India needs to talk about mental illness
National Mental Health survey shows urban areas to be most affected
At least 13.7 per cent of India’s general population has various mental disorders; 10.6 per cent of them require immediate interventions.
While nearly 10 per cent of the population has common mental disorders, 1.9 per cent of the population suffers from severe mental disorders.
These are some of the findings of a National Mental Health Survey held recently and conducted by the National Institute of Mental Health and Neurosciences (NIMHANS).
That is not all. The prevalence of mental morbidity is found to be very high in urban centres, where there is a higher prevalence of schizophrenia, mood disorders and neurotic or stress-related disorders. This disturbing scenario could be due to fast-paced lifestyles, experiencing stress, complexities of living, a breakdown of support systems and challenges of economic instability.
In 2014, concerned over the growing problem of mental health in India, the Union Ministry of Health and Family Welfare had appointed NIMHANS to study mental health status in the country.
After a pilot feasibility study in Kolar district, Karnataka using a sample size of 3,190 individuals, the team which comprised senior professors from NIMHANS, G. Gururaj, Mathew Varghese, Vivek Benegal and Girish N., began the survey in Punjab, Uttar Pradesh, Tamil Nadu, Kerala, Jharkhand, West Bengal, Rajasthan, Gujarat, Madhya Pradesh, Chhattisgarh, Assam and Manipur.
The study — which covered all important aspects of mental illness including substance abuse, alcohol use disorder, tobacco use disorder, severe mental illness, depression, anxiety, phobia and post-traumatic stress disorder among others — had a sample size of 34,802 individuals. Primary data collection was done through computer-generated random selection by a team of researchers, and local teams of co-investigators and field workers in the 12 States.
While the overall current prevalence estimate of mental disorders was 10.6 per cent in the total surveyed population, significant variations in overall morbidity ranged from 5.8 per cent in Assam to 14.1 per cent in Manipur. Assam, Uttar Pradesh and Gujarat reported prevalence rates less than 10 per cent. In eight of the 12 States, the prevalence varied between 10.7 per cent and 14.1 per cent.
Treatment gaps and impact
A major concern in the findings, which were recently submitted to the Union Health Ministry, is that despite three out of four persons experiencing severe mental disorders, there are huge gaps in treatment.
Apart from epilepsy, the treatment gap for all mental health disorders is more than 60 per cent. In fact, the economic burden of mental disorders is so huge that affected families have to spend nearly Rs.1,000-Rs.1,500 a month mainly for treatment and to access care.
Due to the stigma associated with mental disorders, nearly 80 per cent of those with mental disorders had not received any treatment despite being ill for over 12 months, the study says. Poor implementation of schemes under the National Mental Health Programme is largely responsible for this.
Dr. Gururaj says that there is also a paucity of mental health specialists, pointing out that mental disorders are a low priority in the public health agenda. The health information system itself does not prioritise mental health.
Recommending that mental health financing needs to be streamlined, he says that there is a need to constitute a national commission on mental health comprising professionals from mental health, public health, social sciences and the judiciary to oversee, facilitate support and monitor and review mental health policies.
Manipur: 14.1 per cent
Madhya Pradesh: 13.9 per cent
Punjab: 13.4 per cent
West Bengal: 13 per cent
Tamil Nadu: 11.8 per cent
Chhattisgarh: 11.7 per cent
Kerala: 11.4 per cent
Jharkhand: 11.1 per cent
Rajasthan : 10.7 per cent
Gujarat: 7.4 per cent
Uttar Pradesh: 6.1
Assam: 5.8 per cent
Key findings
Common mental disorders such as depression, anxiety and substance use are as high as 10 per cent in the total population
Almost 1 in 20 suffer from depression; it is found to be higher in females in the age-group 40-49 years
22.4 per cent of the population above 18 years suffers from substance use disorder
The highest was contributed by tobacco and alcohol use disorder
Nearly 1.9 per cent of the population is affected by severe mental disorders
These are detected more among males in urban areas
While prevalence of mental illness is higher among males (13.9 per cent) as compared to females (7.5 per cent), certain specific mental illnesses like mood disorders (depression, neurotic disorders, phobic anxiety disorders etc) are more in females
Neurosis and stress related illness is also seen to be more in women
Prevalence in teenagers aged between 13 and 17 years is 7.3 per cent
yasmeen.afshan@thehindu.co.in
Keywords: mental illness, mental disorders
Source: The Hindu, 23-10-2016
