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Sunday, October 16, 2011

Mental illness needs Government's serious attention

INDIA MENTAL HEALTH STATUS
Mental disorders afflict 5 crore of the Indian population (5%) and need special care. 80% of our districts do not have even one psychiatrist in public service.
WHO estimates of 2001 indicate a prevalence level of about 22% of individuals developing one or more mental or behavioral disorders in their lifetime in India.
According to WHO countries like India devote less than 1% of their health budget to mental health compared to 10%, 12%, 18% in other countries.

There are just 3,500 psychiatrists in India. Three psychiatrists per one million people in India, compared to 100 in Australia or 150 in developed countries.
Over 90% of people with mental illness are cared for within their communities by their families and may never even receive a diagnosis.
THE NATIONAL SERVICE CAPACITY

PSYCHIATRIC BEDS AND PROFESSIONALS
Total psychiatric beds per 10 000 population 0.25
Psychiatric beds in mental hospitals per 10 000 population 0.2
Psychiatric beds in general hospitals per 10 000 population 0.05
Psychiatric beds in other settings per 10 000 population 0.01
   
Number of psychiatrists per 100 000 population 0.4
Number of psychiatric nurses per 100 000 population 0.04
Number of psychologists per 100 000 population 0.02
Number of social workers per 100 000 population 0.02
   
Number of Mental hospitals 43 with a bed capacity of 20,000
 Source WHO Country Profiles: India 2001
THE PROBLEM WITH SOCIETY
Stigma and discrimination because of mental illness are still major obstacles to the development of mental health services, to the rehabilitation of those impaired by mental illness, and to an investment into mental health research.
NATIONAL HUMAN RIGHTS COMMISSION 1999 INVESTIGATIONS-INDIA
"The findings reveal that there are predominantly two types of mental hospitals," the report said. "The first type do not deserve to be called 'hospitals' or mental health centers. They are 'dumping grounds' for families to abandon their mentally ill member, for either economic reasons or a lack of understanding and awareness of mental illness. The living conditions in many of these settings are deplorable and violate an individual's right to be treated humanely and live a life of dignity. Despite all advances in treatment, the mentally ill in these hospitals are forced to live a life of incarceration."
The second kind …"are those that provide basic living amenities. Their role is predominantly custodial and they provide adequate food and shelter. Medical treatment is used to keep patients manageable and very little effort is made to preserve or enhance their daily living skills. These hospitals are violating the rights of the mentally ill persons to appropriate treatment and rehabilitation and a right to community and family life". 
roadside destitutes,mentall ill
THE MENTALLY ILL DESTITUTE
Ironically it is in urban areas where medication and psychiatrists are available, but in rural areas medication is not available nor are psychiatrists.
The primary health centers don't stock medication and huge populations of people with major mental illness don't have access to either treatment or to medication.
However in a rural village a patient suffering from schizophrenia, is assimilated within the culture without a lot of discrimination. But when these villages become towns there is a decreased tolerance to these psychiatric illnesses. Gender bias aggravates problems.
The joint family system had assimilated and provided care for many of the mentally ill in their homes but with increasing nuclear families, care provision demands more resources.
Thus India without a massive mental health movement will see a lot of homeless destitute patients
 
I have seen that people sympathise with those who are physically ill  but nobody sympathises with mentally ill person and it is a stigma to be mentally ill.  Of course, as an ex-Govt. servant, I am getting adequate treatment but Govt. needs to do much more in this regard so that 5 crores of Indian population could live with dignity.  A lot of publicity is also needed to make the society realise that mental illness is just an illness and should not be treated as a Social stigma.
 
Satbir Singh Bedi

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