There is a need to chart new approaches in the delivery of mental healthcare, as one of the most pressing public health challenges in India, especially after the outbreak of the COVID-19 pandemic. This requires huge investments, enhanced public-private stakeholder collaborations and in-depth study of the mental health needs of the population. Kanishk Gupta, Director and Co-Founder at Sukoon Health Hospital, clinically governed by Fortis Healthcare, gives an overview on how grave is the situation and recommends measures that should be implemented to set up a trusted, accessible and adequate mental health system in the country, in an interview with Lakshmipriya Nair
How huge is the burden of mental disorders in India?
India has world’s largest population with unipolar depressive disorders. People here, irrespective of their age, suffer from anxiety, schizophrenia, and bipolar disorders also. In fact, one out every 12 Indian needs medical intervention since their symptoms are either chronic or their severity is too high.
A research carried by Public Health Foundation of India found that the mental disorders are prevalent the highest in older adults. In children, it is often seen in the form of idiopathic developmental intellectual disability, sometimes conduct disorders and autism.
In response to this, the Central government only spends about 0.05 per cent of the health budget while the current situation requires a minimum of Rs 95,000 crores to create awareness and involve experts in dealing with the rising numbers.
The inadequacy of mental health services in India has been highlighted before but which are the new fault lines that got exposed after the onset of the COVID-19 pandemic?
The COVID-19 crisis inevitably led to the rise in anxiety levels of general public. The youth is uncertain of their future career prospects while entrepreneurs are uncertain about when things will get normal and so on. The pandemic has brought out the worst around us. And yet, a lack of mental health experts and organisations has left the affected groups vulnerable to their environment.
It is now that the lack of access to psychiatrists, clinical psychologists, and psychiatric nurses seems evident to all. There’s an evident shortage of mental health experts who are accredited to provide patients with the transparency of treatment.
How high is the psychosocial risk of the COVID-19 pandemic, especially in India? What are the factors which will influence vulnerability among the populace?
The COVID-19 pandemic has impacted jobs, education, and mental well-being of most of our population. So, there’s work-related stress and then there’s future’s uncertainty that has been bothering the public leading to florid mental distress.
Then, the frontline healthcare workers are at a continuous risk of contracting the virus (combined with the extended shifts), so the burnout, anxiety, fear, depression, increased substance-dependence, and PTSD is likely to be common among them.
None of us was prepared for this epidemic and so, the psychological risks are too high.
What are the most frequent psychological manifestations in people due to the pandemic? What are the indicators that a person is developing a psychological condition?
The rapidly evolving COVID-19 crisis has placed a burden on our mental health system. The virus has now led to the spread of behavioural changes that are evident in the form of increasing cases of anxiety, depression, domestic abuse, substance abuse, and suicidal thoughts.
The most common symptoms of psychological distress are excessive feeling of fear; tiredness or low energy; shift in eating habits; loss of appetite; insomnia; and suicidal thoughts in critical scenarios.
If one notices any of these significant changes in and around their environment, they must identify and seek help.
What kind of system do we need to create and implement to provide adequate mental healthcare in India?
The system needs urgent attention and a necessary service for people to access. Trusted and accessible channels to make informed choices and protect people from the adverse effects of their behavioral perspectives is what we need right now.
We need active health insurance for mental healthcare, so that people don’t stigmatise a mental illness. The system needs to be more vocal about these disorders to help people understand the symptoms and to catch them before they turn fatal. Educational institutions along with social healthcare facilities must be given access to experts for consultations and therapy. Also, public-private partnerships need to be activated to rapidly increase the number of facilities present in India for the cause. Government must talk about issues in rural India, where the mental health illness is rapidly increasing.
An ideal system in the current situation is one that has established mental health support and access to experts such as psychiatrists, clinical psychologists, and therapists. The system should also work on improving mental health awareness, especially in the rural areas of India where the impact is prominent. Also, there needs to be a family and childcare support system for those who have suffered loss during the pandemic. There must be work arrangements and grievance redressal units as well as people should know they are heard.
As much as there is lack of funding the mental health segment of India, there is a lack of support too. Then there is a vast gap between the need for treatment and services available which can be filled through empowerment and advocacy. While gaps in knowledge will always be present, they should not be any hindrance in taking an action. Then, implementation is the final challenge that we must address.
Tell us about the services that Sukoon Health is offering at this point in time? How is Sukoon Health working towards ushering a new paradigm in India’s mental health services?
Sukoon Health has set up in-patient care for psychiatric and de-addiction services. We not any conventional mental health service provider, rather, we are a first of its kind mental health hospital in India. Along with a full spectrum of mental health services, we also offer emergency hospitalisation and OPD consults all under one roof. Our institution is currently valued at $22 million. In our quest to serve more and better, we have plans to launch 500 beds in the next three years.
We are clinically governed by Fortis Mental Health and have the widest network of professionally equipped clinical doctors from across the country. We ensure a world-class treatment with premium facilities and modern amenities to our patients. It’s our cohesive approach to mental health that has helped us achieve positive patient outcomes for psychiatry, mental health, and de-addiction.
We also offer vocational training for aspiring mental health practitioners so that we can ensure the highest level of treatment to our patients by raising compassionate caregivers.