WHO defines health as a state of complete physical, mental, social & spiritual health, not a mere absence of disease. Mental health is an important component of health. Good mental health is the foundation for good physical health & vice-versa. Mental health is the Cinderella of health, often neglected, ostracized, abused & with a social stigma. We freely talk of physical health issues like, heart disease, blood pressure, diabetes etc, but keep under wraps issues like depression, anxiety & schizophrenia.
Magnitude of mental health disorders: 450 million people suffer from mental health disorders around the globe.(197.3 million in India, almost 40-45% of cases in the world)
45.7 million have depression & 44.9 have anxiety. India has been labelled as most depressing country in the world by WHO. These 2 conditions are most important disorders especially in 15-29 year age group. More in females than in males.
Almost more than 50% mental health disorders begin before 14 years of age.
Suicide is the most common cause of death in 15-29 years of age in India. 1,39,123 suicidal deaths were reported in 2019. 1 death every 4 minutes.( 1 death every 40 seconds in the world. 50% due to family problems & 56% by hanging. Maximum in Maharashtra, Tamil Nadu, Karnataka, West Bengal, & Madhya Pradesh. Rajasthan has 5.8/ 1 lakh whereas Indian average is 10.8 / 1 lakh population.
The cost of mental health disorders has been reported to be$16 Trillion from 2010-2030.
How to recognize person with Mental Health Disorders?
Unduly sad, loss of interest in pleasurable activities for a period more tha 2 weeks.
Generalized Anxiety, fear of social gatherings, panic attacks, bouts of anger
Obsessed with hand washing, cleanliness, repeated checking of locks etc.
Altered sleep ( excessive, poor sleep), appetite ( excessive or poor)
Poor scholastic performance, absenteeism.
Taking undue risks, speed driving, increased smoking, alcohol, drugs, stealing, anger outbursts, getting into fights, aloofness & isolation.
Talking, writing, drawing etc about death
Feeling of helplessness, hopelessness, blaming self, guilt feelings.
Distributing precious possessions, asking for forgiveness, saying good bye & clearing all dues etc.
Collecting means for suicide, visiting websites etc for suicide means, collecting railway time tables etc
What are the bottle necks in access to mental health services?
Trained manpower deficit -1-3 psychiatrist & 2 psychiatric health care staff per lakh population.
75% of population no access to mental health services.
Level of investment only a meagre 2% of the health budget.
The social stigma attached to mental health disorders. Mental health persons are called “Pagal Ka Doctor” till late.
The lack of humane care & focus on recovery is grossly missing.
Ill equipped, poor hygienic conditions at mental health hospitals.
False & poor depiction in movies, mass media, printed literature has lead to social ostracization.
How can we be of help?
Recognize symptoms & signs of mental health disorders in family, friends & colleagues
Ask them directly with empathy & in person about their problem/ Are they planning to hurt themselves/commit suicide? Direct question does not increase risk of suicide. It help as almost 75% are crying to be heard/ ask for help.
Stay with them, inform responsible person, take them to psychiatrist / emergency of hospital, remove means of suicide.Do not laugh off their problem, provoke/ dare them, look down on them for not thinking of family etc, never leave them alone.Motivate to take medication regularly, do exercise/yoga, consult doctor & ask for help without being embarrassed.NGOS may organize parenting program, life skill program ( creative & critical thinking, problem solving, decision making, assertively saying No etc),publication of articles on common problems, use of You Tube, face book, zoom, twitter, TV, AIR , publications in lay press etc.
Schools to have teacher/ staff training to pick up children with problems, regular physical activity, resilience building skills.
At home- have at least one meal together with no media, judicious use of media ( not more than 1-1.5 hrs tv, mobile, computer, besides use for on line classes), sleep hygiene ( 7-8 hrs of sleep, no media in bedroom )
Mental health issues in Corona Pandemic?
Corona pandemic has created a physical, mental, financial, social & emotional havoc all over the globe. Mental health disorders like depression, anxiety, suicide , hyperactivity, anger outbursts, drug use, overdose of online education Important factors responsible are isolation, fear of death, financial hardships, societal ostracization, restriction of movement & fear of harm to dear ones. Simple measures like regulating screen time, regular exercise/yoga/ mindfulness etc, eating healthy & together, adequate sleep, pursuing hobbies, & seeking doctor support. The silver lining is corona has brought families closer. , with working from home culture. For prevention remember the pneumonic MDH ( Mask, Distance & Hygiene). If you were to ask me of one measure, it is a good quality mask covering nose & mouth.
Take Home Message:
1 billion people have a mental health disorder. Anyone, anywhere may be affected. 1 in 5 children are affected my mental health disorder.
Depression & anxiety are the leading ones. Both are preventable & treatable.$1 invested in care gives dividend of $5.
People with severe mental health disorder die 10-20 years earlier than normal.
Suicide is a disease & is preventable. Visit www.zerosuicidealliance.org/ www.relias.co.uk. Ask for help. A number of websites & helpline are available in India & abroad . We have a24x7 helpline in Kota manned by trained counsellors Hope helpline-0744 2333666.
Multipronged approach by health policy, health legislation, community involvement, humane care, dispelling myths, erasing the stigma & each one acting as mental health volunteer. Government of India launched Mental Health policy in2024 & Mental Health Act in2017 to improve care & enhance accessibility.
Everything begins at home. Let us focus on parenting, inculcating positive value, spending time together, judicious media use, nutritious diet & a culture of mutual help.
Schools to focus on Life skill education, physical activity & inculcate culture of fairness & co-operation.
Community & NGOs to inform, educate & communicate. Dispel myths & erase stigma.
Let us join hands to prevent mental health disorders. Make community treat them like any other health issue. Each one can contribute. Let us ensure everyone, everywhere gets help & treated with compassion & love.
Time To Act Is Now. Let Us Just Do It.