India needs to change its stance on mental health

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On 14 June, Indian actor Sushant Singh Rajput died at his home in Bandra by committing suicide. Thousands of social media posts from fans and celebrities alike have poured in honour of Rajput's memory and to offer condolences for his family. Many fans have referred to his tragic and untimely demise as a "murder by the film industry," and while Bollywood's rampant nepotism may possibly a significant factor leading to this incident, it also highlights one of the most pressing issues of this country that does not receive substantial attention: mental health. 

Rajput had reportedly been suffering from depression for six months, and medical prescriptions and reports had been found at his residence. Hence, his suicide has sparked a national conversation on mental health, with a specific focus on the lack of sensitivity and awareness around it. As stated by the World Health Organisation (WHO), more than 90 million Indians - which equates to approximately 7.5% of the population - suffer from issues regarding mental health. Mental health is also one the leading causes of non-fatal disease burden in India. Furthermore, one out of every seven Indians is impacted by mental health issues, and in 2016, suicide was one of primary causes of death between the ages of 15 to 39. 

However, while mental health is plaguing the country, the government has done little to address the issue, especially in terms of the amount of money it allocates this cause. In FY2018, the budget given to the National Mental Health Programme (NMHP) was Rs. 50 crore, and in FY2019, this amount was reduced to Rs. 40 crore. In FY2020, this amount was not increased. When considering the amount of members in mental health faculty, India has 9000 psychiatrists, which is approximately one doctor for every 100 000 people, whereas WHO recommends three doctors for every 100 000 people. 

Addressing the issue of mental health is especially important during the current COVID-19 pandemic, due to the rising rates of unemployment and the large amount of people in self-isolation. A prominent reason for the rise in mental health cases is the social stigma surrounding it. Depression and anxiety are not considered to be serious ailments, and widely dismissed due to the highly inaccurate misconception that patients suffering from such issues can simply "get over it." It has also been reported that some are likely to even avoid those suffering from mental health issues. The treatment of mental health as a taboo leads to a vicious cycle of shame and isolation, abandoning sufferers when they most need help. Such social problems need immediate attention as they can interfere with seeking help and adherence to treatment. 

Societal beliefs, attitudes and responses decide many aspects of mental health care. People with mental illness are members of society, and the social environment is an important determinant of outcome. If the social environment is favourable, it contributes to recovery and reintegration. However, if it is negative, it can reinforce stigma and discrimination. Efforts to enhance the involvement of local communities could include disseminating accurate information about mental disorders and using community resources for specific initiatives, such as volunteers in suicide prevention and collaboration with traditional healers. Shifting care from institutions to the community itself can alter community attitudes and responses, and help people with mental illness lead a better life. 

The Ministry of Health and Family Welfare must also take some administrative and structural actions to best address this crisis, particularly through the method of community-based mental health care. Mental health care should not only be local and accessible, but should also be able to address the multiple needs of individuals. It should largely aim at empowerment and use efficient treatment techniques which enable people with mental disorders to enhance their self-help skills, incorporating the informal family social environment as well as formal support mechanisms. Community-based care (unlike hospital-based care) is able to identify resources and create healthy alliances that would otherwise remain unknown and inactivated. 

While these structural and financial gaps need to be addressed, it is important that members of our society realise the power they have. One must not stigmatise or discriminate against the victims, but rather, provide a communal support system in order to ensure that no one has to battle such issues alone. As demonstrated by the news broadcasts on Rajput's death, it is clear that the media needs to be sensitive and responsible about its coverage of mental health and related issues.