Every other day, we wake up to disturbing headlines about young people leaving us by suicide. India’s suicide rate is among the highest compared to other countries at the same socio-economic level. According to WHO, India’s suicide rate was 12.9/1,00,000 in 2019, higher than the regional average of 10.2 and the global average of 9.0. Suicide is the leading cause of death among young people aged 15-29 in India.
All too many precious lives lost to suicide are just the tip of the mental health iceberg in the country, especially among young adults. Women tend to suffer more. Worldwide, the prevalence of some mental health disorders is consistently higher in women compared to men.
The pandemic has exacerbated this problem. According to a study published in The Lancet, just one year from 2020 to 2021 could have increased the prevalence of depression by 28% and the prevalence of anxiety by 26% globally. Again, due to school closures and social isolation, along with uncertainty and fear about the virus, economic and job losses, grief, and increased childcare burdens, there will be a significant drop in increase can be seen.
Increased use of certain types of social media is also exacerbating stress and mental illness among young people. Social media undermines healthier face-to-face relationships and reduces investment in meaningful activities. More importantly, it undermines self-esteem through unfavorable social comparisons.
Mental illness has greater socioeconomic implications. It is the leading cause of disability globally and is closely linked to poverty, a vicious circle of disadvantage. People living in poverty are at higher risk of experiencing mental health problems. On the other hand, those experiencing severe mental health conditions are more likely to fall into poverty due to unemployment and rising health care costs. Stigma and discrimination often further undermine their social support structures. This fosters a vicious circle of poverty and mental illness. Unsurprisingly, we know that the prevalence of mental illness is higher in countries with greater income inequality and more polarized society.
As we did with the Covid pandemic, we need an urgent and well-resourced “whole of society” approach to protect, promote and care for the mental health of our people. It should be based on his four pillars:
The first pillar is to eliminate deep stigma around mental health problems that keep patients from seeking timely treatment and make them feel shamed, isolated and vulnerable. Actor Deepika Padukone is a role model that other public figures with mental health issues need to follow to show them how to lead productive lives. Her daughter Devika Bhushan, who served as Acting Chancellor, shared her own struggles with mental health issues at a large conference, inspiring others to step out of internalized shame and seek treatment. resistance. She said, “Stigma festers in the darkness and scatters with light.” We need a mission to cut through this darkness and shed light on the fact that most mental health conditions are highly treatable. You can lead a fulfilling life by receiving
The second pillar focuses on promoting mental health in public health programs to reduce stress, promote healthy lifestyles, screen and identify at-risk groups, and strengthen mental health interventions such as counseling services. to be an integral part of Schools need special attention. In addition, particular attention will be paid to groups highly vulnerable to mental health problems, such as victims of domestic and sexual violence, unemployed youth, marginalized farmers, military personnel and personnel working in difficult conditions. is needed.
The third pillar is to create a strong infrastructure for mental health care and treatment. Lack of effective treatment and stigma go hand in hand. Currently, only 20-30% of people with mental illness receive adequate treatment. One of the main reasons for such a wide treatment gap is the issue of inadequate resources. Less than 2% of the government’s healthcare budget, itself the lowest of all her G20 countries, is devoted to mental health issues. By one estimate, there are fewer psychiatrists in the country than there are in New York City, and there is a serious shortage of mental health professionals. A central armed police chief told me he had only two mental health professionals in a strong workforce of 300,000. Addressing gaps in mental health infrastructure and human resources requires significant investment.
Finally, mental health services should be affordable for everyone. Improving coverage without corresponding financial protection leads to unfair service use and consequences. All government health assurance schemes, including Ayushman Bharat, should cover the widest possible range of mental health conditions. Currently, most private health insurance covers only a limited number of mental illnesses. Similarly, the list of essential medicines includes only a limited number of mental health drugs prescribed by WHO. A comprehensive review of these policies is necessary to ensure that economic and other barriers do not keep people from accessing services or drive them into poverty.
WHO’s first Director-General, Brock Chisholm, famously said, ‘No health without mental health’. More than 50 years later, and as he strives to provide universal health coverage to the public, let us ensure that mental health is an integral part of our approach.
The author was Chairman of the Partnership for Impact (P4i) and Founding CEO of the National Health Authority.