The slogan ‘no health without mental health’, used mainly by mental health professionals in the past, has now become a worldwide refrain. This is due in part to the huge impact of COVID-19 on already fragile mental health treatment services, particularly in low- and middle-income countries. During Covid-19, depressive and anxiety disorders have increased by 28% and 26% respectively.
Before the pandemic, there were 970 million people, or 13% of the world’s population, living with mental disorders. Anxiety and depression make up nearly 60% of mental disorders. Nearly one in 10 people with mental disorders have serious illnesses such as schizophrenia and bipolar mood disorder.
Mental health conditions are now recognized as an important part of public health. People with serious mental illness die 10 to 20 years earlier than the general population. Globally, one in every hundred deaths is a suicide. This is more common among younger populations.
At different stages of life development, a person may be vulnerable to different mental disorders. Gender, as well as other social determinants, also explain variability in mental disorders.
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In addition to premature mortality, mental disorders are associated with a high burden in terms of years lost due to disability (YLD) in healthy years. Depression and anxiety are among the top 10 causes of YLD. In addition, there is a significant economic burden from death, disability, and lost productivity.
The use of psychoactive substances is a global problem, growing not only among young people around the world, but also among women and the elderly.
Despite growing awareness, mental health care for the public has remained ‘business as usual’. That is why the World Mental Health Report 2022, released in early June, calls for transforming mental health for all.
We rarely think that factors like economic recession, social polarization, humanitarian emergencies, forced displacement, and climate change can have lasting effects on our psyche, but they do.
The spectrum from wellness to illness can sometimes make it hard to tell a deviation from wellness.
Mental and physical well-being are also highly interrelated. While chronic depression can lower immunity and increase the chance of serious infections, a person with epilepsy, heart disease, diabetes, or cancer is more likely to have mental health problems.
There is still a huge stigma around recognizing mental health problems and seeking help at all levels of society. Stigma, discrimination, and abuse are major barriers to timely mental health care.
One way to address this barrier is by placing a higher value on mental health, improving knowledge about disorders, and improving access to mental health care. It is equally essential to guarantee the human rights of people with mental illnesses and to minimize any type of coercion.
Need for change
If we want to prosper as a society, we must focus on building individuals as social capital. People can make a big difference if they better understand and value mental health and take steps to promote and protect it in their daily lives.
Physical, emotional, cognitive skills and behaviors buffer stress and contribute to individual resilience, ability and control.
Norms, networks, and institutions that improve family relationships, create opportunities to work and learn, and build trust in the community are vital. We need to develop human rights-based, person-centred and recovery-oriented care through a balanced biopsychosocial approach that is gender sensitive. We need to integrate mental health services into general medical care. We need a network of community-based mental health services.
Community providers must be strengthened to support people living with mental health conditions. Early interventions can prevent both mortality and disability.
Community care involves various actors. Primary health care providers trained in providing mental health support and those with lived experience can provide support with the help of helplines, technology, and online services. This applies especially in the case of people who do not have direct contact with health professionals.
Having a network of mental health services is vital. People in crisis must also be quickly identified and referred to specialized mental health care.
Specialized mental health care continues to be lacking due to a lack of professionals.
We must also focus on the environments we provide at home, in schools, at work, and in our communities. Protective measures include positive parenting, quality education and employment, safe neighborhoods, and community cohesion.
The emotional, cognitive and social development of children and adolescents requires attention. The mental health of children and adolescents can be achieved through policy and legislation, good maternal mental health, support from caregivers, school programs, and changes in the community and online environments.
Workplaces, where adults spend most of their waking time, should also encourage healthy lifestyles among employees. In addition to diet, exercise, and healthy sleep, attention should also be focused on psychosocial health, including mitigating stress, improving relationships at work and outside of work, and maintaining a healthy life balance. labor and personal.
The SOLVE model developed by the International Labor Organization looks at the interconnectedness of psychosocial stressors and how they can be effectively addressed to develop a healthy and happy workforce. Such interventions are also vital in correctional settings such as prisons, which have high rates of mental distress.
Carers of people also face tremendous difficulties. Therefore, social benefits for maternity, work accidents, disability and old-age pensions can be a lifeline for people with mental health problems in difficult times.
As the WHO emphasizes, the need of the hour is to improve mental health literacy, close governance gaps, shift focus to community care, make essential medicines available, improve access to digital resources, bridge the gap digital and include people with mental illnesses in various benefit and insurance schemes.
All of us – individuals, governments, non-governmental organisations, caregivers, mental health care providers, employers, academics, the media and civil society stakeholders – must play a role in transforming mental health care. .
Our country has a progressive Mental Health Law and a Community Mental Health Policy. The recently announced Tele-Mental Health program promises to reach millions of people in need of services.
The District Mental Health Program has been expanded to most districts. The health and wellness centers will focus on positive mental health. There are many notable examples of effective mental health promotion and community care that need to be expanded across the country.
We need to see these steps come to fruition, focus on mental health literacy, improve human resources for mental health care, and ensure a multisectoral approach that enables us to bring mental health services to people.
(Pratima Murthy is Director and Senior Lecturer in Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore)
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