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Psychological & Mental Health : First Aid for all

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By : Dr Sasha Raikhy
Stigma surrounding mental illness is not new.  Social & economic burden of mental illness in our country will exceed that of cancer & cardio vascular disease as per WHO assertion.          One in four adult suffers from mental illness in their lives.  Every 40 second somewhere somebody dies of suicide.  About 50 million people are affected by mental health problems in India.  Everybody knows somebody that has some form of mental health problem.  Mental health illness mostly start in childhood & adolescence & might occur with chronic mental illness like heart disease, diabetes, cancer, HIV etc.  In contrast to this high burden, country has only 5000 trained mental health professionals.
World Federation for Mental Health’ has chosen – Dignity in Mental Health – Psychological & Mental Health First Aid for all as its theme for World Mental Health Day, 2016.
People with public health difficulties are offered prompt physical health first aid while mental health crisis is viewed differently because of stigma & ignorance.  According to 2016 world bank group & WHO report, despite the enormous social burden, mental disorders continue to be driven by shadows of stigma, prejudice, fear of disclosing affliction because a job may be lost, social standing ruined or simply because health & social support services are not available or out of reach for afflicted.  Low perceived need & Attitudinal barriers are most commonly reported barriers to mental health treatment as per world WHO Mental Health Survey apart from structural barriers like finance, lack of insurance coverage, gap between policy and financing, inadequate integration with primary caregivers, geographic distance and lack of trained personal.
In our country, there is shortage of qualified psychiatrist. Apart from this, we also do not have adequate and newer medications with lesser side-effects etc.  Problem is not much about government funding, major hurdle is attitudinal. Ours is country of abundant faith healers and few number of trained mental health professionals.  Why mental health/mind is discriminated for treatment when we consult physician for even mild bodily ailments like flu.
Although attitudes are changing with open talks by celebrities, government efforts and new mental health bill but still there exist huge disparity between physical and mental health.
Consistent with this years’ World Mental Health Day theme focus is on that all members of public can learn basic skills to help people with mental health problems.  Community need to be oriented to organize psychological first and local community workers, police, general health staff, teachers, NGOs, disaster management teams, health staff & even lay man can learn basic skills to help people with mental health problems.
To summarize, we need to address following issues:- 
– Mental health crisis to be treated at par with physical health crisis.
– Knowledge and awareness of basic psychological first aid.
– Addressing stigma and discrimination a/w mental illness.
– Mental health first aid to be included in all schools, educational institutions and working places, armed and military forces, just like first aid.
– Mental health first aid course to be taken by police/public safety officers, teachers & school staff, medical personnel, veterans, military, NGOs, first responders (in disaster & accident with general practitioners)
Mental health educational material is freely available on World Federation for Mental Health site.  Information is provided about basic skills to deal with mental health crisis.
We all are capable of providing basic mental health first aid (to support individual with mental health crisis, until crisis resolve and person can be taken for professional help).  Let’s vow on this mental health day to be provider of mental health first aid instead of being passive spectator.  Lets make ‘Dignity in Mental Health’ a reality. 
(The Author is Senior Resident (Psychiatry) Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi.)

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