With 36% of its population likely to be suffering from major depression at any given time, India, as per a WHO report, is one of the world's most depressed nations. However, a majority of Indians lack awareness about mental health. So much so that many of them often miss the signs of depression that they themselves or their close ones are struggling with. According to National Crime Records Bureau, there is an average of 371 suicides committed daily in India. Though the Mental Health Act passed by Parliament in December 2017 is a step closer to fight depression, the ground realities which speak of social stigma, poor infrastructure and alarming low psychiatrist-patient ratio put a question mark on the country’s readiness to combat the challenge.
The recent unfortunate news of popular Indian stand-up comedian Kapil Sharma undergoing heavy medication for depression has once again brought to the fore the fragility and vulnerability that lies beneath the surface of sometimes seemingly “normal” people. And the most tragic part is that the number of such “seemingly normal people” is dangerously increasing in India.
Anyone and everyone stand susceptible to depression. According to an ASSOCHAM report, 42.5% of corporate employees in India suffer from depression and the rate has increased by 45-50% between 2008 and 2015. In another shocking disclosure, the Global Burden of Disease Study reveals that depression was one of India's biggest causes of early deaths in 2015.
Amidst such grim statistics, the Mental Health Act passed by Parliament in December 2017 is a welcome long-awaited move to address the issue of depression. However, with several policy and regulatory hurdles, India’s fight against the silent killer, it seems, is going to be a long battle.
The Dark Clouds
The Mental Health Act, according to Institute of Human Behaviour and Applied Sciences (IHBAS) Director Dr Nimesh G Desai, is “aspirational, but partly unrealistic” as though the law makes access to treatment a “right” for mentally ill people, “delivering it is a challenge”. The IHBAS is the only Government mental health hospital in the national capital.
Experts opine that social stigma attached to mental health is the biggest challenge in the fight against depression. In majority of the cases, even if a person is aware that there are some psychological issues which need to be addressed, the social stigma surrounding the disorder makes it difficult for that person to seek psychiatric help and sweeping the issue under the carpet seems a more feasible option.
According to a Government statistics, only 20% people currently are able to access mental healthcare. What is more ironical is that even as 60 million people in India, as per a study done by The Economist Intelligence Unit, are suffering from some sort of mental health disorder, there are only around 43 mental hospitals in the country.
Even more frightening is the Central Government’s admission in the Lok Sabha about the abysmal shortage of psychiatrists in India. According to the Ministry of Union Health and Family Welfare, there are only 3,827 psychiatrists in the country against the required number of 13,500. Also, there are less than 900 psychiatric social workers and 1,500 psychiatric nurses against the 37,000 and 1,500 needed.
This gap, according to Dr Kersi Chavda, Consultant Psychiatrist of Mumbai-based PD Hinduja National Hospital and Medical Research Centre, is due to the fact that not many seats for post graduation in psychiatry are available in medical or teaching colleges in India. Additionally, bureaucracy and regulatory hurdles are making it difficult for the system to deliver, opines Desai in an interview to Sunday Guardian. Citing an example, he says while IHBAS currently produces eight MDs annually, it can easily produce 15-20 MDs a year.
Due to this shortage, the psychiatric treatment cost is also soaring in India. Though this issue can partly be resolved if insurance is made available for mental health but the challenge, as Desai says, is to “make insurance companies comply” with the Mental Health Act.
The Silver Lining
However, all is not lost. According to the Indian Journal of Psychiatry, “the major depressive episodes are treatable in 70–80% of patients”.
Also, there is a growing awareness and acceptance, albeit to a minuscule extent, among the millennial generation in India regarding mental health. They are no longer shunning topics related to the issue. Conversations regarding depression are now taking place more in the open and in social media as well.
Adding to this growing positive atmosphere is the effort of some budding entrepreneurs in India whose aim is to make mental health care accessible and affordable to all. Of late, the country has seen emergence of start-ups like YOURDost, ePsyclinic, InnerHour, Wysa, nSmiles, HealthEminds, Seraniti, GrowthEX, TrustCircle and Trijog which are bringing effective psychiatric therapy and counselling to one’s doorsteps through online platforms in the form of apps, web and video chats and phone calls.
The Path Ahead
Some courageous youngsters in India have already taken the maiden step by bringing the issue of mental health in the limelight and now it is up to us how we take it further. There is not an iota of doubt that it is the mandate of the Government to address the infrastructure, policy and bureaucratic hurdles in regards to the mental health issue in the country, but at the same time, we also have to bring a paradigm shift in our attitude and develop a more open mindset on mental health. And to begin with, let’s not throttle our inner voice. Let’s speak to someone!
The Fact Sheet