India’s mental health crisis: A PPP between State and private mental health professionals can help

Last week, V Radhika Reddy jumped off the fifth floor of her Hyderabad apartment and left behind a suicide note that said: “My brain is my enemy.” Depression may have driven the 38-year-old news presenter to end her life, but she isn’t the only one. India has one of the highest prevalence of mental illnesses in the world. So, anybody from the IT professional chasing deadlines, to the journalist doing graveyard shifts or that teenager glued to the tablet seated next to you in the Metro, could be nurturing a mental health condition. With more than 300 million cases around the world, depression is the single largest public health problem in the world, says the World Health Organization. According to the data journalism website, IndiaSpend, at least 60 million Indians suffer from mental disorders. At present, people with mental illnesses account for nearly 6.5% of India’s population: By 2020, the number is estimated to be 20% — or one in five people suffering from a mental illness. Although there is little government data on the linkage between mental illnesses and suicides, psychiatrists say 90% of those who end their lives are likely to be suffering from a mental disorder.

Despite this, India spends much less than the rest of the world on mental health issues (0.06% of its health budget on mental healthcare) and has an acute shortage of professionals who can help people fight mental disorders. There are 0.30 psychiatrists, 0.17 nurses, and 0.05 psychologists per 1,00,000 mentally ill patients in the country.

Worryingly, the age profile of mental health patients is getting younger. With work pressure and long working hours, parents often find it difficult to engage adequately with children. The National Mental Health Survey 2015-16 published by the National Institute of Mental Health and Neurosciences, Bengaluru, estimated that nearly one in seven teenagers growing up in India’s metros could be suffering from mental health disorders.

One of the biggest reasons for depression today is the pressure to live up to the expectations of society, peers and social media followers. Success and acceptance have become paramount, often at the cost of one’s mental well-being. Earlier people could unwind in a communal social setting such as the joint family, the local barber, the coffee house adda, or common interest groups. Today’s young professionals tend to socialise with co-workers and peers — people they compete with and with whom they never let their guard down.

Another reason for depression, in a country with one of the highest smartphone and Internet penetrations in the world, is social isolation. Unlike interpersonal bonding that makes it more difficult to mask emotions, online interactions are often transient, leading to withdrawal.

Even as technology is seen as a trigger for mental health problems, it can also prove to be a cost-effective solution for crisis intervention. Most present-day psychiatrists have some form of telephone counselling or virtual chat apps to reach out to those who need help. One of the recommendations of the new Mental Healthcare Bill last year, which will be implemented in July 2018, is the provision of medical care to each of the 60 million citizens suffering from mental health conditions. Although the mechanics of the funding are yet to be spelled out, a public-private partnership between mental health professionals in the government and private hospitals to train physicians at the village and block level through video conferencing — to identify and provide basic treatment and drugs for depression and anxiety — could be the way out.