- A 2017 ICMR report revealed that 1 in 7 persons in India suffers from mental health disorders
- Conversations around mental health are growing louder by the day, especially in the times of Covid-19
- A growing tribe of startups are addressing accessibility and affordability to mental health services
As Covid-19 continues to take lives across the world, there’s another pandemic that’s looming large, one around mental health. Over the last few months, India has been incapacitated by social and economic issues like job losses, loan defaults, and millions slipping into poverty.
This post-Covid landscape makes India a fertile ground for an increase in mental health issues like chronic stress, depression, and suicides.
Mental health is not a novel issue in India and has in fact flared up over the years. A report by the Indian Council of Medical Research (ICMR) published in 2017, revealed that about one in seven persons in the country suffers from mental health disorders, such as depression and anxiety, affecting 45.7 million and 44.9 million people respectively.
Furthermore, the findings of the National Mental Health Survey 2015-16 by the National Institute of Mental Health and Neuro Sciences (NIMHANS) stated that nearly 150 million Indians need active mental health care interventions, although only 30 million are seeking support.
These alarming statistics bring to the fore how mental healthcare has been put on the backburner, largely due to the stigma associated with it, as well as the lack of appropriate policy interventions by the government.
“At-risk populations include the 150 million with pre-existing mental health issues, Covid-19 survivors, frontline medical workers, young people, differently abled people, women, workers in the unorganised sector, and the elderly,” shared Nelson Vinod Moses, a leading suicide prevention advocate in India, with Hindustan Times.
However, there’s a silver lining – the Covid-19 pandemic has put the spotlight on mental health, and there are growing conversations around the subject, none like the country has ever seen before. Experts suggest that this might be India’s ‘watershed moment’ for mental health advocacy.
Spotlight on Mental Health During Covid-19
Dr. Amit Malik, Founder and CEO of online psychological wellness platform InnerHour, believes that across industries and governments, people are recognising the need to find support and access to services for mental healthcare.
“The pandemic has given rise to several new conditions related to health anxiety, financial anxiety, stress and an uncertain future, in addition to existing conditions that people have already been suffering from. There has been a steady rise in the investment and allocation of resources, both at public and private sector levels, for mental healthcare. The Ministry of Health and Family Welfare has created helplines in over 20 states to address mental health conditions in these times. In addition, there are several digital tools and resources that are extensively being made available,” he shared with The Blue Circle.
A recent survey by the Indian Psychiatry Society (IPS) found that the number of mental illness cases had increased by 20% since the lockdown, and that at least one in five Indians were affected.
Although this is a pressing problem, Tanya Percy Vasunia, psychologist and public researcher, feels that the time for mental health is coming of age now. There is growing awareness amongst people today, and that is slowly but steadily making a difference in the way the subject is perceived.
“The space is definitely changing and conversations around mental health are growing louder, especially in the times of Covid-19. India is a collectivist society, where advice is given freely without realising the implications. But I feel, finally things are beginning to change. Moreover, there is growing awareness around mental health, because people are asking the right questions during this lockdown, whether it is about the kind of techniques I use or my qualifications, and I feel this is a step in the right direction,” she shared with TBC.
Although mental health as a subject has become more mainstream now, Gerald Jaideep, CEO, Medvarsity (a healthcare ed-tech startup) believes that the industry is still nascent, just as it was with nutrition about 15 years ago.
“Earlier, doctors would not speak about nutrition as much; they would just prescribe medication and the rest would be left to the family. In the last 15 years, clinical nutrition has become proven and has become relevant in the management of healthcare. It will take time for mental health to reach that stage, but I am glad this subject is now part of mainstream conversations,” he shared with TBC.
One of the pressing problems that plagues the mental health industry is lack of access to good-quality services – there are 900 psychiatrists in India for a population of 1.3 billion, added Gerald. But the bigger problem is the stigma associated with it that prevents people from seeking help.
“When we speak of urban centres, people have access to mental health professionals. It is important to break the stigma and make these conversations a part of daily lexicon,” he shared.
India also has a paucity of well-qualified and ethical mental health professionals that needs immediate attention from policymakers and the government.
“We do lack ethically sound and qualified professionals; there are so many people masquerading as professionals and that needs to be addressed at the earliest. Confidentiality and privacy are markers of a good therapist, but sadly these crucial things are compromised with. We as mental health professionals are raising our voice against all these issues,” shared Tanya.
Hyderabad-based Medvarsity recently launched two certificate courses to tackle this burgeoning problem. Medvarsity’s certificate course in Mental Health is aimed to equip therapists, psychiatrists, and doctors with comprehensive knowledge of the subject, while the Certificate Course in Anxiety Disorder focuses on how counseling, therapy, and medication help the patients of various anxiety disorders.
“If we speak about mental health education in India, there’s only 10-12 hours of content that is taught in MBBS over 5 years, while in the UK, it is about 250 hours. There is a difference in commitment to mental healthcare to enable the clinical workforce to understand that ‘a sound mind means a sound body’. Speaking about our courses, over 6,000 doctors, educators, nurses, medical interns, and healthcare professionals have completed it, since its launch in June. These courses are put together by a specialised faculty management team consisting of a group of key opinion leaders, course directors, and other content developers,” shared Gerald.
Rise in the Number of Startups
A slew of startups like InnerHour are deploying technology to deliver psychological wellness, helping ease issues of accessibility and affordability. By way of video-based online therapy and counselling sessions, the startup aims to tackle mental health issues like depression, stress, sleep disorders and anger-related problems.
“There is a tremendous amount of content and engagement – we have witnessed a whopping 700k views on our content in the last few months in these Covid times. Our self-care app offers self assessments, a mood tracker, goal setting, psychological activities, resources, a relief chatbot and personalised plans for emotional health in different areas of mental health,” added Dr.Amit.
In addition, InnerHour has created a lockdown-specific pro bono programme that is being offered to healthcare workers, frontline agencies and corporates. They have also added several free short courses on the app addressing concerns that would be particularly relevant at this time, such as health anxiety, working from home, parenting, and loneliness.
“We have on-boarded some leading healthcare brands, in addition to over 60 corporates. This programme offers institution-wide assessments to identify areas of concern and targeted action plans that consist of free access to our self-help app, therapy sessions with qualified therapists and webinars on topics/areas relevant to the organisation.
We’ve also added more conversations in our relief bot so that it can offer support to patients with COVID, loved ones of those who are afflicted, healthcare workers, and employees working from home,” expressed Amit, adding that they have had over 10k people on their app every day over the last few months, with a rise of 65% in therapy sessions across 7 local languages.
A pioneer in this space, ePsyClinic – India’s first online mental portal (primarily chat and call-based support) was founded by Shipra Dawar in 2015 to create a voice around mental health. In the last few years, they have garnered a community of over half a million people.
She has also created the world’s first structured therapy application, IWill t+herapy, to provide solutions to mental problems.
“We have witnessed more than 10k paid therapy programs on IWill, only in the last 1.5 years. During Covid-19, we have made services completely free on ePsyClinic, after we were funded by ACP Grants. In fact, we have seen more than 85k people taking help on ePsyClinic in the last two months, and I feel that has been possible due to our partnerships with Rajasthan, Haryana, Maharashtra and Karnataka governments, and also our association with large unicorns like Swiggy, Zomato and Urban Company,” shared Shipra with TBC.
What Lies Ahead?
Paltry budgetary support and lack of implementation of policies on the ground are other problems that are ailing the mental health industry.
The budget allocated to the National Mental Health Programme (NMHP) in 2019 was decreased to Rs 40 crore from Rs 50 crore in the previous year, estimated to be only 0.05 percent of the total healthcare budget. The average allocation for mental health in developed countries is at least five percent. Even in 2020, the mental health budget did not see a difference, though there was a seven percent spike in the funds allocated for healthcare.
The need of the hour is to implement the Mental Healthcare Act, 2017 that promises mental health care to all and introduces a suicide prevention policy. According to research, many countries including China have been able to significantly reduce suicides after a suicide prevention policy was implemented.
Experts believe that the Covid-19 pandemic is likely to accelerate investments in the sector, which is even more critical for a country like India.
“There is a need for more investments to scale mental health platforms, just like how it has been with a Swiggy or Zomato. Governments have also woken up to the mental health crisis, and I believe the requisite steps will be taken going forward. There is no dearth of professionals I feel, but there is a paucity of specialised platforms, where you can get them together, and that will only happen once investments begin to pour in. Lastly, once the Mental Healthcare Act comes into play, insurance will ensure that the affordability problem is erased, and that’s going to solve a huge problem,” shared Shipra.
A mental health pandemic is in the offing, but experts believe a holistic approach to mental health will help to absolve the stigma and promote accessibility.
(Edited by Anu Choudary)
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