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Only funds will not be enough

India’s mental healthcare system is in a shambles. We must innovate to improve.

india Updated: Dec 23, 2011 23:43 IST

In 1982, the Centre launched a mental health programme with three main aims: to prevent and treat mental disorders; the use of mental health technology to improve general health services; and apply mental health principles in national development to improve the quality of life. But after 29 years of planning, according to the ministry of health, today we have a shortage of 8,000 psychiatrists, 17,000 clinical psychiatrists, 23,000 psychiatric social workers and 9,000 psychiatric nurses. To understand the import of these figures, one should read it with two other figures: 9% Indians have reported as having an extended period of depression and 36% suffered from major depressive syndromes. Replying to a question in Parliament recently, the health minister said that there is no study available on whether the number of depression cases has increased or not when, according to the World Health Organization, the country has the highest rate of major depression cases in the world.

To bridge this manpower shortage, the Centre has now allocated Rs470 crore and under the 12th plan, the ministry is also planning to start counselling services in colleges and upgrade facilities at 29 State-run mental hospitals and 88 psychiatry wings in government colleges. While the shortage of personnel is a key reason why things have not improved, there are several other issues that must be looked into: first, the programme has placed too much emphasis on curative services and not preventive measures. This is also exacerbated by the fact that families of mentally ill patients never seek medical help when the first signs are visible, thanks to the social stigma attached to mental illnesses. Not many are aware that mental illnesses, like any other ailments, are medical disorders and can be cured — or at least contained — through medication and support. In our mental hospitals — and most of them are not up to the mark — one can hear stories of how patients have been abandoned by their families even after they have recovered. A former member of the National Commission for Women once found mentally-ill female patients in chains and naked at a government facility in Kerala. Worse still, the wards were manned by male attendants. Most of these hospitals are custodial in nature and experts say that these need to be changed to foster a more therapeutic approach. Moreover, whatever medical intervention is available in the country is more or less concentrated in the urban areas. Therefore, the Central and state government need to deploy mental health personnel at the sub-centre and village levels. But, probably this is too much to hope for considering that our basic health services are in a shambles.

Yet, the most critical element is making people aware that mental illness i like any other ailment and must be treated with compassion, love and timely medical intervention.