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India is facing a grave shortage of behavioural health providers and facilities on similar lines of the US. Besides, there is a geographic problem for India, going by its proximity to the major opium-producing regions of Southwest and South East Asia which fueled the drug abuse epidemic, said Dr. Tonmoy Sharma, founder and CEO, Sovereign Health.
Despite federal laws that require health insurance companies to provide mental health services on par with other medical conditions, it is still a struggle to obtain approval for the full spectrum of care required. Added to this is the shortage of professionals in the field, he added.
These hassles discourage many to enter the field of mental healthcare. There is a stigma surrounding psychiatry just as patients with psychological issues are stigmatized. There is still a bias that psychiatry is a squishy science, or a soft profession, even when it is about workings of the brain. Even government entities are looking to attract and retain counsellors and physicians. There is a dire need for professionals going by the massive shortfall in mental healthcare, Dr. Sharma told Pharmabiz in an email.
Europe also faces shortage of professionals and treatment networks. However, most European countries have a national healthcare plan and disorders are caught earlier because people access primary care providers more often and don’t face financial barriers to seek treatment. However, in all countries, without exception, stigma is a barrier to receiving care. Until we all globally can agree that mental health and substance uses are brain diseases, he said.
It is the stigma surrounding mental health which makes treatment complicated. There is anxiety and guilt among patients and their families. Since patients come in with co-existing mental health and substance use disorders, there is a lot that goes into creating a treatment plan which effectively treats both issues, concurrently. At times a certain approach or medication is found not working and this is where constant patient feedback about the treatment plan allows to adjust it accordingly.
Another issue is that it is difficult to receive proper reimbursement for services rendered . In the some cases, staff spend more time justifying the treatment that was already approved upon admission, which takes valuable time away from the main focus of patients’ well-being. This had led to even some reputable mental health facilities to cease due to lack of reimbursement causing a catastrophic loss of operating funds, he said.
Nevertheless, there are new, good medications that help patients control cravings, or their withdrawal symptoms, anxiety and depression. Doctors are seeing that some medications used for other medical conditions actually have applications for behavioural health issues. New applications in brain stimulation are showing promise to alleviate both substance use and mental health conditions. Horse therapy and art therapy are really beneficial to patients when used in conjunction with medications. New psychotherapeutic approaches for post-traumatic stress disorder have been shown to be beneficial too, said Dr. Sharma.
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