Mental health in an unequal world

Monday 11, 2021 | Dr Sona Kaushal Gupta | Dehradun

Guest Column

Dr. Sona Kaushal Gupta

World Mental Health Day is celebrated on October 10 every year to create awareness about mental illness, to prioritise, sensitise and focus on spreading awareness of the importance of public mental health issues prevailing in people and empowering them against stigma and discriminating anyone. The theme of World Mental Health Day this year as observed on Sunday was mental health in an unequal world.

The WorldHealth Organisation (WHO) says that health is complete physical, mental and social well-being and not merely the absence of disease.

According to WHO, mental health is stated as one’s well-being in which the individual understands his or her own abilities, and can cope with the normal stresses of life, can work productively and make a contribution to the community.Mental disorders of varying severity affected one in seven Indians even prior to Covid 19 pandemic. This number has significantly increased during and after the peak of the pandemic.

According to the Global Burden of Diseases, Injuries, and Risk Factors Study (2017) about 200 million or 20 crore people are having mental disorders in the country. According to the National Mental Health Survey (NMHS), nearly 80 per cent of those suffering from mental disorders do not receive treatment for years, and mental health disorders are also accompanied by stigma, thereby affecting education and livelihood opportunities. This can increase the poverty levels of our country if not addressed. Mental disorders are reported to be a major cause of suicides and Indians account for more than one-fourth of deaths by suicide globally.

It was an unequal world before the Covid-19 pandemic but now after the pandemic it has become even more unequal. This has triggered a global crisis in terms of heath care, finances, employment, education and relationships. It has affected us in many ways—healthwise- both physically and mentally, economically, socially and also created an educational crisis world over. The pandemic has created more inequality by creating more mental health issues in everyone all over the world be it children, adults or the older people.It has further strained our overstretched and inadequate mental health care services.

The plethora of problems brought about by the pandemic has polarised the world by making the poor poorer and heightened its medical and mental health problems. The rich were always able to access the treatment easily and they could pay and receive the best treatment before and even during the pandemic but the poor were not able to get/access it easily.The treatment gap for mental health problems has greatly increased especially for the poor. Before the pandemic, this was stated to be about 70 to 80 per cent and this gap has further increased during the pandemic. After the pandemic with the mental health issues increasing almost double fold, this problem has become much bigger.The world scenario has unfortunately become more unequal with the gap between the ‘haves’ and ‘have nots’ increasing widely after the pandemic.

After the pandemic, our concern about our physical wellbeing has increased, though it was always there before also, taking a toll on our mental health which has been further neglected. The lockdown, social distancing, work from home culture, the closure of schools and online classes of children from home have increased our stress, depression and anxiety levels with frequent panic attacks.This has happened in all countries across the world.Domestic violence has increased and the children and the geriatric population has also suffered a lot of mental health issues.This pandemic has been universal with an increase in physical illnesses and co-morbidities and also the mental health of nearly everyone has suffered in some way or the other.

Instead of doubling our efforts and resources for mental health care, unfortunately the resources have been diverted to physical health treatment and other areas of management of the pandemic. Thus, the inequality in the world of healthcare has further increased. Severe stress of the pandemic, lesser availability of essential free psychotropic drugs, lesser care of the vulnerable or existing cases of people with mental illness has exaggerated or caused relapse of the condition in many people.

The poor suffered the most as they were the most affected by the pandemic.They were the hardest hit by the physical and mental consequences of the pandemic and had to pay for their treatment thus making them poorer and plunging the world into more inequality and poverty.

What is the solution? The government needs to wake up to the fact that there is grossly disproportionate funding of the mental health care sector by the government, compared to the overall health budget. This contributes grossly to the mental health treatment gap.There, should be an appropriate budget allocated to mental health services.

There should be easy accessibility to mental health care services and emergency mental health care services with adequate indoor and outdoor treatment facilities, easy availability of free ambulance services for the serious mentally ill patients, easy access to prescribed free essential psychotropic medications and proper rehabilitation and counselling facilities thereafter.This will help in some degree to bring about equality in the health care services in the unequal world today where physical health has always been given more importance than mental health.

Section 21 of the MCHA 2017 says that there should be no discrimination and there should be a parity between mental and physical health care services because till now we have seen that physical health issues always got a priority over mental health.In this pandemic mental health has been totally neglected by the health care sector all across the world and this has caused a lot of disparity and morbidity.

Medical insurance should include mental illness in its aid appropriately and free legal help should be provided for the mentally ill patients to be aware of and fight for their rights.There should be parity in the services offered to mental illness in all the developed developing and underdeveloped countries.Human life is precious for everyone whichever part of the world we may be in.

People should be made aware of mental illness signs and symptoms by campaigns and articles and workshops and encouraged not to stigmatise mental illness because it is treatable in most cases.

Let’s remember that there can be no health without mental health.

(The author is a neuro psychologist & founder of a crisis helpline. Views expressed are personal)

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