October 10 is being observed as ‘World Mental Health Day’. It was observed for the first time in 1992 and is supported by the World Health Organisation (WHO), World Psychiatric Association (WPA) and World Federation for Mental Health (WFMH) among others.
The chosen theme for ‘World Mental Health Day - 2015’ is ‘Dignity in Mental Health’. WHO estimates the lifetime prevalence of mental and emotional problems to be 25% - meaning one out of four persons are likely to have a mental health problem in their lifetime. More alarmingly, recent research shows, majority of mental health problems have their onset before a person turns 15-years-old. This shows the paramount importance of childhood and adolescent mental health care.
Unfortunately, mental health care is facing neglect in many parts of the world, including in India. Persons with mental illness (mental disability) face discrimination and marginalisation in society. Emotional and physical abuse and human rights violations are common against them. One of the greatest impediments is social stigma - the negative and prejudiced mindset- which prevents people with mental disability from seeking early treatment and care.
Quality of Care: We are unable to provide quality care to persons with mental disability. Poor infrastructure, lack of resources, official apathy and low prioritisation leads to poor quality of health care. Many of the government-run mental health institutions in the country are under-staffed and in a state of neglect. Some of them operate from dilapidated buildings. Although private sector mental health care is available in many places, it is unaffordable to many.
District Mental Health Programmes provide a ray of hope, but they need more investment and support.
Treatment Gap: According to WHO, the treatment gap in many developing countries including India is as high as 80-90%. This means, 80-90% of people with mental health problems receive no treatment or care. Thus, persons who could otherwise have been treated and fully cured, go on to become chronically ill. This ruins the lives of patients and their families besides contributing to the burden of disease.
Dignity in mental health: Dignity of patients with mental illness (disorder) are paramount to ensuring their full and effective participation in the society. Many have only minor problems like anxiety, psycho-somatic problems, adjustment disorders or depression. These are like physical problems and there is nothing undignified here. Societal and economic inequalities not only lead to social tensions, but also to high prevalence of mental health problems.
Preventive strategies: Measures to prevent mental disorders are very effective and should be initiated early. Information, guidance and support in childhood and adolescence is very important. Life-skills training and fostering a sense of well being are also very useful. The ‘WPA Position Statement on Social Justice for persons with mental illness published in September this year underlines that the exclusion of mental health from developmental initiatives leads to poor treatment outcomes, poverty and discrimination. Social justice leads to mental health and well being. And mental health should be our global priority now!
(The author is a psychiatrist and the secretary general of World Psychiatric Association)