There is a need for tremendous improvement in the mental health infrastructure

The Mental Health Care Act of 2017 has a systematic framework for mental health and effective provisions from the identification of patients to rehabilitation.  But even after five years, this law has not been implemented in all the states of the country.  The state governments that cry for the federal structure are not showing any seriousness on this issue.
Mental illness has emerged as a serious threat in the country after the Covid pandemic.  In Madhya Pradesh, seven people committed suicide in the last ten days due to mental depression.  Everyone made and shared videos before committing suicide.  Even before this, especially in the last two years, the incidents of suicide have increased rapidly.  These incidents are a clear indication that people are increasingly becoming victims of mental ailments due to the situation.
The seriousness of the situation is revealed by the statistics presenting about the mental health of the people in the country.  According to an estimate, a total of twenty crore citizens in the country are suffering from some kind of mental illness.  That is, every seventh Indian is ill on the parameters of mental health.  Only one person in every ten gets standard treatment for mental ailments.  There is no authentic mechanism in our public health infrastructure to characterize whether a person is mentally ill along with physical illness.  In this year’s Union Budget, the government has made special announcements to deal with the challenges of mental health.
Common people hardly know that the National Mental Health Program is in force in the country since 1982 and the District Mental Health Program since 1996.  But the ground reality is that these programs are only nominal.  The Mental Health Act was also enacted in the year 1987.  The present government tried to make this 1987 law inclusive in 2017 by redesigning it, but more than a dozen states of the country have not implemented it yet.
For the first time in this year’s budget, budget allocations have been seen on other provisions including nationwide tele-counselling for mental health.  This time around 12 percent of the total health budget has been allocated for spending on mental health.  This is a good start, but the fact remains that the challenge before the country to deal with the mental problems of the people is increasing day by day.  The loneliness of Kovid has surrounded not only the financially prosperous, but also the enlightened and poor class with mental disorders.
There are only forty seven mental hospitals in India, out of which only two or three are equipped with standard facilities.  That is, there is only one mental hospital in our country for three and a half crore people.  The Mental Health Care Act of 2017 has a systematic framework for mental health and effective provisions from the identification of patients to rehabilitation.  But even after five years, this law has not been implemented in all the states of the country.  The state governments that cry for the federal structure are not showing any seriousness on this issue at all.
Eighty three thousand crore rupees have been allocated for the Health and Family Welfare Department in the Union Budget for the financial year 2022-23.  This is an increase of about thirty three percent compared to the financial year 2019-20 before the Kovid epidemic.  The proposal to set up a National Tele-Mental Health Program is important for quality services related to mental health.
Twenty-three centers in the country are claimed to provide tele-consultation services to citizens.  This service will be provided through technical collaboration of IIT Bangalore with supervision and regulation of National Institute of Mental Health and Neuro Sciences.  Despite this, the goal of mental health for the common man of the country still seems very difficult because if we look carefully at the increase of 12 percent in the mental health budget, then basically it is two institutions being funded by the central government- mental health.  Institute is for Bangalore and Tezpur only.  What is needed is a major overhaul of the National Mental Health Mission, which has no specific allocation and has been left to the states, which are already indifferent.
In the budgets of the last four financial years, less than one percent of the funds related to health and family welfare have been allocated for mental health services.  The coverage of Ayushman Bharat or other insurance was also not given to these diseases.  Obviously, it is not easy to solve this problem by relying on the government machinery of the country.  Studies have shown that one out of every three people who have been cured of corona are likely to be found with some kind of nervous or mental disorder.
Amidst the government’s claims of tele-counselling, we also have to note that according to the National Family Survey, only thirty-three percent of women in India use the Internet.  Whereas among men this number is fifty-seven percent.  When only fifty-five out of a hundred people have internet access, the question arises as to how many mental patients will have access to the tele-consultation service starting from twenty three centers?  The District Mental Health Program, already running across the country, is a component of the National Mental Health Programme.  This program is applicable in six hundred ninety nine districts of the states and union territories.  In the last six years, more than fifty percent of the amount released for this was returned without utilisation.  Specialist psychotherapists are not available in eighty percent of the districts.  Citizens have to go only to big cities for the services of specialists.
The World Health Organization has estimated that India is facing huge economic losses due to mental health disorders.  The government has acknowledged in the Rajya Sabha that mental health disorders more disproportionately affect families with low income, low education and low employment.  Most of the cost of treatment is direct expenses and there is a lack of state services and insurance coverage in this regard.  As a result of which the poor and vulnerable have to face a lot of crisis financially.
In fact, there is a dire need of tremendous improvement in the mental health infrastructure as it has lost its connectivity with the wider system of health system.  The corona pandemic has made this problem worse.  Primary physicians are not even trained to diagnose mental illnesses and depression.  They are unable to send patients to places where they can get adequate and better care.
The problem has become more serious due to the lack of trained staff.  In India, there are only 0.40 psychiatrists per one lakh population, whereas this figure should normally be three.  In developed countries, six to seven psychiatrists are available per one lakh population.  Surveys conducted by the World Health Organization in several countries have shown that about eighty-five percent of severe cases of mental health are never treated.  What could be more serious than this?