India needs to talk about mental illness

Sun 23 Oct 2016


At least 13.7 per cent of India’s general population has various mental disorders; 10.6 per cent of them require immediate interventions.

While nearly 10 per cent of the population has common mental disorders, 1.9 per cent of the population suffers from severe mental disorders.

These are some of the findings of a National Mental Health Survey held recently and conducted by the National Institute of Mental Health and Neurosciences (NIMHANS).

That is not all. The prevalence of mental morbidity is found to be very high in urban centres, where there is a higher prevalence of schizophrenia, mood disorders and neurotic or stress-related disorders. This disturbing scenario could be due to fast-paced lifestyles, experiencing stress, complexities of living, a breakdown of support systems and challenges of economic instability.

In 2014, concerned over the growing problem of mental health in India, the Union Ministry of Health and Family Welfare had appointed NIMHANS to study mental health status in the country.

After a pilot feasibility study in Kolar district, Karnataka using a sample size of 3,190 individuals, the team which comprised senior professors from NIMHANS, G. Gururaj, Mathew Varghese, Vivek Benegal and Girish N., began the survey in Punjab, Uttar Pradesh, Tamil Nadu, Kerala, Jharkhand, West Bengal, Rajasthan, Gujarat, Madhya Pradesh, Chhattisgarh, Assam and Manipur.

The study — which covered all important aspects of mental illness including substance abuse, alcohol use disorder, tobacco use disorder, severe mental illness, depression, anxiety, phobia and post-traumatic stress disorder among others — had a sample size of 34,802 individuals. Primary data collection was done through computer-generated random selection by a team of researchers, and local teams of co-investigators and field workers in the 12 States.

While the overall current prevalence estimate of mental disorders was 10.6 per cent in the total surveyed population, significant variations in overall morbidity ranged from 5.8 per cent in Assam to 14.1 per cent in Manipur. Assam, Uttar Pradesh and Gujarat reported prevalence rates less than 10 per cent. In eight of the 12 States, the prevalence varied between 10.7 per cent and 14.1 per cent.

Treatment gaps and impact

A major concern in the findings, which were recently submitted to the Union Health Ministry, is that despite three out of four persons experiencing severe mental disorders, there are huge gaps in treatment.

Apart from epilepsy, the treatment gap for all mental health disorders is more than 60 per cent. In fact, the economic burden of mental disorders is so huge that affected families have to spend nearly Rs.1,000-Rs.1,500 a month mainly for treatment and to access care.

Due to the stigma associated with mental disorders, nearly 80 per cent of those with mental disorders had not received any treatment despite being ill for over 12 months, the study says. Poor implementation of schemes under the National Mental Health Programme is largely responsible for this.

Dr. Gururaj says that there is also a paucity of mental health specialists, pointing out that mental disorders are a low priority in the public health agenda. The health information system itself does not prioritise mental health.

Recommending that mental health financing needs to be streamlined, he says that there is a need to constitute a national commission on mental health comprising professionals from mental health, public health, social sciences and the judiciary to oversee, facilitate support and monitor and review mental health policies.

yasmeen.afshan@thehindu.co.in

[source:TheHindu]

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