Mind the Gap

Bridging the enormous deficit of mental healthcare in India- DASRA

(As compiled by Aarohi Doshi)

 

 

Dasra meaning ‘enlightened giving’ in Sanskrit, is a pioneering strategic philanthropic organization that aims to transform India where a billion thrive with dignity and equity. Since its inception in 1999, Dasra has accelerated social change by driving collaborative action through powerful partnerships among a trust-based network of stakeholders (corporates, foundations, families, non-pro ts, social businesses, government and media). Over the years, Dasra has deepened social impact in focused elds that include adolescents, urban sanitation and governance and has built social capital by leading a strategic philanthropy movement in the country.

For more information, visit http://www.dasra.org

dasra-logo-2

 

Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.

-World Health Organization (WHO)

 

There are myths that surround the world today. Mental illness will never affect me. The fact of the matter is that ‘One in five Indians will experience a mental illness by 2020’. Mental illness is common. It affects people of all ages, educational and income levels and cultures. This brings us to a serious question. What do we mean by Mental Health?

 

Mental Health is 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 his or her community.

 

Mental health is a key part of an individual’s capacity to lead a fulfilling life- it influences the ability to form and maintain relationships, study, work, pursue leisure interests and make a day-to-day decisions about education, employment and housing.

 

Lets delve deeper into ‘UNDERSTANDING of MENTAL ILLNESS’:

 

Mental Health is not just a health issue, but one that is inextricably linked to socioeconomic and cultural factors, both in its causes and effects on society. According to the American Psychiatric Association a mental disorder is:

  • A clinically significant disturbance in an individual’s thinking, mood, or behavior.
  • A manifestation of a behavioral, psychological or biological dysfunction in the individual.
  • Usually associated with significant distress and impaired functioning in social, occupational, or other important activities.

 

Another myth that the society believes in is that people with mental illness are violent and dangerous whereas the fact of the matter is that they are more likely to be victims of violence than to be violent.

 

Recognizing the limitations of a purely clinical approach, many experts are advocating for the need to look at mental health problems not as binary (existing or non existing), but as a continuum of wellness and illness.

This approach acknowledges that:

  • Mental health is more than just the absence of mental disorders or disabilities.
  • People with mental health problems often fluctuate along the spectrum in their experience of ill health.
  • This fluctuation may happen as often as on a daily basis, regardless of whether or not the individual has a pre-existing mental health condition.

 

Each of us lies somewhere on the continuum and is likely to, at some point, move along it in one direction or another.

  • Wellness: Optimal state of mental health with no functional impairment or need for treatment
  • Distress: Common and reversible distress with no significant functional impairment. May require low-intensity treatment.
  • Disorder: Significant functional impairment that needs intensive treatment.
  • Disability*: Severe and persistent functional impairment requiring life-long treatment.

*While the term ‘disability’ has been used here mainly as a medical construct, it is important to acknowledge the social model of disability, which emphasizes that the ‘deficiency’ that thus ‘disables’ someone is caused by the way society is organized rather than a person’s impairment or difference.

 

Key Gaps:

According to estimates, even if all ~4000 psychiatrists available in India are involved in face-to-face patient contact for eight hours a day, five days a week, and see single patient for a total of 15-20minutes over a 12 month period, they would together be able to care for only 10-20% of mental health patients in India.

 

Using a WHO- adapted framework, Dasra has highlighted the seven key dimensions of India’s mental health crisis:

 

  • Workforce
  • Infrastructure
  • Service Delivery
  • Awareness
  • Evidence and Research F. Policy
  • Financing

 

WORKFORCE:

  • Shortage of mental health professionals
  • Inadequate training facilities:
  • Dearth of leadership

INFRASTRUCTURE:

  • Scarce infrastructure
  • Rural areas are even worse equipped

SERVICE DELIVERY:

  • Disproportionate emphasis on biomedical approach
  • Inadequate focus on community-based care
  • Institution-based care
  • Community mental healthcare
  • Lack of support of caregivers

AWARENESS:

  • Lack of mental health literacy
  • Mental health is shrouded in myths
  • Widespread stigma surrounding mental illness

EVIDENCE AND RESEARCH:

  • Serious dearth of evidence to build and scale programs

POLICY

  • Inadequate provisions to protect legal and human rights of those with mental illnesses
  • Lack of regulations to license mental health professionals

FINANCING:

  • Limited government funding
  • Inadequate private funding

 

Interventions:

To address the gaps in mental healthcare in India, non-profits conduct a range of activities – in communities, schools and institutions – across four key areas:

PREVENTION:

  • Create awareness among key stakeholders

TREATMENT:

  • Provide short-term care in outpatient facilities
  • Deliver long-term treatment in mental health institutions
  • Provide remote support through technology

REHABILITATION:

  • Provide rehabilitative care

SECTOR EXPANSION:

  • Train and build capacity of key stakeholders
  • Provide formal education and certification
  • Advocate with the government through evidence-building

 

Fact: 90% people who die of suicide have a diagnosable mental disorder

 

Priorities for Action: For most stakeholders in mental health, the overarching objective is to provide affordable and accessible care, and to create an inclusive and just society in which everyone without exception can lead full lives. Funders keen on such a transformation should prioritise scaling the following approaches.

  • Emphasise prevention and promotion in mental health
  • Focus on inclusive, community based mental healthcare
  • Secure basic dignity and rights for people with mental illness

 

ITS TIME WE INVEST IN MENTAL HEALTH

 

JOIN THE MOVEMENT:

The challenges to solving India’s mental health crisis are great, but the willingness to address them is growing, There is a wide range of empirical evidence demonstrating that with approximate treatment and community support, people can recover, achieve their goals and contribute positively to our society.

What we need now are more funders championing the cause of one of society’s most vulnerable and violated groups- so that millions of people can come out of the shadows, regain their dignity and live fuller lives in a world that better understands them.

 

 

*For more detailed report, kindly click on the link herehttps://www.dasra.org/cause/bridging-the-enormous-deficit-of-mental-healthcare-in-india

 

 

 

 

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