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Picture Courtesy:  THE  HINDU

Context

World Mental Health Day on October 10 serves as a reminder for India about the growing mental health burden.

What is Mental Health?

According to the World Health Organization (WHO), it is a state of well-being in which an individual realizes their own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to their community.

It is more than just the absence of mental illness. It includes emotional, psychological, and social well-being, affecting how we think, feel, and act.

Mental disorders range from common conditions like depression and anxiety to severe illnesses like bipolar disorder and schizophrenia.

What is the status of mental health problems in India?

High Prevalence of Disorders

Nearly 230 million Indians live with mental disorders, from depression and anxiety to bipolar and substance-use conditions, with a lifetime prevalence of 13.7%.  (Source: The Hindu)

Rising Suicide Cases

According to the National Crime Records Bureau (NCRB) 2023 report, India recorded 1,71,418 suicides, rise of 0.3% from the previous year. Suicide remains the leading cause of death among youth aged 15–29 years.

The World Health Organization (WHO) estimates a suicide rate of 16.3 deaths per 1,00,000 people,  highlighting India’s heavy mental health burden. (Source: The Hindu)

Massive Treatment Gap

The gap between the need for and the availability of care ranges from 70% to 92% across various disorders. Over four in five people with severe mental illness receive no formal care. (Source: The Hindu)

Severe Workforce Shortage

India has only 0.75 psychiatrists for every 1,00,000 people, far below the WHO-recommended minimum of three. There is a similar scarcity of psychologists, nurses, and social workers. (Source: The Hindu)

High-Risk Groups: The crisis disproportionately affects specific demographics: (Source: The Hindu)

• Men: Constitute 72.8% of all suicide victims, reflecting gendered economic and social stress.
• Farmers: Agrarian distress continues, with 10,786 farmer suicides in 2023. Over 1,00,000 farmers have died by suicide since 2014. (Source: The Hindu)
• Women: Homemakers and caregivers face high rates of depression and domestic violence but remain largely invisible in official statistics.
• Students: Academic pressure, particularly in coaching hubs like Kota, has led to a high number of student suicides.

Untreated mental illness could cost India over $1 trillion in lost GDP by 2030 — employers already lose over ₹1.1 lakh crore annually to absenteeism, attrition and burnout. (Source: The Hindu)

What are the root causes of the mental health crisis?

Socio-Economic Triggers

• Family and Relationship Issues: Family problems (31.9%) and marriage-related issues (5%) are the leading causes of suicide. (Source: The Hindu)
• Illness and Substance Abuse: Illness accounts for 19% of suicides, substance abuse is linked to 7%, and relationship or marriage-related issues (about 10% combined). (Source: The Hindu)
• Economic Distress: For farmers, triggers include debt, crop failure, and market shocks. For others, financial distress and unemployment are significant factors.
• Urban Pressures: Cities report higher suicide rates than rural areas, reflecting the pressures of urban life, competition, and loneliness.

Systemic Failures

• Deep-Seated Stigma: Over 50% of Indians attribute mental illness to personal weakness or shame. This stigma prevents individuals from seeking help. (Source: The Hindu)
• Inadequate Infrastructure and Funding: The mental health budget is only 1.05% of the total health budget, far below the WHO-recommended minimum of 5%. Even this small budget goes unspent. (Source: The Hindu)
• Lack of Access to Care: Shortage of professionals, high cost of treatment, and urban-centric services mean that care is inaccessible for the vast majority, especially in rural areas.
• Poor Policy Implementation: Laws and schemes exist on paper but fail in practice. The District Mental Health Programme (DMHP) functions poorly in many states, and school-based programs like Manodarpan remain largely inactive.

Initiatives taken by the Indian Government

Mental Healthcare Act, 2017: Guarantees the right to mental health care, decriminalises suicide, mandates insurance coverage for mental illness, and protects patient dignity.

Judicial Intervention: In the Sukdeb Saha vs State of Andhra Pradesh case, the Supreme Court reinforced mental health as a fundamental right under Article 21, making the government legally responsible for providing care.

District Mental Health Programme (DMHP): Decentralize mental health services by providing counseling, outpatient services, and suicide prevention at the district level, covering around 767 districts.

Tele MANAS: A 24x7 national mental health helpline that has provided over 2 million tele-counseling sessions, improving reach in underserved areas.

Manodarpan: A school-based psycho-social support scheme aimed at providing mental health support to students.

National Suicide Prevention Strategy (2022): This policy aims to reduce suicide mortality by 10%.

What India can learn from other countries

Advanced countries like Australia, Canada, and the UK offer valuable lessons 

• Higher Budget Allocation: These countries allocate 8-10% of their health budget to mental health, compared to India's 1.05%. This demonstrates political prioritization.  (Source: The Hindu)
• Use of Mid-Level Providers: They effectively use a mid-level mental health workforce (trained counselors, therapists) to deliver nearly 50% of counseling services, bridging the specialist gap. (Source: The Hindu)
• Lower Treatment Gaps: Their treatment gaps, range at 40-55%, are far lower than India's 70-92%, indicating better access and integration of services. (Source: The Hindu)
• Universal Health Coverage: Insurance coverage for mental health exceeds 80%, compared to under 15% in India, making care affordable. (Source: The Hindu)
• Robust Monitoring Systems: They maintain real-time mental health surveillance systems to track patient care, identify dropouts, and guide policy.

Way Forward for India

Increase Funding: The mental health budget must be increased to at least 5% of the total health expenditure, as recommended by WHO, to build infrastructure, recruit a workforce, and ensure a steady supply of medicines.

Strengthen the Workforce: Scale up the training and deployment of mid-level mental health providers to overcome the urban-rural disparity and the shortage of specialists.

Make Counselling a Public Infrastructure: Every school, college, district hospital, and agrarian block must have a full-time, trained counsellor.

Integrate Mental Health into Primary Care: Fully integrate mental health services into primary health centres and universal health insurance schemes like Ayushman Bharat to ensure accessible and affordable care for all.

Launch Anti-Stigma Campaigns: Public campaigns to destigmatize help-seeking, normalize conversations about mental distress, and share recovery stories.

Establish Robust Monitoring: Create monitoring and evaluation systems at the district and state levels to improve accountability and track treatment outcomes.

Regulate Digital Mental Health: Regulate AI tools and emotional-support apps to ensure privacy, disclose risks, and provide access to licensed professionals, preventing them from becoming dangerous substitutes for real care.

Form a Cross-Ministerial Task Force: Establish a task force with representatives from the health, education, agriculture, and women and child welfare ministries, with independent funding and clear accountability.

Conclusion

India must adopt a rights-based, data-driven mental health approach—strengthening systems, integrating care, reducing stigma, and using innovation—to turn silent suffering into shared strength and drive inclusive national progress.

Source: THEHINDU