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It took a pandemic for mental health to make a dent in the budget suitcase (tablet in 2022)! Finance Minister Nirmala Sitharaman announced a national telemental health program powered by NIMHANS and IIIT. While this is a critical step in providing care to millions of people, mental health is a complex issue that requires solutions to address challenges across the ecosystem. This is a gargantuan task that might take several tries before you get it right. However, the government can avoid trial and error. The precedent for such helplines already exists. There is an opportunity to learn about and build on the work of mental health helplines in India, anchored by social sector organizations and supported through philanthropy. Collaboration with existing stakeholders will be critical to success.
The 2022 budget promise
In the last decade, telemental health solutions managed by social sector organizations have played a crucial role in advocating for easy access to quality mental health for people from lower socioeconomic backgrounds, vulnerable populations, and underserved communities. Today, there are more than 20 helplines in India that provide mental health support through different means like phone, email and even WhatsApp in more recent times. The government (at the national and state levels) has made inroads into creating mental health helplines. For example, it launched the first toll-free mental health rehabilitation helpline. Kiranaddressing a Change.org Petition for suicide prevention. Similarly, the Maharashtra government began let’s talk1on1with the support of Mpower Minds, as a response to the pandemic.
To move from theory to implementation faster, the experience of operating helplines in the social sector offers insights that can make a difference. Here are some recommendations:
- Invest in behavior change campaigns
In 2016, NIMHANS reported that approximately 150 million needed active interventions, but only 30 million people sought care. In establishing the national helpline, it is critical that the government invest in national awareness and behavior change campaigns (reaching even the most underserved regions of the country) to de-stigmatize mental health and empower people to seek help. Polio was successfully eradicated in India through the world’s largest awareness campaign. Can we do the same for mental health?
- Not just access, but access to quality care
While the shortage of mental health professionals continues to be a problem for the sector, the lack of standardization in the quality of care is even more alarming. With mental health, poor quality can do more harm than good. The government will have to invest heavily in ongoing training mechanisms and processes to maintain quality. “A counselor’s understanding, attitude, and beliefs not only about social issues, but also about everyday life experiences influence how they handle a particular caller’s concern. We invest heavily in ongoing learning (and unlearning) that covers topics like understanding youth, affirmative queer practices, relationships, and sexual health issues.” she shared an expert in strategy and operations.
- Infrastructure to provide end-to-end support
Mental distress or illness does not occur in isolation. It is often multidimensional with an individual’s gender, caste, sexual orientation, family, and financial status all playing a role. Meghana Jadhav, a Mumbai-based counseling psychologist who has run helplines shares that “If you are a helpline counselor, your job is not limited to providing emotional support. When speaking with survivors of domestic violence, there is a responsibility to create a safe space, provide ongoing support over extended periods of time, and connect them with a relevant nonprofit or legal aid when they are ready. We also have to treat the involvement of law enforcement agencies sensitively.” Ensuring a diverse referral network, resources for ongoing support, deploying strong data privacy policies, and being transparent about the use of data collected will be key to building trust with people and unleashing the power of this national helpline. .
- Integrating community care models
It is essential to also create safe spaces for people from different communities of all socioeconomic classes. In low-income communities, paramedical professionals or community workers can be trained to lead interventions (Sangath, Basic Needs in India, and StrongMinds in Kenya are good examples). Group therapy interventions in the lower and upper middle class population have great scope for impact and scale. Integrating mental health with community care interventions that nurtures the human touch can be transformative.
Ultimately, to solve the massively complex mental health crisis, we need government, the private sector and civil society to really work together. Social causes have benefited from a collaborative approach, whether in education, health or livelihoods. But we haven’t seen much of that in the mental health sector. Instead of reinventing the wheel, we hope this telemental health program will focus not only on leveraging existing government infrastructure, but also engage deeply with international nonprofits, social enterprises, philanthropists and foundations working in this space. .
The 2022 budget proposal puts India in the league of other developed countries that have national initiatives on mental health, and will increase access to care. However, as with all policy proposals, success lies in implementation capabilities and integration with the state’s health infrastructure. If India can also integrate the holistic approaches detailed above, the quality of life for all Indians in the coming decades will be vastly improved. We are hopeful.
Disclaimer
The opinions expressed above are those of the author.
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Disclaimer
Views expressed above are the author’s own.
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