The Union Government has handed down regulations concerning mental healthcare amidst the COVID-19 pandemic.
On Sunday, the Centre offered instructions as to how mental health issues ought to be handled in the form of a series of guidelines. As reported by Livemint, the substance of the guidelines include that
“The Government suggested establishing a hotline between a mental health institution and a nearby COVID-designated hospital to facilitate easy transfer of patients across facilities. The guidelines also stressed the importance of training all healthcare workers in waste disposal, sanitisation of establishments, maintaining social and physical distancing, and putting on and taking off personal protective equipment.
“Rules have been drawn up to address the needs of COVID-19 patients who are suffering from trauma or stress, pandemic-induced depression and those who are already suffering from severe mental health conditions.”
The report added that the Government drew upon Indian Council of Medical Research (ICMR) “recommendations and protocols” and “the available information on COVID-19.” The report added that the guidance “will be updated and revised from time to time. The guidelines have been prepared by experts from the National Institute of Mental Health and Neurosciences, Bengaluru.”
Mental healthcare has been a matter of significant concern during the COVID-19 pandemic. As reported by Health issues India in May, “the Indian Psychiatry Society (IPS) said a recent study showed a twenty percent rise in mental health disorder cases, affecting at least one in five Indians. “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.””
Our report highlighted that “individuals affected by mental health issues suffer in silence too often. 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. This is despite the substantial number of Indians affected.” One in seven Indians are estimated to be affected by mental health issues.
An ICMR study has, as Health Issues India previously reported, “found that roughly 197 million persons were affected by mental disorders in 2017. The conditions surveyed included depression, anxiety disorders, schizophrenia, bipolar disorders, idiopathic developmental intellectual disability, conduct disorders, and autism. Depression and anxiety disorders were the most common conditions. In total, 45.7 million people experienced depressive disorders. Anxiety affected 44.9 million people.” However
“There is an enormous shortage of mental healthcare professionals across the country…dissuading many from coming forward and seeking treatment. This manifests in a treatment gap spotlighted by…figures released by the Union Ministry for Health and Family Welfare (MoHFW). There is a fifty to seventy percent treatment gap when it comes to mental illness, the statistics suggest. Staffing shortages go some way towards accounting for this disparity. Just 898 clinical psychologists and 3,800 psychiatrists are available to service the entirety of India’s population with mental health conditions. They are heavily concentrated in urban areas. This entails that the mental health of those living in rural areas often goes neglected.”
In the pandemic’s context, the situation has only become more pronounced both in India and at the global level. The World Health Organization (WHO) stated last month that “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. 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.”
“For fourteen years, Meenakshi Raman (name changed) had been taking her younger sister, 46-year-old Shruti (name changed), for treatment to the Institute of Human Behaviour and Allied Sciences (IHBAS) in New Delhi once a month. The sisters would spend the better part of the day there for Shruti’s treatment, occupational therapy and counselling for obsessive compulsive disorder (OCD) with bipolar affective disorder and traits of borderline personality disorder. Their monthly routine was abruptly halted in March with the outbreak of COVID-19 and the subsequent lockdown. Shruti’s OCD symptoms and compulsive behaviours worsened due to her fear of infection. Without access to therapy and regular dosage of medicines–available for free at IHBAS’ outpatient department (OPD)–Shruti’s health deteriorated.”
The report goes on to outline
“Shruti is among thousands of Indians with chronic mental illness whose lives, and those of their caregivers, turned tumultuous after the pandemic hit. Pandemics are known to exacerbate mental health conditions, and India’s mental healthcare system failed to deliver during the COVID-19 crisis…People living with chronic mental illnesses were unable to access state mental hospitals for care and were unable to procure and/or afford medication, we found. It was “weeks to months” before they were able to access hospitals, and many had relapsed or experienced psychosis. This was especially the case for patients who relied on hospitals across state borders due to restrictions on train services. As a result, many had to be admitted as in-patients, psychiatrists and medical superintendents at these hospitals said.”
Outlook India queries whether or not “Mental Health [is[ India’s Next Pandemic?” That article highlights how “the first wave was the physical health crisis, then came the financial crisis and this has led to the mental health crisis. But the question is whether India is ready for it.”
The fact is that the mental health crisis in India predated the pandemic and will virtually certainly outlive it. India’s record on mental healthcare is far from what it should be. Amending the failures and plugging the gaps will require concerted efforts. If India is up to it, it is incumbent upon those in the position to govern and legislate to prove it.