Tuesday, December 12, 2017
 
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Mental Illness: Waiting for attention





By Dr. Iqbal Malik



Today is the world mental health day, as a mental health professional it is my duty to inform the people about its effects on the health of an individual. The stigma associated with mental illness where it is often undermined and related to supernatural powers needs to be destroyed. In this article, I have tried to explain the magnitude of Mental Illness in our society, through the reference of various reports from WHO and our ministries, the efforts of the government and their impacts are also mentioned. My special focus will be on Depression which is one of the most common mental illness.



The WHO report states that Psychosis a severe mental disorder in which thought and emotion are impaired and lost contact with reality, whereas Anxiety disorders refer to a group of mental disorders characterised by feelings of anxiety and fear, including generalised anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).


Depressive disorders are characterised by sadness, feelings of guilt or low self-worth, feelings of tiredness, Persistent sad, anxious or "empty" mood, Feelings of hopelessness, pessimism, Feelings of guilt, worthlessness, helplessness, Loss of interest or pleasure in hobbies or activities that were once enjoyed, including sex, decreased energy, fatigue, feeling “slowed down”, difficulty in concentrating, remembering, making decisions, changes in sleep patterns: insomnia, early morning waking two hours or more before the usual time or oversleeping, appetite and weight loss (often defined as 5% or more of body weight in the past month) thoughts of death or suicide, or suicide attempts, Restlessness, irritability, Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders or chronic pain, depression worse in the morning.



As per the International Classification of Diseases (ICD) 10, if two or three above Signs and Symptoms present for at least two week, we diagnose it as depression.



Depression is one of the leading causes of disability across the world. The World Health Organization (WHO) estimates that depression will rank second only to heart disease by 2020 in terms of global disability. It is a common a serious and complex illness that affects around 322 million people worldwide and 56 million Indians. One in four families in India have at least one member with a behavioural or mental disorder at any point in time.



In October 2016, the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru, released a mental health survey, said that the incidence of depression is roughly one in every 20 Indians or 5% of the population.


Thus, according to the latest World Health Organization report on depression almost 7.5% of Indians suffer from major or minor mental disorders that require expert intervention. At least 13.7 per cent of India's general population has been projected to be suffering from a variety of mental illnesses; and 10.6 per cent of this requires immediate intervention. another 38 million Indians suffer from anxiety disorders. The common mental disorders such as depression, anxiety disorders and substance use disorders are as high as 10 per cent in the total population.



Due to the stigma attached with mental disorders, nearly 80 per cent of people suffering from mental disorders had not received any treatment despite being afflicted by the illness for over 12 months.


As per the Ministry of Health and Family Welfare, New Delhi India spends 0.06 per cent of its health budget on mental health care. This is less than Bangladesh (0.44 per cent). Most developed nations spend above four per cent of their budgets on mental health and also short of health professionals to address mental issues, particularly at the district and sub-district level.



There are 3,800 psychiatrists, 898 clinical psychologists, 850 psychiatric social workers and 1,500 psychiatric nurses nationwide.
This means there were three psychiatrists per million people, according to data from WHO, 18 times fewer than the commonwealth norm of 5.6 psychiatrists per 100,000 people.
By this estimate, India is short of 66,200 psychiatrists. Similarly, based on the global average of 21.7 psychiatric nurses per 100,000 people, India needs 269,750 nurses.


This huge burden of mental, behavioral and substance use disorders, in India, calls for immediate attention of political leaders, policy makers, health professionals, opinion-makers and society at large.


Most significantly, mental health should be given higher priority in the developmental agenda of India. All policies and programmes in health and all related sectors of welfare, education, employment and other programmes should include and integrate mental health agenda in their policies, plans and programmes.







(The author is a Psychiatrist (NIMANS Bangalore)
BMO, Block Darhal, District Rajouri, State, J&K,facebook.com/bmodarhal )








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