E-Paper
Mental health gets precedence as India set to de-criminalise suicide
A bus that functions as a mobile tele-psychiatry unit is helping thousands get diagnosed and treated for mental health diseases in the Puddukottai district of Tamil Nadu for as little as Rs 700 per patient per month.
A bus that functions as a mobile tele-psychiatry unit is helping thousands get diagnosed and treated for mental health diseases in the Puddukottai district of Tamil Nadu for as little as Rs 700 per patient per month.
Video-conferencing with experts using 3G connectivity and home-based rehab services using local NGOs and trained members of the community have helped more than 1,500 people get care within one year.
Run by the Chennai-based Schizophrenia Foundation, the bus is among the many innovations showcases at the World Innovation Summit for Health (WISH) in Doha, Qatar, to make quality treatment and care accessible to all.
The bus, for example, will help people with mental illnesses reach specialised care in underserved India that has less than 5,000 psychiatrist for a population of more than 1.2 billion.
India's new Mental Health Care Bill 2013, which was tabled in Parliament in August though it hasn't been passed, seeks to de-criminalise suicide and give primacy to the person with illness.
It will replace the Mental Health Act of 1987 which, though a huge improvement on the Indian Lunacy Act of 1912, was still conservative and leaves almost all decision-making in the hands of doctors.
"India has redrafted its legislative mental health legislation to focus on the person with the illness as individuals with a capacity to take their own decisions guarding their treatment," Union Health secretary Kesav Desiraju told delegates at the World Innovation Summit for Health.
"Doctors hate it, the families of people with illness a wary, but Parliamentarians have been extraordinarily supportive," said Desiraju. "India has a very strong lobby of psychiatrist, about 5,000 of them, many of who strongly believe that institutionalisation is the only way to go," he added.
"Instead of doing short-term tinkering, India has put together a structure that will guide treatment and care over the next few decades," said Desiraju.
Mental illnesses -- from depression and anxiety to substance abuse and schizophrenia -- affect at least 900 million people worldwide, which puts it among the top-five non-communicable diseases (see box), said the report 'Transforming Lives, Enhancing Communities| Innovations in Mental Health', which was released at WISH Summit.
The cost of disability associated with mental illnesses is an astonishing US$2.5 trillion, which is projected to rise to $6 trillion by 2030. Two-thirds of these costs are because of lost productivity and income owing to the consequences of untreated problems.
People with mental health problems are more likely to experience social exclusion, violent victimisation and human rights abuse compared with the rest of the population. Those with severe problems are likely to die up to 30 years earlier than people without them – even in high-income countries.
"We have to learn from the HIV success that reduced stigma and increasing diagnosis and treatment by involving stakeholders, such as the people affected and their families'" said Professor Vikram Patel from the Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and the Centre for Mental Health, Public Health Foundation of India.
Depression and anxiety account for almost half of mental-health disability in rich countries.
"I'm interested in what makes people and in survey after survey have found that mental illness is the biggest hurdle to happiness. We were able to show in the UK that if we could expand on mental health programme, it would pay for the money lost through disability benefits. By curing mental illnesses, we can save up a lot of expenditure on physical illnesses too," Lord Richard Layard, Director, Wellbeing Programme LSE Centre for Economic Performance, UK.
Mind the Numbers
Top 5 non-communicable disease causes of disability
• Heart disease
• Infections, including diarrhoea, respiratory infections, meningitis
• Neonatal disorders
• Cancer
• Mental health problems
Top 10 mental illnesses
• Depression 40.5 %
• Anxiety disorder 14.6%
• Drug use problems 10.9 %
• Alcohol abuse 9.6%
• Schizophrenia 7.4%
• Bipolar disorder 7.0%
• Pervasive development problems 4.2%
• Childhood behavioural problems 3.4%
• Other mental health problems 2.4%
Source: Global Burden of Disease study, 2010
