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> Who is mentally ill??
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The Sunday Indian
Prasoon S Majumdar
Editor, Economic Affairs - The Sunday Indian
Dean Academics (All India), The Indian Institute of Planning and Management
Who is mentally ill??
India lacks political will to improve lives of mentally deranged
M ental health is not only an under-represented issue in India, but has also failed to attract political attention. Even after 10 long years of Erwadi incident — where 28 mentally-disabled people charred to death on August 06, 2001 — no substantial progress has been made towards improving the conditions of mental patients in the country. Even today, with inrush of infotainment has brought the issue to the forefront, mental patients suffer from the same social stigma and societal exclusion. With advancement in medical research, effective and accessible treatments are available, these scientific developments get largely undermined because of relentless and pervasive stigma against such disorders. Social exclusion and low availability of medical practitioners further discourages families from seeking medical and social help. This prevailing hesitation among mentally ill patients also results in ‘family-rejection’ and suicides. This is also evident from the fact that more than 8,000 mentally ill patients committed suicides in 2008 alone!
In spite of being home for 20 million mentally ill patients, we still lack adequate infrastructure and medical facilities. Going by WHO's survey, there are only 3,500 psychiatrists in India (most of these psychiatrists are based in cities) and have just one bed for every 40,000 patients. Even though there are only 40 government hospitals for the mentally-challenged, which in itself, is abysmally low, on top of that almost all these hospitals are understaffed and lack modern facilities. This makes 80-90 per cent of cases go undiagnosed, and most of the times, these patients are finally found dawdling on the streets. And the negligence flows from the top! Otherwise, how can one justify that when it comes to allocation of funds, less than 1 per cent of total health budget is allocated to mental health compared to 10-20 per cent other countries. Despite of huge hue and cry by social groups and NGOs, not much heed is being given to plan a nationwide awareness. Going by the fact that most of undiagnosed cases take place in rural areas, where family resort to “faith-healers” for treatment, the importance of such awareness camps increases manifolds. These ignored cases of mental illness not only deteriorate social values but also dent the economy of India. A recent media report estimates that mental illnesses pull down India’s GDP by 2-3 per cent every year. Thus, it makes more sense for authorities to plan out structured interventions and also design and develop awareness camps with the help of local panchayats and NGOs.
Further, the next bigger predicament that dispirits family from sending their loved ones to mental hospitals is the horror that patients go through in these centre. A few years back, a survey by the NHRC established a well-known fact that people being treated in mental hospital undergo a series of inhuman physical and mental torture. Even these hospitals lack basic hygiene conditions viz. proper sanitation, clothing, beds, adequate food et al. Patients are seen to live in an atmosphere of fear rather than with a feeling of getting treated. With these hospitals catering to a very special segment of society, it is far more important to make them more “humane” and integrate them with the process mental healthcare from grassroots level to national level. In order to eliminate prevailing social stigma, it is necessary to involve medical community, policy-makers, media, schools etc. De-stigmisation will not only encourage people to come out and seek medical help, but will also make it easy for authorities to make their facility reach every needy.
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