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Observing that India has an unsatisfactory status in terms of mental well-being, life satisfaction and happiness across the globe, a Parliamentary Panel has suggested to the central government to take various necessary measures including formulation of national and state-level action plans to actualise the recommendations of the National Mental Health Policy (NMHP) to address the treatment gap in the country.
The Department-Related Parliamentary Standing Committee on Health and Family Welfare in its 148th report on Mental Healthcare and its Management in Contemporary Times, also recommended to the Ministry to address various issues identified in the National Mental Health Survey (NMHS) in the next survey and conduct a comprehensive study of the mental health issues and mental healthcare landscape in India.
The Committee observed that the treatment gap in India for mental disorders ranged between 70 to 92% for different disorders.
While the NMHP establishes crucial strategic directions and offers actionable recommendations, despite almost a decade since its introduction, the policy's progress has been limited.
"Due to India's quasi-federal governance structure and healthcare being a concurrent subject, both the central and state governments share the responsibility for implementing the policy. However, only a few states have embraced and implemented the outlined recommendations of the National Mental Health Policy," said the Committee headed by Member of Rajya Sabha Bhubaneswar Kalita.
The Committee, after analysing the implementation of the NMHP, said that it is of the consensus that strategic objectives identified in the NMHP are yet to be translated into full action by responsible authorities and those in charge of implementation.
"To address this issue, the Committee recommends formulating national and state-level action plan (s) to actualise the recommendations given in the NMHP," said the report.
Furthermore, the Committee said that it believes there is still scope for policy and programmatic interventions to effectively prioritise and address the underlying factors, that are, vulnerable groups, unemployed youth, women, and others contributing to mental health issues.
"The Committee, therefore, recommends the Ministry to integrate psycho-social interventions targeted at specific vulnerable groups into schemes and programs, such as those related to social justice, women's empowerment, and child development. The Committee further recommends enhancing intersectoral collaborations and establishing synergy among different ministries, departments, and agencies while implementing NMHP," it added.
It is crucial to recognise that the ultimate goal of development should be to improve people's lives and enhance their overall satisfaction and happiness. Therefore, for India's sustainable socio-economic growth, it is necessary to give the citizens a sense of equality, inclusiveness, justice, social security and participation.
The Committee also observed that while 2015 was a welcome step, it still had scope to be more comprehensive, that is, the Survey, which was done only in 12 states out of 36 states/UTs in India, covered only about 40,000 people which is a tiny sample considering the population of the country.
Secondly, the Survey relied on self-reporting (and not clinical analysis) of mental morbidities by the interviewees, which can be subject to recall biases and underreporting due to the stigma associated with mental health. Furthermore, the Survey was limited to collecting data on certain specific mental disorders, potentially overlooking mild or moderate mental health issues like emotional breakdown, etc, that may still require support and intervention.
Additionally, the Survey did not include specific vulnerable populations, such as homeless individuals, prisoners, and those living in institutions, which may have led to underestimating the prevalence of mental disorders.
"The Committee, therefore, recommends the Ministry to address these issues in its next NMHS and conduct a comprehensive study of the mental health issues and mental healthcare landscape in India," said the report.
Considering the burden of mental issues amongst the population of India, the Committee suggested various measures for the government and the society including increasing funding towards mental health, infrastructure development, training programmes and awareness campaigns.
Going forward, mental health services should be integrated into primary healthcare centres to ensure accessibility and early intervention and comprehensive mental health policies that address prevention, treatment, rehabilitation, and destigmatisation should be developed and implemented.
Effective enforcement of Mental Healthcare Act (MHCA), 2017 and other laws that protect the rights of individuals with mental health conditions and ensure access to quality care and investment into training and capacity building for mental health professionals to meet the growing demand for services should also be focused on.
Massive nationwide campaigns to raise awareness about mental health, reduce stigma, and promote help-seeking behaviours should be launched and School and college programmes should be launched to incorporate mental health education into the curriculum to enhance understanding, early identification, and emotional well-being. Also, community outreach programmes should be devised to provide information, support, and resources related to mental health.
Telemedicine and Tele-Manas schemes should be expanded to reach underserved areas and increase access to mental health professionals. The government should also allocate resources for research on mental health, including epidemiology, intervention strategies, and the development of culturally appropriate approaches.
It should also foster partnerships between the government, non-Governmental organizations (NGOs), and the private sector to enhance mental health services and support, it added.
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