Dr Vihan Sanyal, Psychotherapist, informs about the mental health scenarion in India including Agoraphobia
How huge is the problem of agoraphobia in the country? Is Agoraphobia on the rise? What are its causes and symptoms?
Diagnosed cases of Agoraphobia are not prevalent in our country. However, cases of generalised anxiety, social anxiety and OCD are on the rise compared to Agoraphobia. Possible causes of Agoraphobia may be a result in a chemical imbalance in the brain, genetic component, an anxious personality type, a person who is living under constant emotional stress, result of emotional trauma, has constant panic attacks. Seeking timely help for panic attacks and panic disorder can prevent a person from entering an Agoraphobic state.
What is the burden of mental health issues in India?
We have a situation where various forms of mental illness is rising in India and we are not equipped with enough mental health professionals to deal with the requirement. According to WHO, our mental health workforce per 100,000 population, stands at 0.3 per cent psychiatrists, 0.12 per cent mental health nurses, 0.07 per cent psychologists and 0.07 per cent social workers vs. the burden of mental health problems being at 2,443 DALYs per 100,000 of our population.
What share of public health spending is attributed to mental health? Are there any government initiatives when it comes to treating Agoraphobia?
India spends only 1.4 per cent of its total GDP in health (including mental health), lower than that of Nepal and of Russia. We face scarcity in good government funded primary care centres and our tertiary care centres are over burdened. When we look at mental health, we do not have the much required centres dedicated towards caring for the mentally ill nationally. Many of our hospitals do not have inpatient facility to cope with caring for mentally ill patients and many may not have the resources to deal adequately with a mental health emergency. Currently, there are no specific government initiatives to deal with the treatment of Agoraphobia. The only aspect being that certain generic drugs are available for the public (depending on availability) which are cheaper than branded medicines to treat Agoraphobia.
Do we have any provisions for agoraphobia in the public health system of India?
No, currently there are no provisions available to deal specifically with Agoraphobia.
What are the treatment options? What are the costs incurred?
Treatment options including medicines like SSRI antidepressants and benzodiazepines are commonly prescribed for anxiety disorders including Agoraphobia; Counselling & Psychotherapy; Alternative Treatments. Typically, taking pills is a cheaper alternative to counselling & psychotherapy. However, it depends on the individual and if they prefer to try therapy for long term benefits which are free of side effects or to take conventional medication instead.