Akanksha Kaushal - Research Intern - Quality Education
Picture Credit: The Hindu
Mental health is a state of well-being and is essential to our personal and social capacity to reflect and connect with others, make a living and live a happy life. Mental health and mental disorders are, unfortunately, not recognized as significant as physical health in several parts of the world, including India.
India does not have a long tradition of mental health discussions. The historical hesitation to discuss mental health in India may be due to a lack of terminology, experts claim. None of the 22 languages in India have appropriate vocabulary to refer to words such as "mental health" and "depression." Although in Urdu and other Indian languages, there are words for sadness (udaasi), grief (shok) or devastation (bejasi), the basic terminology to describe various mental disorders is missing.
In 2016, a National Mental Health survey performed across 12 states identified a list of more than 50 negative terms associated with individuals with mental illnesses. One of the participants stated that;
"Usually, the public believes that individuals with psychiatric illnesses are incompetent, irrational, and untrustworthy consequently, they have low marriage opportunities."
Dr. S.K. Chaturvedi, Head of Department at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore, suggested the above statement was made due to the practice of psychiatry being predominantly Western. He suggested that;
"It is easier for people to talk about physical symptoms and illnesses than to express to their families that they are feeling low or depressed."
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The WHO has described and commented on the effect of mental disorders and suicide on sustainable development goals. In India, the suicide rate is higher than the regional average of 12.9 in 2015 at 15.7/100,000, and the global average of 10.6. Among those aged 15-29 in India, suicide is the leading cause of death.
In May, research conducted by the Suicide Prevention in India Foundation (SPIF) identified that almost 65% of 159 mental health practitioners surveyed registered a rise in their patients' self-harm tendencies.
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According to the National Mental Health Survey, 83% of people suffering from mental health illnesses in India face a lack of appropriate mental health care.
According to the World Health Organization (WHO), India had three psychiatrists for every million individuals and even fewer psychologists. In contrast, for every million persons, the US had 100 psychiatrists and almost 300 psychologists.
Mental health experts agree that more funding is what is required. Just two percent of the overall 2020-2021 budget has been reserved for healthcare. And less than one percent of the amount has been dedicated to mental health.
THE PERSPECTIVE OF THE SOCIETY
In the National Mental Health Survey of India, 2015-2016, participants of a focused group discussion stated that severe mental illnesses were commonly associated with black magic and evil deeds. A participant from Rajasthan commented, ‘Once mentally ill, always mentally ill,’ representing the lack of knowledge about mental health problems in the community. Due to these beliefs, individuals suffering from mental health problems tend to undergo treatment in various faith healing practices instead of seeking necessary professional help. Individuals often prefer hiding their difficulties from their families and community.
Media has played a significant role in derogating and stigmatizing mental health issues. Media tends to label anyone behaving slightly differently has been termed as “pagal” (mad). Media often portrays mental health patients receiving shock treatments in mental hospitals suggesting it to be the only modality of treatment.
A respondent from Manipur stated that,
‘Picturizing mentally ill persons (especially women) unable to look after her family thereby abusing her verbally & physically in few movies of Manipur.’
While mental health issues inevitably interfere with growth, development, education, and social interactions, they could lead to long-lasting adverse effects if not addressed in time.
Picture Credit: ET HealthWorld
WHY ARE THESE MENTAL, BEHAVIORAL, AND SUBSTANCE USE DISORDERS, IN ADOLESCENTS OF INDIA ARE A CAUSE OF CONCERN?
A critical measure of the development of a nation is the accessibility to mental health services for children and adolescents. India is home to the world's largest number of adolescents (243 million), representing around a fifth of its population. Approximately 50 million Indian children suffer from mental illnesses at any given moment in time, and this number would increase if the teenage community is also considered.
Another cause for concern is the high suicide rates of older adolescents. A report by WHO found that the prevalence of suicide is 21.1/100,000 people, and approximately 258,075 Indians committed suicide in 2012, a significant proportion of whom are students aged 0-19 years.
It is alarming that there is no access to adequate care for people of all ages in India that suffer from mental health problems. The mental health care gap is roughly 50-60 % for schizophrenia, 88% for depression, 97.2 % for opioid addiction, and 22-95 % for seizure disorders. The treatment gap for psychological disorders is 95 % greater than the 76 % gap for severe disorders.
Health literacy and knowledge are two sides of the same coin. The adverse effects of ignorance and misconceptions are stigma and discrimination. In the Indian sense, there are a few studies that have assessed mental health literacy. One study showed that mental health awareness among teenagers was very low, i.e., 29.04% of depression was recognized and only 1.31% of schizophrenia/psychosis was identified. In help-seeking, stigma was noted to be present.The only way ahead for the vast Indian population to be invested in its mental health is to increase understanding of mental health, stimulating its value. As awareness grows, early identification and access to care can be expected to follow, as can implementing precautionary action.
Picture Credit: Development + Cooperation
WHAT CAN BE DONE?
Educational settings have a considerable effect on the well-being of teenagers, thereby providing different possibilities to tackle the factors of mental health.
To date, the development of school mental health in India has generally been adopted on a comparatively small scale, while in the National Adolescent Health Program ('Rashtriya Kishor Swasthya Karyakram'; RKSK), adolescent mental health is a required field for program development.
In research, a need for school-based mental health services to help relieve tension resulting from various difficulties in their daily lives has been seen in adolescents. The key stressors were pressure to succeed in tests, anxiety about finding a job after college, one-sided romantic attractions, romantic relationship rejections and breakups, social acceptance, bullying, peer pressure, and family disputes (often arising from education and romantic relationship disagreements).
The media can also be a pillar of mental health awareness programs.
It is a reasonably easy move to make evidence-based mental health information readily accessible to journalists and other content providers, such as internet portals from trustworthy and credible sources such as the Indian Psychiatry Society, academic organizations, and medical schools via their websites.
Cinema is a powerful tool for developing a culture of collective belief, and cinema has always played and continues to play a vital role in disseminating information and generating perceptions and attitudes about mental illness. Occasionally, Hindi movies have touched on the sensitive subject of mental health.
In 2014, India adopted the National Mental Health Policy (NMHP), which is intended to guide all steps to step up its mental health support and services. The policy focuses on the mental health requirements of vulnerable groups such as orphans with mental disorders, children of persons with mental illnesses, and children in custodial facilities.
The Rashtriya Kishor Swasthya Karyakram (RKSK)—2014 National Adolescent Health Program is the only comprehensive adolescent health policy with the vision that by making educated and responsible choices associated with their health and well-being, adolescents can achieve their full potential.
Recently, A 24/7 toll-free helpline was launched by the Union Social Justice and Empowerment Ministry to provide support to individuals facing anxiety, stress, depression, suicidal thoughts, and other mental health issues. At 1800-599-001919, the mental health recovery helpline, KIRAN, can be called from landline and cell phones throughout the country. The helpline will work as the first stage for callers to obtain guidance, feedback and referral to psychologists and psychiatrists. The helpline has 660 clinical / rehabilitation psychologists and 668 psychiatrists as volunteers and is accessible in 13 languages.
India has gained significant achievements in many health metrics since its independence from England in 1947. Still, only a few attempts are established to maintain the intellectual and spiritual well-being of the young people, who are the nation's future leaders. The government of India needs to begin prioritizing services for mental health. Labeling mental well-being as "taboo" and going on without discussing the problem is no longer defensible. The significance of building substantial human capital for the nation's brighter future must be recognized. A national strategy for treating mental health disorders and the promotion of mental well-being among India's children and adolescents must be developed. Communication needs to be normalized. Schools and Colleges need to involve parents and make them comfortable, allowing children to communicate their issues with their parents more freely. Progressive government initiatives focused on evidence-based interventions, an active media, and a dynamic educational system will all help to dispel the mental illness blight.
Akanksha is a Final Year BSc (Hons) Psychology with Counselling Skills student at Middlesex University, Dubai. Her interests revolve around mental health and working towards destigmatizing mental health problems. She has previously worked on projects involving training and monitoring students with behavioral issues, creating learning and content strategies to meet the needs of students with mental and physical disabilities, and worked with individual students to provide personalized educational, behavioral, and emotional support.