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Imagine you live in a village in what has been romanticized as the rural “heart” of India. You can be a farmer, a small shop owner, or even a young woman starting a family. You try to do the best you can with the resources you have, but lately you have been feeling depressed, unable to eat, sleep, or refuel with your daily tasks. You may feel that your family is starting to get frustrated with you. This is not the version of you they know or need. Every day you feel more isolated, numb inside, and you just go with the motions of life. If only there was a way for you to know that you are dealing with the onset of depression and that you can get over it with a little help. It could mean the difference between life and death, but most likely, because you live in the hinterland, you will end up like another number in the midst of India’s growing mental health crisis.
This is just a glimpse of the grim reality of rural India that 65% of our people face. It would not be an exaggeration to say that India’s mental health crisis is at an inflection point. A 2017 study published in The Lancet estimates that mental health issues affect 14% of India’s population, and the pandemic has added 20% to that number. While we seem to be making progress in breaking down barriers to awareness and access in metropolitan areas, we don’t even have enough specific data on rural mental health challenges.
In a way, I believe that the subject of mental health is lost among all the other challenges of rural development. We live in an unequal world, with the vast majority of our population on an equal footing in money, education, employment and even access to basic amenities. These challenges only add to the psychological burden, making entire communities vulnerable to mental health issues that remain undiagnosed, untreated and mired in obscurity and stigma. So far, most of our efforts to integrate mental health into mainstream health care have been tragically skewed towards the urban areas of our country. It is time to address the issue of integrating mental health care into the rural mainstream, starting with the three problematic A’s.
Acceptability
80 percent of people with mental health issues don’t get the help they need to do it. In rural India, the stigma surrounding mental health makes it perceived as a debilitating and dehumanizing condition that is met with ostracism and ignorance instead of compassion and medical care. What we need are widespread outreach efforts that teach people that it’s okay for the mind to not feel well every now and then. Most regional languages ​​don’t even have names for common mental issues like depression and anxiety. While stigma and lack of awareness are problems at the community level, their solution also lies in interventions at the community level.
Availablity
The WHO (World Health Organization) recommends that there be at least one mental health professional for every 100,000 people in a country. With the exception of one state, India has just 0.3 while other developed countries have over 6.6. Despite the provisions of the Mental Health Care Act, most rural areas of India do not have enough social workers, psychologists, psychiatrists or even hospitals for mental health care.
Accessibility
Even when mental health resources are available, people in rural areas find it difficult to access them. Often these resources are located too far away for people to travel regularly for therapy and treatment. There is also a financial barrier, as the economic burden of accessing mental health care can cost as much as Rs 1,000 to Rs 1,500 per month, according to a study by the NMHS (National Mental Health Survey). Mental health issues require regular intervention for months or even years, and the cost of access can be crippling for the average family.
Bringing mental health care to rural India is a Herculean effort that truly requires a public-private partnership approach to make a difference at the local level. Joint programs between state governments and mental health organizations can strive to bring mental health awareness, accessibility and training to villages in rural India. As part of these programs, local volunteers and health workers can be trained to go door-to-door, screen for mental health issues and raise awareness through workshops. These projects may also aim to bring psychiatrists and psychologists to these areas on a visit basis, with follow-up advice over the phone. Building on the strong sense of community that exists in villages, projects like these can help build capacity and train more people to stimulate self-help efforts in the community. .
The only way to solve the mental health crisis in India is to make sure that basic care and support is readily available to all, without prejudice and without affecting their long term quality of life. After all, mental illnesses do not discriminate based on the age, gender, or social demographics of the people they affect. So why should there be a disparity in the treatment and perception surrounding it?
The author is founder and chairman of Aditya Birla Education Trust.
