South has higher prevalence of mental disorders: study
GS Paper III
Topic: Government Policies & Interventions Welfare Schemes. Issues Related to Women
Mains: Mental health act
What’s the News?
The first comprehensive estimates of disease burden attributable to mental health from 1990 prepared by the India State-Level Disease Burden Initiative and published in the Lancet Psychiatry finds one in seven, or 197 million, Indians suffered from mental health issues of varying severity in 2017.
Report other findings:
- Tamil Nadu, Kerala, Telangana, Karnataka and Andhra Pradesh account for a higher prevalence of mental disorders that manifest primarily during adulthood in depression and anxiety.
- Mental disorders of varying severity include depression, anxiety disorders, schizophrenia, bipolar disorders, idiopathic developmental intellectual disability, conduct disorders, and autism.
- Importantly, the contribution of mental disorders to the disability adjusted life year (DALY) — the sum of total years of life lost and years lived with disability — has doubled between 1990 and 2017 increasing from 2.5% to 4.7%.
- The study divides different States into three categories on the basis of their socio-demographic index (SDI), i.e low, medium and high SDI States.
The socio-demographic index (SDI) is a composite measure of per-capita income, mean education, and fertility rate in women younger than 25 years and is calculated on a scale of one.
- Mental disorders were the second leading cause of disease burden in terms of years lived with disability (YLDs) and the sixth leading cause of disability-adjusted life-years (DALYs) in the world in 2017
Disability-adjusted life years (DALYs):
The burden of disability associated with a disease or disorder can be measured in units called disability-adjusted life years (DALYs). DALYs represent the total number of years lost to illness, disability, or premature death within a given population.
DALYs are calculated by adding the number of years of life lost to the number of years lived with disability (YLDs) for a certain disease or disorder.
It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Mental health care Act 2017
- India’s new mental health legislation, the Mental Healthcare Act, 2017, was commenced on 29 May 2018. It grants a legally binding right to mental healthcare to over 1.3 billion people, one sixth of the planet’s population.
- Key measures include (a) new definitions of ‘mental illness’ and ‘mental health establishment’; (b) revised consideration of ‘capacity’ in relation to mental healthcare (c) ‘advance directives’ to permit persons with mental illness to direct future care; (d) ‘nominated representatives’, who need not be family members; (e) the right to mental healthcare and broad social rights for the mentally ill; (f) establishment of governmental authorities to oversee services; (g) Mental Health Review Boards to review admissions and other matters.
- 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.
- 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 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 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.
We will need a genuine partnership of a diverse range of groups — from the mental health and development communities to policy makers and civil society — coming together to transform mental health across the country.