / 123RF Stock Photo
Nearly 200 million Indians suffer from mental health conditions — most do so in silence. mental health Copyright: silentgunman / 123RF Stock Photo

Earlier in the year the World Health Organization (WHO) noted that this situation is now not unique to India. “The COVID-19 pandemic has disrupted or halted critical mental health services in 93 percent of countries worldwide while the demand for mental health is increasing, according to a new WHO survey,” read the opening paragraph of a press release from the agency earlier this year. “The survey of 130 countries provides the first global data showing the devastating impact of COVID-19 on access to mental health services and underscores the urgent need for increased funding.”

This has created a vicious cycle in a situation where mental health issues are at an all time high. As more and more individuals find themselves in need of treatment and counselling services, they have become less available.

A study conducted by the Indian Psychiatry Society (IPS) showed a twenty percent rise in mental health disorder cases, affecting at least one in five Indians during the initial stages of the COVID-19 pandemic in India. “The lockdown has had a massive impact on the lifestyle of people,” says Manu Tiwari, a mental health and behavioural sciences expert. “They are staying indoors with limited resources. They are now suffering from anxiety and panic attacks.”

Even under normal circumstances, these individuals would be unlikely to avail treatment. Mental healthcare accounts for just 0.16 percent of the government budget for health. In addition, there is an acute shortage of psychiatric professionals in the country. Data indicates that there are 0.3 psychiatrists, 0.12 psychologists and 0.07 social workers for every 100,000 Indians.

Legislation on the matter is moving forward. However, the translation from legislation to actual treatment being provided is simply not occurring. In the past five years, we have seen the enactment of the Rights for Persons with Disabilities Act (RPDA), 2016 and the Mental Healthcare Act (MHCA), 2017. Both laws set out to recognise the rights of people with mental illness and psychosocial disabilities. However, while enshrining rights is a major step forward, the significant treatment gap is a far more difficult burden to address.

Government-sponsored mental healthcare is free or heavily subsidised. This, in theory, would suggest that the mental health burden and the provision of treatment is under control. However, surveys have cited that between seventy percent and 92 percent of persons in need of mental healthcare are unable to access quality services.

Provision of government-run services is available only in select hospitals. This also tends to only be the case in cities, leaving the rural population entirely uncatered for. For those that try to avail mental health treatment in these facilities, it can often involve travel, or several days away from work, still incurring a financial burden regardless of the subsidised treatment. For many, stockouts or low prescription amounts mean repeated trips to the cities to search for hospitals providing treatment.

With COVID-19 placing India’s collective mental health under a heavy burden of isolation, the loss of loved ones, economic impacts and potential uprooting of work opportunities in the cities and rural communities, more must be done to ensure provision of mental health services not only occurs, but occurs equitably throughout the country.

Contact details for mental health support in India can be accessed here. 

If you are suicidal or experiencing suicidal thoughts, visit your nearest hospital or contact AASRA on 91-22-27546669 or Sneha India on 91 44 24640050 helpline. A list of other suicide helplines can be accessed here.

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