Introduction

Mental illnesses affect 19% of the adult population, 46% of teenagers and 13% of children each year. People struggling with their mental health may be in your family, live next door, teach your children, work in the next cubicle or sit in the same church pew. However, only half of those affected receive treatment, often because of the stigma attached to mental health. Untreated, mental illness can contribute to higher medical expenses, poorer performance at school and work, fewer employment opportunities and increased risk of suicide. 
The number of students reporting mental health problems has increased dramatically in recent years, and the signs are that it will continue to rise further. For most students, their first steps into higher education will be some of the most challenging times they have faced. Most will be dealing with new-found independence, along with the challenges of balancing their academic work, new financial pressures, and building new social relationships. For many, the pressures can deeply affect their mental health, and for others who are already dealing with difficult mental health problems they can find themselves struggling. Very often, students are unwilling to speak out, whether that is due to stigma, concerns about the consequences of asking for help, or simply embarrassment.

What Exactly in Mental Illness?

A mental illness is a physical illness of the brain that causes disturbances in thinking, behaviour, energy or emotion that make it difficult to cope with the ordinary demands of life. Research is starting to uncover the complicated causes of these diseases which can include genetics, brain chemistry, brain structure, experiencing trauma, and/or having another medical condition , like heart disease.

The two most common mental health conditions are:

Anxiety Disorders: More than 18% of adults each year struggle with some type of anxiety disorder, including post traumatic stress disorder, (PSTD), obsessive,-compulsive disorder, (OCD), panic disorder(panic attacks), generalized anxiety disorder, and specific phobias

Mood Disorders: Mood disorders, such as depression and bipolar depression affect nearly 10% of adults each year and are characterized by difficulties in regulating one’s mood. 


Issues 

High Public Health Burden: An estimated 150 million people across India are in need of mental health care interventions, according to India’s latest National Mental Health Survey 2015-16. 

Lack of Resources: Low proportion of mental health workforce in India (per 100,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07).
Low financial resource allocation of just over a percent of GDP on healthcare has created impediments in public access to affordable mental healthcare.

Loss to Economy: Due to delayed or non treatment of mentally ill persons there is loss in terms of human capital and an overall loss to the economy in the form of lost man-days, plus the poor is stressed as most of mental healthcare is in urban areas and are unavailable in primary healthcare centres in rural areas, this increases out of pocket expenditure.

Demographic Dividend: According to WHO, the burden of mental disorders is maximal in young adults. As most of the population is young (India has more than 50% of its population below the age of 25) so it requires a special focus in mental health of youth by the government to reap the benefits arising out of the demographic dividend in India. 

Post-Treatment gap: There is need for proper rehabilitation of the mentally ill persons post his/her treatment which is currently not present. 

Poor awareness : Poor awareness about the symptoms of mental illness, social stigma and  abandonment of mentally ill especially old and destitute leads to social isolation and reluctance on part of family members to seek treatment for the patient has resulted in a massive treatment gap, which further worsens the present mental illness of a person.

Rise in Severity: Mental health problems, tend to increase during economic downturns, therefore special attention is needed during times of economic distress.

Prone to abuse: Mentally ill patients are vulnerable to and usually suffer from physicalabuse, sexual abuse, wrongful confinement, even at homes and mental healthcare facilities which is a cause of concern and a gross human right violation.




Suggestions

Increase Resources

Increasing mental healthcare facilities and related infrastructure through more resource allocation in the budget.
Adequate Mental healthcare professional availability.

Increasing Awareness

For patients to undertake timely treatment
To breakdown societal prejudices/stigma
To discourage questionable treatment from faith healers.
For e.g.  “The Live Love Laugh Foundation” which aims to reduce the stigma, spread awareness and change the way we look at Mental Health.

More investment in PHC
There is only one primary healthcare centre for more than 51,000 people in India. The World Bank estimates that 90% of all health needs can be met at the primary healthcare level thus more investments are needed in order for patients to get easier, cheaper and faster access to services, plus, training at grass root level for ASHA, ANM, AWW centre workers on how to recognize common to severe mental health problems like schizophrenia, anxiety, depression, and alcohol abuse.

Digital initiatives 
Digital initiatives are helping improve  rural India’s mental health through telemedicine like Schizophrenia Research India’s (SCARF) mobile bus clinic which is run by an NGO; there is need for scaling up such initiatives which will bridge the rural-urban divide.

Community Partnership 
By forming their self-help groups of carers families along with NGO’s which brings community participation and helps reduction in social stigma associated with mental illness.

Healthcare 
Healthcare is a state subject – there is need for better coordination between Center-States for proper implementation.

Make psychotropic drugs available
Essential psychotropic drugs should be provided at all levels of healthcare. These medicines should be included in essential drugs list

Empathetic Service delivery
Delivery of services should be sensitive, compassionate and free from stigma and discrimination in public healthcare institutions plus there is need for police sensitization and training regarding recognition of acute mental disorders and undertaking of necessary action to protect the human rights of the mentally ill, his family and his fellow citizens.

Financial support
Financial support from the government to the families so that direct costs of treatment are covered and families are not overburdened.


Way Forward

Increasing the number of psychologists and psychiatrists alone won’t help. Stigma and awareness are two separate issues although interlinked. They need to be addressed in parallel in order to tackle the burden of mental illness in India.
If individuals continue to view mental illness with apprehension and resistance, it will remain difficult for people with mental health concerns to seek the support they require due to the fear of being labelled or judged.


What can you do to help?

Although the general perception of mental illness has improved over the past decades, studies show that stigma against mental illness is still powerful, largely due to media stereotypes and lack of education, and that people tend to attach negative stigmas to mental health conditions at a far higher rate than to other diseases and disabilities, such as cancer, diabetes or heart disease.

Stigma affects not only the number seeking treatment, but also the number of resources available for proper treatment. Stigma and misinformation can feel like overwhelming obstacles for someone who is struggling with a mental health condition. Here a few powerful things you can do to help:

Showing individuals respect and acceptance 

Showing individuals respect and acceptance removes a significant barrier to successfully coping with their illness. Having people see you as an individual and not as your illness can make the biggest difference for someone who is struggling with their mental health.

Advocating within our circles of influence

It helps to ensure these individuals have the same rights and opportunities as other members of your church, school and community.

Learning more about mental health 

It allows us to provide helpful support to those affected in our families and communities