Need to move conversation away from psychiatrists: Dr Pathare on mental healthcare gap in India

“Over the years, there have been knee-jerk reactions to the findings of new suicide reports. We need to steer the conversation away from psychiatrists. They are not a solution to the mental health gap that we have,” said Dr. Pathare. indianexpress.com.

The National Crime Records Bureau (NCRB) in a recent report noted that the number of suicide-related deaths in the country reached an all-time high in 2021. A total of 1.64 lakh people died by suicide in India in the year. last year, an increase of 7.2 percent from 2020, according to data from the NCRB. Notably, more than half of the women who died by suicide in the past two years were homemakers. Daily wage earners remained the largest occupational group among suicide victims. In addition to these findings, NCRB data has indicated an increase in suicides among students and even retirees.

Dr. Pathare noted that suicides are multifactorial and that mental health is only one component. “We don’t have an integrated strategy for suicide prevention. Sectors such as education must address suicide death among young people, while other sectors must understand issues such as unemployment and financial hardship. Some sectors need to seek strategies to reduce access to lethal means for suicide. The media also play an important role. There is plenty of evidence on how media reports of death by suicide can influence one to two percent of suicides. In the Indian context, one to two percent of suicides may mean 3,000 to 4,000 people. Therefore, the media reporting suicide deaths more responsibly could mean a reduction in these numbers,” Dr. Pathare said.

“There is no single cause of suicides. It is a combination of everything. Suicide is the end point of a path in which many things have happened to people at various times. There is no single intervention that can make everything okay,” said the prominent psychiatrist.

Noting that stigma around mental health persists, Dr Pathare said: “Even if someone is identified as having the problem, we don’t have resources. Clearly, we don’t have adequate and appropriate mental health services that are readily available, accessible and affordable.”

The expert also called for an intensified approach in which a variety of mental health professionals can treat a variety of problems. “Even if we have enough psychiatrists, the problem will not be solved. Look at the United States: it has half the world’s psychiatrists and four percent of the world’s population, yet 25 percent of people with mental health problems in the United States go untreated. So we have to look at this issue from the perspective of the health system. My concern is what we are doing in our health system,” said Dr. Pathare.

Solutions like getting a variety of highly-skilled professionals to treat simple mental health issues can be taken, he said. “If you have a cold and cough, don’t rush to see a chest specialist, but get treated by a local general practitioner. Even in the realm of mental health, there needs to be this intensive approach where a variety of mental health professionals can address a variety of issues. What happens is that everyone runs to a psychiatrist and that means they end up not seeing the sickest people…”, observed Dr. Pathare. While there are no immediate solutions to reduce the number of suicides in the country, policymakers must have an integrated suicide prevention policy and provide adequate funding for the effort, he reiterated.