CHENNAI: With increasing awareness and dialogue about mental health, many psychiatrists and counsellors conceded that there has been a surge in the number of patients they are treating. However, most felt the stigma attached to visiting a counsellor, psychologist or psychiatrist is still deep-seated and many suffer in silence.
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The World Health Organisation (WHO) has defined ‘mental health’ as being ‘more than the absence of mental illnesses’. It says, “mental health refers to a broad array of activities directly or indirectly related to the mental well-being, prevention of mental disorders, and treatment and rehabilitation of people affected by mental disorders.”
Dr R Balakrishnan, psychiatrist at Ramachandra Hospital, said that there are more people seeking help, especially youngsters, due to increased awareness and exposure to the wealth of information available on the Internet. “About 10 years back, I would see only five to ten patients a day.
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Now, I see close to 25 cases a day in the hospital and about 15 cases in my clinic. Often, they are people who come in with physical symptoms. When the doctor finds all the tests to be clear, they send these patients to us and we find that these physical symptoms are triggered by mental health illnesses like stress, anxiety, depression. We spend time with patients, speak to them and understand the root cause. It is important that people realise good mental health is as crucial as good physical health,” he said.
However, not all psychiatrists attribute the rise in patients visiting them to awareness. “Psychiatrists in India see about 60 per cent more patients now compared to 25 years ago. This is the same as the increase in India’s population. So, we cannot attribute awareness to this increase. Seeking help for mental disturbance is still a taboo. The stigma is fuelled by the cultural notion that mental health should not be talked about because ‘you should not make an issue out of nothing’ and just ‘learn to deal with it’,” said Dr Gauthamadas, specialist in neuro-behavioural medicine at DocGautham’s Neuro Center.
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Dr Nappinnai Seran, the founder of Psyhub — Brain and Behaviour Clinic, said, “People are reluctant to seek professional help because they feel that mental illness is because of bad karma. The WHO has said that by 2020, maximum deaths will be due to depression and cancer, and in India, we are not ready to deal with this burden.”
The WHO says the mental health workforce in India (per 100,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07). Adding to this is the resistance of patients and families to take medication for mental health conditions.
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“The scenario is rendered murky by the misconception that medication for mental health issues is an absolute ‘No-No’ because of side effects and ‘dependency’ on the medication for life. People will readily swallow pain-killers, totally ignorant that they have far more lethal side effects than any anti-depressant — because it is for treating a bodily disorder. They want to avoid taking medicines for the mind because the mind ‘is under our control’ as espoused by spiritual gurus.
That the mind is a function of the brain, which runs on chemicals, and that any chemical imbalance of the brain results in mental disturbances, which can be cured with medicines that have few irreversible or lethal side effects, combined with counselling to learn to cope, is something that has to be propagated to educate people, reduce stigma, and avoid serious loss of productivity and life (through suicide),” Dr Gauthamadas said.
● Determinants of mental health and mental disorders include not only individual attributes such as the ability to manage one’s thoughts, emotions, behaviours and interactions with others, but also social, cultural, economic, political and environmental factors such as national policies, social protection, living standards, working conditions, and community social supports.
● Poverty and low education levels are the key amongst these factors. Specific psychological and personality factors also contribute towards the vulnerability. Genetic factors also play some role.
● The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. *SOURCE: WHO website