Mental health - A reality we all miserably fail to address
Mental health in India has always been one of the most ignored illnesses and the taboo around it is also quite horrifying. Labelling people suffering from mental illness and judgements over psychiatrists have long been associated as a ‘mad man’s way of living.’
From a cultural perspective, mental disorders are associated with a considerable amount of stigma in Indian society, leading to neglect and marginalisation. Such individuals and their families face numerous challenges in daily life, both for managing the condition as well as for making them productive due to prevailing attitudes, media portrayals, societal discrimination and deprived opportunities.
The awareness among the generations about mental illness is fast spreading, but it is not as fast as the illness is gripping people in its claws and driving them to end their life. With suicide numbers increasing every year, the failure of our system and society is already an open book to the world.
1 in 20 people in India suffers from depression. The weighted prevalence of depression for both current and lifetime was 2.7% and 5.2% as of 2015-16, respectively, indicating that nearly 1 in 40 and 1 in 20 suffer from past and current depression, respectively.
Prevalence of mental disorders in the age group 13-17 years was 7.3% and nearly equal in both genders. Nearly 9.8 million young Indians aged between 13-17 years are in need of active interventions. Prevalence of mental disorders was nearly twice (13.5%) as much in urban metros as compared to rural (6.9%) areas. The most common prevalent problems were Depressive Episode & Recurrent Depressive Disorder (2.6%), Agoraphobia (2.3%), Intellectual Disability (1.7%), Autism Spectrum Disorder (1.6%), Phobic anxiety disorder (1.3%) and Psychotic disorder (1.3%).
While the fact that it interferes in their growth, development, education and day to day social interactions is undisputed, their vulnerability is greater due to several factors within and outside the home. Early recognition and intervention will help to realise favourable outcomes.
The data becomes alarming when we look at the suicide rates of children below 18 which accounts for 7% of total suicides in India. Almost one child dies every hour and one of the basic reasons for this is our education system. If we look for suicides only due to education, it will rise further by 0.6%, which will become 7.6%. The suicide rate in adolescents and children has also spiked in recent years as the pressure of performance and constant comparison with their friends and cousins has become rampant. Parents driving their children to perform to massage their social ego and boast their kid’s achievement in front of their friends and family have also been one of the key reasons.
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Reasons for and Stigma around Mental Health
Mental illness results in the poor quality of life, decreased productivity and lower-earning potential. The burden was reportedly higher in middle-aged individuals, where disability due to mental illness significantly affected their productivity resulting in a sizeable economic impact in a cumulative manner to the country. There is a high prevalence of psychoactive substance use disorders (SUDs), including alcohol use disorder, moderate to severe use of tobacco and use of other drugs (illicit and prescription drugs) was prevalent in 22.4 % of the population above 18 years. This also shows why there is a constant increase in the death rate due to substance abuse.
Mental illness is not limited to any specific age group. The prevalence of various mental health conditions and their suppression by family heads which include ignorance, calling the illness a ‘bluff’ or even seeking help through religious means to solve the mental issue. Mental illness is also suppressed in India to “save a person” from social stigmatization, with the fear of not getting a potentially good “future spouse”
Ironically, the social construct is such that a man always wears a facade of being tough, emotionally absent, the front runner of the family who can soak it all when it comes to the mental challenge. While on the other side women are expected to be soft-spoken, shy and enduring. But in both ways, this mental turbulence is compromised.
Since the introduction of the Protection of Women from Domestic Violence Act, 2005, there has been an exponential increase in the suicide rate of men. The law has been, at multiple occasions, used for extortion, vengeance and heated altercations and has resulted in many false court cases which drove numerous men to suicide.
Poverty and disability catalysed by poor access to care and treatment significantly affect the quality of life of persons with mental illness as well as their families. Poor quality of life is also closely related to suicide attempts as daily wage earners account for almost 22% of the total suicides in India. The housewives, which in most of the cases are, dependents also account for 17% of the total suicides.
Poverty, low levels of education and working status are closely interlinked to mental disorders which in turn contribute to impoverishment. Data from the NMHS reveals that mental disorders were significantly higher in households with lesser income, poor education and limited employment. It is evident that these individuals have a greater vulnerability to mental disorders moderated by adverse social and economic determinants of health.
Education also plays a key role in keeping the sanity of people intact as almost 90% of the suicides are committed by people who have studied either till high school or primary. This shows why there is an urgent need to educate people with better infrastructure and quality education as we can save a large amount of manpower and a significant amount of the population who are dying due to mental issues.
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Stigma contributes to the huge burden of mental morbidity, being a road-block to treatment seeking. Nearly 80% of persons suffering from mental disorders, had not received any treatment despite the presence of illness for more than 12 months. The stigma associated with mental disorders affects access to work, education and marriage of those with a disorder and it also affects family members of those affected.
Social status of people is another huge factor as married people account for more than 70% of total suicides and men are more vulnerable in marriages as their suicide rate is 2.5 times higher than women. Suicide rate due other reasons is exponentially high in men. And governments to maintain their political correctness have always ignored men and never recognised them as victims.
During this unforeseen situation of COVID-19 pandemic induced lockdown and social distancing, mental health has become a key concern of the authorities apart from the regular health issues as people are most likely to get stuck with mental illness. Government has issued various guidelines for tackling the situation. Links for those guidelines are being attached below and the esteemed readers are requested to please read those guidelines and keep themselves away from any mental illness which could even harm them further.
High time to take note, make ‘communication’ a norm
Sushant Singh Rajput’s untimely demise has sent shockwaves across the nation and has yet again underlined the importance of mental health that we all have failed to address miserably. It also triggered various mental health activists who came out and criticised the Bollywood handling of the severe mental health issues which includes but is not limited to depression, anxiety, fear, ADHD, financially induced trauma. Notable film personalities also put forward their experiences and how they handled the situations which lacked support from the acting fraternity. The industry has in the past too has seen various such cases which includes famous personalities like Silk Smitha, Kuljeet Randhawa, Nafisa Joseph, Jiah Khan, Kushal Punjabi and various others.
A good mental health system has the onus of reducing the substantial burden of untreated mental disorders, decreasing human rights violations, ensuring social protection and improving the quality of life especially of the most vulnerable and marginalised subgroups in a society. Moving beyond care, it should also integrate and include mental health promotion and rehabilitation components.
Also as responsible fellow human beings, it is essential to look after those who may be showing an intent to suicide. Help them with professional assistance, with suicide helpline numbers like:
Telangana Roshni- 040-66202000
Andhra Pradesh 1Life- 78930-78930
Karnataka Arogya Sahayavani- 104
Tamil Nadu Sneha- 044-24640050
Delhi Sanjivani, Society for Mental Health- 011-40769002
Mumbai BMC Mental Health Helpline- 022-24131212
Vandrevala Foundation- 18602662345/ 18002333330
I Call- 022-25521111
The Samaritans, Mumbai- 8422984528/ 8422984529/ 8422984530
Sahai, Bengaluru- 080-25497777
Maitri, Kochi- 0484-2540530
Chaithram, Kochi- 0484-2361160
Lifeline Foundation, Kolkata- 033-24637401/32