A state-run mental health authority is the need of the hour

The World Health Organization (WHO) estimates that India will suffer economic losses amounting to $1.03 trillion due to mental health issues between 2012 and 2030. The raging COVID-19 pandemic has covered people inside their homes for the past two years, nurturing within this is a long-running silent pandemic – of mental health.

COVID -19 pressed the panic button.

Communities, families and individuals have been plagued by loneliness, violence, panic, fear of infection, ill health, co-morbidities, death, bereavement, migration stress , job insecurity and financial crises. This prolonged uncertainty with disruption of the social fabric has led to chronic anxiety and stress, leading to an array of mental health issues. Impact has been increased in already vulnerable subsections. Age-based differences in one study found that younger age groups were more susceptible to symptoms of stress, depression and anxiety. The impact has also been felt among health workers, the frontline warriors in our fight against the pandemic.

The sudden lockdown has compounded the already biased and unequal access to coping mechanisms and mental health services. A WHO survey of 130 countries found that 93% of countries face severe disruption in the delivery of their critical mental health, neurological and substance abuse services and an increased need for these services.

While society must begin to normalize mental illnesses as much as other physical illnesses, it is even more essential that medical professionals do so.

Maharashtra’s BMC-Mpower 1 on 1 mental health helpline received around 45,000 calls in the first two months of the pandemic. Of these, 82% of callers complained of anxiety, isolation, malaise and depression, while others stemmed from sleep irregularities and exacerbation of pre-existing mental health conditions.

These consequences were significantly higher among vulnerable subgroups such as women, young children, people in conflict, and caste minorities. An ORF survey reported that 65% of nearly 6,000 young people aged 18-32 felt lonely during lockdown, and 37% felt their mental health had been “significantly affected”. “The pandemic has seen an exponential increase in cases of depression, anxiety and stress among adolescents, who were leading abnormal and isolated lives and in many cases there has been an increase in substance abuse,” explains the Dr. Rohit Garg, an eminent Indian psychiatrist. Poor sleep, lower levels of resilience, loneliness and lack of social interactions with peers impacted young people.

Prolonged school closures have set back progress in accelerating education and empowering girls. More than 240 million Indian students readjusted their daily routine several times instead of schools closing and reopening due to COVID-19. The lack of routine, peer interactions, and classroom settings essential to a child’s overall development also affected their mental health.

Most important, but often overlooked, was the mental health of the health workers themselves. In the face of unprecedented emergencies, they responded with agility and long working hours, often walking away or isolating themselves from their families. They were exposed to prolonged trauma, heartbreak and demanding circumstances during this time. Anecdotal evidence indicates that to appear infallible and competent, they would dismiss and hide their symptoms such as anger, anxiety, PTSD and suicidal behavior.

Now that we seem to have passed through the acute phase of the pandemic, health workers continue to deal with anxiety and chronic stress as they nervously return to the new normal, guiding communities and patients for the same. .

Mental Health May

The Mental Health Month of May (Awareness Month) organized by WHO prioritizes getting back to basics, where multiple stakeholders inculcate proactive and preventative mental health interventions at all levels.

The Center for Knowledge and Development (CKD) recognizes this need and has undertaken initiatives in all ongoing projects to mainstream mental health among engaged stakeholders and communities served.

The past year has brought the public health system to its knees during the peak of COVID-19 and presented abundantly evident insight into the growing need for holistic mental health services. The asymmetry between supply and demand for mental health services in India continues to be a challenge; the estimated number of psychiatrists per 100,000 population in India is a dismal 0.75 compared to 3 in developed countries.

Collective action – need of the hour

Mental health is a deeply intersectional and cross-sectoral issue. To tackle the chronic underfunding, continued neglect, misunderstanding and stigma around mental health, collective action by different stakeholders is needed – including health professionals, activists, non-profit organizations profit and government systems.

Synergistic mental health conversations among all stakeholders, engagement of technical experts, training of health workers strengthening early identification and management and leveraging government initiatives such as the Mental Health Authority of the state are imperative to averting a mental health epidemic.

The COVID-19 pandemic has changed the world as we know it. We were caught off guard and struggling with our response, suffering as we faced it. As a result of this learning, it is now our moral responsibility to prevent the mental health epidemic that is looming on the horizon. There is an urgent need to establish targeted synergies, cross-sectoral efforts and investments to strengthen our poorly equipped mental health infrastructure.

Written by Seema Gupta, Advisor, Center for Knowledge and Development. The opinions expressed here are personal.

Donald E. Patel