Mental Health

 

Mental health is a major concern worldwide and India is not far behind in sharing this. If we evaluate developments in the field of mental health, the pace appears to be slow. Dr. Brock Chisholm, the first Director-General of the World Health Organization (WHO), in 1954, had presciently declared that “without mental health there can be no true physical health. More than 60 years later, the scenario has not altered substantially. About 14% of the global burden of disease is attributed to neuropsychiatric disorders. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the inter-play between mental illness and other health disorders. There remain considerable issues of priority-setting based on the burden of health problems and of addressing inequalities in relation to determinants and solutions for health problems.

Progress in mental health service delivery has been slow in most low- and middle-income countries. Barriers include the existing public-health priorities and its influence on funding; challenges to delivery of mental health care in primary-care settings; the low numbers of those trained in mental health care; and the lack of mental health perspective in public-health leadership. There have been numerous calls for invoking political will, for enhancing advocacy and for galvanizing community participation; all with scant improvement in outcomes.

 

MENTAL HEALTH 

Mental health awareness campaigns have yielded positive outcomes. Some of the strategies undertaken to target awareness and address stigma around mental illness include participation by family members, sensitization to treatment and social inclusion. Lack of knowledge about the mental illnesses poses a challenge to the mental health care delivery system. Research has highlighted the role of community-based systems in low-income countries and has also yielded positive results in creating awareness, thereby impacting participation.

Awareness and health literacy are two sides of the same coin. Stigma and discrimination are negative consequences of ignorance and misinformation. There are a few studies which have measured mental health literacy in the Indian context. One study found mental health literacy among adolescents to be very low, i.e. depression was identified by 29.04% and schizophrenia/psychosis was recognized only by 1.31%. Stigma was noted to be present in help-seeking.

These findings reinforce the need to increase awareness of mental health. Mental health literacy is a related concept which is increasingly seen as an important measure of the awareness and knowledge of mental health disorders. Health literacy has been described as “ability to access, understand, and use the information to promote and maintain good health. Mental health literacy encompasses recognition, causes, self-help, facilitation of professional intervention, and navigating the information highway . Attitudes which hinder recognition and appropriate help-seeking can be counter-acted by information which is already readily available in the public domain. There are plenty of examples of awareness positively impacting mental health outcomes like the Norwegian campaign to reduce the duration of untreated psychosis.

Components of mental health literacy: 

The impact of stigma has led to the institution of various programs worldwide to challenge the stereotypes and discrimination that generate social disability. Mental health awareness programs have had favorable impact and can produce positive change in people's views of mental illnesses. However, more robust evaluations are needed to assess the long-term impact of approaches to increasing mental health literacy worldwide.

ROADMAP FOR MENTAL HEALTH AWARENESS

For the large Indian population to be involved in its own mental health, the only way forward is through enhancing mental health awareness which will generate its own demand. With rising awareness, it can be expected that early recognition and access to treatment will follow, as will the adoption of preventive measures. It can also be expected that with enlarging awareness in a democratic society, advocacy, leveraging of political will, funding, and cross-synergies shall follow. It is envisaged that bulk of the awareness contributions shall flow from the following six platforms.