Status of Mental Health in India

“Mental pain is less dramatic than physical pain, but it is more common and also harder to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken.” – C.S. Lewis.

Watching cartoon on television during my holidays at my grandparents was a different fun altogether. And the mental freedom to do whatever I want without constant pestering is something I have always cherished. Of course, my school life was like a living hell. The students in my class were in a constant race against each other to get the first rank. I never fell prey to that race, simple because it never intrigued me to be the best academically and neither did my parents force me to score highest marks in the exams. But they of course expected  me to read and learn as much as I could every day. School environment was extremely competitive, and everyone was so absorbed into the race for marks with other students. Teachers encouraged such behavior and commended three students with highest marks whose self-esteem was boosted. And the three students with low-ranking marks became more and more inferior with every single test because of the humiliation they suffered for scoring low marks. There are countless number of times when I was humiliated by teachers for scoring low marks. At one point the only way I responded to humiliation was by giggling to myself and telling myself how stupid the teacher was. Students being pressurized and humiliated in front of the class was very common when I was in school. It was so normalized that we felt we were the culprits, and parents were the victims of our misbehavior. Everyone has a different coping mechanism to such kind of humiliation inflicted on them. One way of responding would be like mine, where the student is least concerned about the insult or makes an attempt to irritate the teachers even more. Another way to respond is to take the humiliation positively and try to be more disciplined. The most terrifying response is the one in which a student keeps absorbing all the insult feeling guilty all the time, and at a certain point decides to take a drastic step by giving up one’s life. During my school days it was very common for newspapers to report suicides by school children, especially one’s in tenth and twelfth grade. It was a result of the board exams in those two grades. Students who couldn’t handle the pressure and thought that they did poorly in the exam would give up their life so as to avoid facing their family and friends with those shameful marks. Even talking about it gives me goose bumps today. The constant pressure to perform well in the exams exercised not only by the parents but also by the community and the teachers puts the students in an extremely vulnerable position mentally. The pressure keeps accumulating in students mind, ultimately forcing them to take drastic steps (Bhattacharjee, 2016).

All of these experience is an integral part of a child’s life in most parts of India, and it greatly influences growth and development of a child. Every child responds to such situations in a different way , but in one way or another they form a defense mechanism to make themselves feel secure. And every child has a different defense mechanism, which can be reflected in their actions as adults either negatively or positively. Sometimes adults who have gone through serious traumatic experiences in childhood need to undergo psychiatric care and counselling.

The condition of mental health institutions in India is extremely poor. Mental health forms an integral part of the overall health and well-being of people. Mental health is influenced by a number of social, cultural, political, economic and environmental factors such as national policies, living standards, working conditions and community support (“Mental Health in India”, WHO, 2018). Treatment and cure for mental illnesses is of utmost importance, and ignoring them can escalate the issue pretty exponentially. Unfortunately, mental health in India has never been given any importance or attention at all. Yoga and meditation are said to have originated in India. Practicing both helps improve mental health, but despite this the state of mental health in India today is appalling. World Health Organization (WHO) estimates that the burden on mental health problems is around 2443 DALYs* per 100,000 population, and the age-adjusted suicide is 21.1 per 100,000 population. It is estimated that the economic loss due to mental health would be around 1.03 trillion (of 2010 dollars) from 2012 – 2030. The mental health work force in India is also extremely low – there are 0.3 psychiatrists, 0.12 nurses, 0.07 psychologists and 0.07 social workers per 100,000 population(“Mental Health in India”, WHO). These figures are alarming. It is exacerbated by the fact that people in many cases are not even ready to acknowledge mental health issue. The patriarchy in India has taught people that “it’s not okay to not be okay”, and there is a constant pressure on people to act normal when they are actually experiencing a lot of stress and depression.

Depression is the leading mental health problem, and many people in India suffer from it. An estimated 56 million people suffer from depression. Constant depression and mental pressure ultimately lead to suicide. From 1990 to 2016 contribution of India to suicide death rates has drastically increased. The numbers are shocking: there were an estimated 230,314 suicide deaths in India in 2016 (Dandona et al). Suicide was the leading cause of death in 2016 for those aged 15-39 years. Number of students committing suicide under the pressure of studies has also been on the rise, close to 26,000 students all over India committed suicide from the year 2014-2016(Sharma 2018). If the situation continues in the same way, then India won’t be able to achieve the sustainable development goal of the UN to reduce to global suicide death rates (SDR) by one-third by 2030 (Dandona et al).

The SDR among women in India is almost three times higher than that of countries with similar socio-demographic development globally (Dandona et al). Married women in India are the biggest victims of suicide deaths among women in India, mainly because of arranged marriage, early motherhood and economic dependence on husbands. In most cases women are also subject to domestic violence which puts them under heavy mental pressure. The social stigma associated with the mental health disorders makes the situation even worse. Until 2017 attempted suicide was a criminal offence in India. As a result, there was underreporting of such cases, no one ever openly talked about it.

Combining all of these and the lack of adequate infrastructure for mental health, it is not surprising that India is among the most depressed countries in the world. And it is not just India, mental health issues have been on rise in almost all the countries around the world. Every country in the world is in a race to be the most powerful country, and this race among countries globally is driven in the culture. Every aspect of people’s day to day life has become a race – the race to have the biggest house, the race to have the most expensive car, the race to get highest marks in the class and so on and so forth. The list is endless, it is honestly very difficult for me to understand what people actually gain from this race. Is it the ego satisfaction? Is that it? How far can people go to satisfy their ego? What is the use of all of these if we are not able to value human life? These are the questions which really haunt me. I think it is a high time we start focusing on the issue of mental health. We should not always wait for the worst to happen in order to take a grievous action.

*Disability Adjusted Life Years (DALY) refers to years of potential life lost due to premature mortality and the years of productive life lost due to disability (“Definitions”, WHO)

References:

  1. World Health Organization (2018). “Mental Health in India”, http://www.searo.who.int/india/topics/mental_health/about_mentalhealth/en/ [Accessed 30th December 2018]
  2. India’s ignored mental health problemhttps://www.livemint.com/ September 19, 2018. https://www.livemint.com/Opinion/COVxfV61DLbRD3QxCTr3pK/Opinion–Indias-ignored-mental-health-challenge.html [Accessed 29th December 2018]
  3. Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990–2016, Dandona, Rakhi et al. The Lancet Public Health, Volume 3, Issue 10, e478 – e489
  4. India is the 6th most depressed country: WHO reporthttps://timesofindia.indiatimes.com/defaultinterstitial.cms October 12, 2018. https://timesofindia.indiatimes.com/life-style/health-fitness/de-stress/india-is-the-6th-most-depressed-country-who-report/articleshow/66179026.cms [Accessed 29th December 2018]
  5. Thomas M. “Charted: India’s shocking attitudes towards mental illness.https://qz.com/india/. https://qz.com/india/1237314/fear-and-apathy-how-indians-look-at-those-suffering-mental-illnesses/ [Accessed 30th December 2018]
  6. Bhattacharjee S. ‘Academic Pressure Pushes Teens to Suicide, Say Doctors’, https://www.thehindu.com (28th March 2016) https://www.thehindu.com/news/cities/Visakhapatnam/academic-pressure-pushes-teens-to-suicide-say-doctors/article8404527.ece [Accessed 28th December 2018]
  7. World Health Organization “Definitions: DALY”, Mental Health https://www.who.int/mental_health/management/depression/daly/en/ [Accessed 27th December 2018]
  8. Sharma K. ”In 2014-16 26,000 students committed suicide in India”, https://www.dnaindia.com (3rd January 2018), https://www.dnaindia.com/india/report-in-2014-16-26000-students-committed-suicide-in-india-2572463 [Accessed: 30th December 2018]
  9. GoodReads, “Quotes” https://www.goodreads.com/quotes/422155-mental-pain-is-less-dramatic-than-physical-pain-but-it [Accessed 10th February 2019]

Mahir finished his Bachelors in Civil Engineering in 2015. During this time, he volunteered with an international not-for-profit organization for three and a half years and took up several leadership roles in the organization. He worked full time as national vice president of AIESEC in Nepal for a period of one year post his Bachelors. He is currently working with Swasthya Swaraj Society, an NGO based in Kalahandi, Odisha. He has been working to strengthen government schools in remote tribal villages of Thuamul Rampur block. In the coming years, he wants to understand and work on framing evidence-based public policy. Mahir is passionate about personal development, and he loves travelling and reading.

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