Globally, over 322 million people suffer from depression; what’s more, the number of people living with this condition has jumped by a whopping 18.4% between 2005 and 2015 (WHO). That apart, every 40 seconds, a person kills himself/herself (chiefly due to mental illness), putting suicide amongst the leading causes of death in the world. Approximately 1.5% of deaths in 2015 were a result of this; in fact, the number of suicides committed globally stood at 7,88,000 in 2014 itself!
Probably more worrisome is the fact that over half of the total number of depressed people belong to the South-East Asian and Pacific regions, with people in India and China constituting a large part of this population. The study by WHO which states this ultimately concludes that India is the most depressed country in the world – a very grave fact. What did we do to deserve this place?
Before we think of the answer – there’s more to consider: WHO, 2015 states that in 2015 alone, 56 million people in India suffered from depression, and 38 million from anxiety. Moreover, more women than men suffer from depression, due to a combination of physical and socio-cultural factors – 1 in 5 women suffer a depressive episode in their lives, as compared to 1 in 10 men.
This leads us to the obvious follow-up question to our place as the most depressed country – ironically enough, one of the few things we’re in the top for – what’s causing this? WHO, once again, feels that this is not only limited to an individual’s ability to deal with a situation – though it is certainly a big part, but also dependent on social, cultural, economic, political, and environmental factors. Sometimes, even genetics play a role!
Reasons for not seeking care
- Availability of psychiatrists, counselors: The number of available people to treat/counsel per 100,000 population include 0.3 psychiatrists, 0.12 nurses, 0.07 psychologists and 0.07 social workers – which means that there is only one person per a lakh population, or no one to address the needs of mentally ill people (indicating skewed presence of the support system in urban areas, etc.);
- Cost of treatment (affordability): According to the NMHS, the cost of treatment for mental health issues is at least Rs. 1250 per session. The per capita income in India is Rs. 75000, of which Rs. 1250 is a very large part. This renders people incapable, on the financial front as well, of addressing mental illnesses;
- Lack of awareness: Many people undergoing mental illness/depression don’t even realise that they are affected, simply because they are not aware of such conditions. This could turn out to be very dangerous since
- Stigma surrounding mental health: While lots of discussions on mental health have been doing the rounds lately, most people still shy away from it. Surviving heart disease, cancer, etc. is a matter of pride, but surviving depression/mental illness is kept under the wraps, or trivialized – leaving mentally ill people with a huge lack of trust in anyone to share their problems.
For instance, according to a study by TLLLF in a sample of 3,556 people in Delhi, Kolkata, Mumbai, Patna, Pune, Kanpur, Bangalore and Hyderabad,
- 47% of people surveyed viewed people having mental illness in a judgmental way, and 26% displayed fear towards people with mental illness.
- 40% of the surveyors felt frightened that there were people with mental illnesses living in their livelihoods.
- Majority of the respondents (ranging from 35% – 70%) felt apathy, fear, anger, annoyance, disgust, and hatred towards people with mental illnesses.
- People are confused between the symptoms of mental illness (like the lack of sleep/too much sleep) and aspects which indicate prejudice towards people with mental illness (such as thinking of them as mad or distracted).
The Way Forward
Most treatment systems present currently work in such a way that people seek treatment/help only in extreme cases – and some others, not even then. The way it works is more curative than it is preventive. However, there is a need to ensure mental wellness first, before even addressing problems as they arise. Economic growth/development and mental well-being are being perceived as two separate streams of study, without realizing the impact one has on the other. For instance, poverty/economic loss is one of the chief causes of poor mental health. Moreover, it is estimated that, in India, the economic loss due to mental health conditions (between 2012-2030), is 1.03 trillions of 2010 dollars. Hence, there is a need to think of solutions to addressing overall mental wellness in India. Current initiatives (of Sangath, for postnatal depression, of Nalam, a community mental health initiative, and a National Mental Health Policy – which released in 2016) focus on specific target groups. However, there is a need for a systemic change – one which views mental health as an integral part of all walks of life – birth, growth, education, employment, marriage, having children, old age, and death. According to the World Bank, there is no health without mental health. Keeping with this philosophy, there is an urgent need to address this issue in India.
The first step towards this is the creation of awareness about the presence, types, and causes of mental illness in India, and the hosting of sessions/panels which initiate talks around them. We host one such initiative in Chennai called DESHA Dhwani (refer below). Another important dimension is the breaking of societal taboo and barriers to talking about it – which means that people at the top – those who are prominent in their own fields, and have ample awareness about mental health should come together to discuss this.
“Never give up on someone with a mental illness. When “i” is replaced with “we”, “illness” becomes “wellness” – Randle Grimes
Neharika Rajagopalan is currently a Senior Policy Associate at IFMR LEAD, one of the leading research organisations in South Asia.
She has previously worked with Ernst & Young LLP and the Indian Council for Research on International Economic Relations (ICRIER), and the Asia Society for Social Improvement and Sustainable Transformation (ASSIST). She holds an M.Sc. in Economics from the University of Warwick and did her undergraduate degree at the Ethiraj College for Women, Chennai, India.
To discuss more on India’s Depression problem, Neharika is convening a panel discussion on Mental Wellness in Chennai, India called DESHA Dhwani on March 9, 2019 between 10 a.m. and 12.30 p.m at 2nd floor, Shri Geeta Bhavan, Gopalapuram, Chennai, India.For participation, please email to firstname.lastname@example.org.