A Right On Hold: Destigmatising Mental Healthcare In India
The recent news of a young Dutch woman, aged 28, who ended her life through euthanasia due to severe mental health struggles, throws a harsh light on the stark disparity in access to mental healthcare across the globe. While some countries contemplate assisted dying for those with untreatable mental illness, India grapples with a far more basic issue: ensuring timely and affordable mental healthcare for its citizens.
This year's World Health Day theme, "My health, My right," resonates deeply in the context of India's mental health scenario. The National Mental Health Survey 2015-16 found that nearly 10 per cent of Indians suffer from a mental health condition. Yet, access to affordable care remains a distant dream for many. A 2023 NITI Aayog report states that over 50 per cent of Indians lack health insurance, leading to high Out-of-Pocket (OOP) expenditure on healthcare. The affordability crisis extends to mental healthcare as well. A 2021 study published in the Indian Journal of Psychiatry revealed a vast gap between the required mental health professionals and available ones, with a significant shortage of psychiatrists, psychologists, and counselors, especially in rural areas.
Stigma surrounding mental health is another major barrier. A 2020 study by the National Institute of Mental Health and Neurosciences (NIMHANS) found that societal perceptions often prevent people from seeking help. Many don't recognise mental health issues or hesitate due to fear of judgment opines health experts. This creates a vicious cycle. The lack of affordable healthcare discourages people from seeking help early, potentially worsening their condition and leading to a greater financial burden in the long run.
Seeking Solutions: Expert Insights
To understand the challenges faced by individuals and the potential solutions, mental health professionals offer valuable insights. Dr. Kersi Chavda, Consultant Psychiatry at P.D. Hinduja Hospital and MRC, Mahim, identifies lack of awareness, stigma, shortage of professionals, cost of treatment, language and cultural barriers, and insufficient government funding as key hurdles. He emphasises the need for a multi-pronged approach involving awareness campaigns, training more mental health professionals, improving infrastructure, increasing government funding, and implementing policies to make mental healthcare services more accessible and affordable.
Destigmatising the Conversation
Ritu Mehrotra, CEO and Founder of United We Care, adds her perspective: “The primary challenge is stigma. While in a post covid world a lot of Urban Indians did develop a deeper and better understanding of mental health challenges yet there is still not much ready acceptance around the same. People still are shamed when they visit a therapist and most are told to seek support within family instead of seeking therapy.”
Another healthcare expert Dr. Prerna Kohli, a clinical psychologist and Founder MindTribe highlights the challenges hindering mental healthcare accessibility in India, citing shortages of professionals, financial constraints, and pervasive stigma. To combat this, she stresses the importance of multi-level efforts, including increased funding, expanded workforce, and awareness campaigns.
Deepak Sahni, Founder of Healthians, highlights the importance of education and open communication in destigmatising mental health. He suggests normalising discussions about mental health, integrating it into primary care, and fostering supportive environments in workplaces and online communities. Dr. Neerja Agarwal, Psychologist and Co-founder of Emoneeds emphasises mindfulness as a tool to promote overall well-being and emotional resilience. Techniques like meditation and deep breathing can be integrated into daily routines to foster self-understanding and self-compassion.
Technology as a Bridge
Mudit Dandwate, CEO and Co-Founder of Dozee, sees Artificial Intelligence (AI) powered solutions as a bridge to narrow the gap in access to mental healthcare. Remote patient monitoring tools can improve care and empower healthcare providers. Sudipta Sengupta, Founder-CEO of The Healthy Indian Project (THIP), emphasises the role of screening programs in schools and workplaces for early detection of mental health issues. He also advocates for culturally sensitive interventions and integrating mental health services into primary care.
The Role of Policy and Industry
Sajeev Nair, a peak performance consultant, proposes a shift in perspective, viewing mental health issues as physiological and neurological problems requiring medical intervention. This, he believes, could help reduce stigma. He suggests expanding routine health checkups to include vitamin and mineral panels to identify potential deficiencies that could contribute to mental health issues. He also highlights the potential of genetic testing to identify predisposition to mental health problems, allowing for preventative measures.
Beyond Treatment: A Culture of Wellness
Nair emphasises the importance of proactive wellness strategies like biohacking to optimize mental and physical health. He sees wearable technology and health-tech apps as powerful tools for monitoring mood, stress levels, and even basic blood tests. Companies can incentivise employees to adopt such technologies and participate in educational programs on the importance of gut health and nutrient deficiencies that can impact mental well-being.
Challenges and Solutions
Dr. Veena Gholap, Associate Professor, Department of Psychiatry, K J Somaiya Medical College and Research Centre, highlights the alarming rise of mental health issues in India, impacting both workplaces and students. She emphasises the importance of prioritising employee well-being for organizational growth. To create supportive work environments, Dr. Gholap suggests:
Encouraging open dialogue: Companies should foster a culture where employees feel comfortable expressing their feelings freely about mental health.
Interactive activities: Workshops, decluttering sessions, and group discussions can enhance emotional awareness and provide coping mechanisms.
Reliable resources: Providing access to accurate information and mental health resources empowers employees to seek help.
Empowering Patients
Sudipta Sengupta, Founder-CEO of The Healthy Indian Project (THIP), underscores the importance of patient education and collaboration in treatment plans. He emphasises understanding the condition: Basic knowledge about mental health conditions empowers patients to be open to treatment options.
Combating misinformation: Access to verified medical information from doctors or trusted sources helps patients make informed decisions.
Advocacy: Empowered patients become active participants in their treatment plans and advocates for their mental health needs.
India faces a significant challenge in ensuring accessible and affordable mental healthcare for its citizens. Destigmatising mental health, creating supportive environments, leveraging technology, and adopting a preventative approach are crucial steps towards a future where everyone has the opportunity to thrive, not just survive.
