“One in five people suffer from a mental illness sometime or the other in India” says a Times of India article. Mental health care in India is a neglected area in India due to factors such as ignorance, stigma and lack of doctors. With both increasingly stressful lifestyles and figures of depression, this field needs to be given more priority in the country’s health care agenda.
There are a range of common mental health disorders or illnesses that are often neglected and are much more common in society than the more severe mental disorders such as schizophrenia. These include stress and anxiety-related disorders, depression, obsessive-compulsive disorders (OCDs), addictions, eating disorders (anorexia and bulimia), sleep problems, psychosis (chemical imbalances in the body ) and neurosis (poor attitudinal learning due to poor training in growing years) and are startlingly common in India.
Another recent article in the Times of India takes a look at the range of mental health facilities and services in India. According to this, “there is a lack of mental health facilities in the country. For example, there are around five to seven thousand psychiatrists in the whole country. In contrast, there are as many cardiologists in just Mumbai city alone.” says Dr. Kersi Chavda, a senior psychiatrist working in Mumbai. “An anxiety-ridden or a depressed patient, is usually given tips like, ‘snap out of it’, ‘go for a movie and you will be fine’, or ‘just cheer up’, without realising that these are diseases and they need treatment from qualified doctors” says Dr. Chavda.
The shame and stigma associated with mental illnesses still looms large, say experts. “Fundamental resources for handling mental health facilities are lacking. In the entire country, only a handful of psychologists are trained and researching on severe trauma cases” says clinical psychologist Dr. Seema Hingorrany.
Dr. Harish Shetty, another expert and senior psychiatrist also says that there is a paucity of not just hospitals, but of doctors as well. Most government hospitals have relegated their worst wards with the fewest beds to mental illnesses. Another concern is that insurance companies do not provide medical insurance to people who are admitted in hospitals with mental illnesses .In India, suicide is a criminal act and becomes a police case. According to National Crime Records Bureau report 2013, Maharashtra has one of the highest suicide rates and there are not enough helplines.
“Three to four people commit suicide every day in Mumbai, yet, there are not philanthropic activities and no steps to prevent this,”says Dr Shetty.
According to an article by the World Health Organization, factors such as the experience of insecurity, rapid social change and the risks of violence and physical ill-health explain the greater vulnerability to common mental disorders. They need to be given priority alongside other diseases by policy-makers and donors. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.
The India Mental Health Bill 2013 aimed to provide for mental health care and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental health care and services .
According to an article by James T Antony in the Indian Journal of Psychiatry, the Mental Health Care Bill-2013 has an over-inclusive definition for mental illnesses. He feels that this will hurt a huge number of victims suffering from even minor mental illnesses and their families, because of the wide prevalence of stigma.
Here are some of gaps and criticisms of Mental Health Bill 2013 as stated by him in the article :
- There is no mention about the huge resource-mobilisation that is required .
- Without penal provisions that would force them to act, Government functionaries are unlikely to extend various promised services to concerned beneficiaries.
- A precise and restrictive definition for mental illnesses is needed so that a vast majority of people suffering in the country would not be required to face stigma-related problems.
- It is important to strengthen the State Mental Health Authorities.
- The “Mental Health Care Bill-2013” has already been cleared by the Parliamentary Standing Committee. Unfortunately, they have cleared it without remedying many defects and by retaining many counter-productive provisions.
- In its present form, the bill would have a negative impact on the future delivery of mental health care in the whole country.