Mental Health for all: Greater investment-Greater access

Dr Mona Nongmeikapam
Why invest in Mental Health ? Around 1 billion people world-wide are living with mental disorders but only few have access to quality mental-health care. The coronavirus pandemic has resulted in a deterioration in the mental health and well-being of many people.
Inappropriately diagnosed and treated mental illnesses are leading causes of poor work performance, family disruption, increasing crimes and contribute to the global burden of disease. Many mental-health conditions are treatable/preventable. However lack of due attention and concern by the general public, general healthcare system, and elected public policy-makers has resulted in inadequate management.
Hence the World Federation for Mental Health has designated the theme for World Mental Health Day 2020 as “Mental Health for All: Greater Investment, Greater Access,” and urges increased investment in appropriate and equitable mental health services including support for the social determinants of health to address mental health promotion and prevention.
Sad reality
Growing stress due to the Corona Pandemic? Agreed. Rising crime and anguish amidst masses? Accepted. How much is the government investing to combat this Mental Health crisis ? A casual search reveals that a kingly sum of 33 paisa is being spent on a mental health sufferer in a whole year in our country! India reportedly spends only 0.05 percent of its health budget annually on mental health over the last few years. India’s healthcare budget in 2018 was 528 billion rupees out of which 500 million rupees for mental health, which was reduced to 400 million in the following year.
However, India has actually spent only 50 million rupees annually on mental health. And taking into account the 150 million people requiring urgent mental health care, hence the 33 paisa! Do the math.
Now leaving the disturbing figures aside, how much are we as individuals willing to invest in our respective Mental Health ?
1. A little respect to begin with : Conversation starters at social-dos I am beginning to dread: “We actually have everything under control but the thing is that XYZ has been behaving a little abnormally and our whole family has been having sleepless nights because of this ?” I am like : “Really?” Is that why you have cornered me with that conspiratorial look on your face when I am knuckle-deep in my Sareng curry ? And the hush-hush tone needs to go too. Any mental health issue is a health issue. Period. It is time that we gave it the due importance it deserves.
2. Mental health treatment needs time, patience and yes, money ! Individuals young and old get “Complete Health Check-up” done all the time, and the bills run up to 5-digit figures, if not more.
Now ask the same persons to get a follow- up session with the therapist or spend half an hour more helping us figure why they have decided not to live anymore, then come the barricade of excuses ! They are running late for this and that, the financial crisis and so on.
3. Integration of Mental Health into Well-Being for All: This is also the vision of Healthy People 2030; in fact, the WHO (1948) definition of Health states “the complete state of physical, MENTAL and social well-being, and not merely the absence of disease or infirmity”.
4. Combatting the treatment gap ? The mental health consequences of COVID-19 have taken a toll on an already overburdened mental health landscape in which the number of people living with depression and or anxiety increased by nearly 50% from 416 million to 615 million (WHO, 2016).
Mental, neurological and substance use disorders accounts for 13% of the total global burden of disease (WHO, 2012). The treatment gap remains large with 50% of people with mental disorders in high-income countries and 85% of persons in low-and middle income countries having no access to treatment (WHO, 2012).
 Take the population of our state for example, 3 million individuals (May, 2020) versus a meagre populace of about 100 mental-health professionals. Studies in earlier pandemics involving quarantine recommends a minimum of 6 months’ follow-up of individuals having undergone isolation and long-drawn treatment.
The existing fragile Mental-Health facilities falls extremely short to cope with such high-scale demand and hence the gap and resulting anguish.
5. Normalizing help seeking: Statistics (and not me) states that one person in every four individuals will be affected by a mental disorder at some stage of their lives. Now why be stigmatized of something this common? Why can’t speaking to a professional or help-seeking be as common-scene as “LaiKhoiram Thokpa” (offering a prayer) for example, which is very common in our culture? ‘I have a bad intuition, bad vibe’- might be true, might be baseless but ‘I offered my prayers and I feel better’. So if one is finding coping difficult in one’s current day and scenario, seeking help is completely ok and that doesn’t necessitate the individual to wear a lifelong label or be stigmatized, either by the society nor worse, by themselves.
6. Starting at the grass-root level : Starting right from peri-partum mental health factors to early childhood developmental issues, counsellors being accessible in-house in educational institutions, as now is being mandated, to identify mental health issues faced by the students on a daily basis, work-place based psychological support facilities- the list is just endless and better access can only lead to better recognition and quicker aid.
Individual Efforts to start with: That extra endorphins that come from exercising, dancing, pursuing a hobby or doing something fun. Physical distancing- not social distancing, Sleep hygiene and no popping unprescribed pills, Behaviour and lifestyle modifications
 Now let us make a pledge today!
I ---------- make a pledge to invest my sincerest effort to make my Mental Health a priority.
I will invest time and effort to look into the mental well-being of my near and dear ones and of people I come in contact with. I further promise to join and support the local, state/provincial, national or international organizations that are working to make mental health a priority.
Together, we will make a difference!

The writer is Consultant Psychiatrist, Shija Hospitals and Research Institute, Imphal, Manipur
For any doubt or feedback, the author can be reached at: [email protected])