World Mental Health Day is observed on October 10 every year, with the overall objective of raising awareness of mental health issues around the world and mobilising efforts in support of mental health.

The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.

World Mental Health Day was observed for the first time on October 10, 1992. It was started as an annual activity of the World Federation for Mental Health.

The theme for Mental Health Day 2020 is ‘Mental Health for All. Greater Investment - Greater Access’. 

This year’s World Mental Health Day comes at a time when our daily lives have changed considerably as a result of the COVID-19 pandemic. Given past experience of emergencies, it is expected that the need for mental health and psychosocial support will substantially increase in the coming months and years. 

Significance of access to quality mental health services

Mental health is one of the most neglected areas of public health. According to WHO, close to one billion people are living with a mental disorder, three million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide. And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people’s mental health.

Yet, relatively few people around the world have access to quality mental health services. In low and middle-income countries, more than 75 per cent of people with mental, neurological and substance use disorders receive no treatment for their condition at all. Furthermore, stigma, discrimination, punitive legislation and human rights abuses are still widespread.

Countries spend on average only 2 per cent of their health budgets on mental health. Despite some increases in recent years, international development assistance for mental health has never exceeded 1 per cent of all development assistance for health. This is despite the fact that for every $1 invested in scaled-up treatment for common mental disorders such as depression and anxiety, there is a return of $5 in improved health and productivity.

The limited access to quality, affordable mental health care in the world before the pandemic, and particularly in humanitarian emergencies and conflict settings, has been further diminished due to COVID-19 as the pandemic has disrupted health services around the world.

Mental health care programmes in India

In India, a growing number of people seek professional help as multiple forms of mental health issues have risen exponentially during the coronavirus pandemic. Majority of them, mostly the city residents, have opted for online tele-medicine platforms to seek counselling on various issues ranging from loneliness and anxiety to concerns over job loss and dwindling income.

Recognising the importance of mental health issues, the Centre has urged all states and Union Territories to put in place and strengthen mechanisms to spread awareness about rising psycho-social concerns among people.

A state-level report by the Indian Council of Medical Research (ICMR), published in 2017, had noted that about one in seven persons in the country suffers from mental disorders of varying severity, with depression and anxiety disorders being the most common, affecting 45.7 million and 44.9 million people, respectively.   

Further, the findings of a countrywide National Mental Health Survey 2015-16 by the National Institute of Mental Health and Neuro-Sciences (NIMHANS) revealed that nearly 150 million Indians need active mental health care interventions while fewer than 30 million are seeking this support.

Kiran helpline 

In September, the Centre launched a 24x7 toll free mental health rehabilitation helpline for providing psychological support to people. The helpline — Kiran (1800-599-0019) — functions as a lifeline to provide advice, counselling and reference in 13 languages to individuals, families, NGOs, parent associations, professional associations, rehabilitation institutes, hospitals or anyone in need of support across the country.

The toll free helpline offers mental health rehabilitation services with the objective of early screening, first aid, psychological support, distress management, mental wellbeing, promoting positive behaviour and psychological crisis management.

It is backed by 660 clinical and rehabilitation psychologists and 668 psychiatrists.

Mental Health Care Act

The Mental Health Care Act, 2017 was passed on April 7, 2017 and came into force on July 7, 2018. The law was described in its opening paragraph as “An Act to provide for mental health care and services for persons with mental illness and to protect, promote and fulfill the rights of such persons during delivery of mental health care and services and for matters connected therewith or incidental thereto.”

This Act superseded the previously existing Mental Health Act, 1987 that was passed on May 22, 1987.

According to the Mental Health Care Act, 2017, every person with mental illness shall be treated as equal to persons with physical illness in the provision of all health care.

Also, attempts to commit suicide by a mentally ill person will not be punishable under the law. The Act also prohibits the use of electroconvulsive therapy, referred to as “shock therapy”, without the use of muscle relaxants and anesthesia on a patient suffering from mental illness.

Besides this, such patients cannot be chained in any manner as per the Act.

National Mental Health Programme

The government launched the National Mental Health Programme (NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it.

The District Mental Health Programme was added in 1996. The programme was re-strategised in 2003 to include two schemes — Modernisation of State Mental Hospitals and Upgradation of Psychiatric Wings of Medical Colleges/General Hospitals. The manpower development scheme became part of the programme in 2009.

Three main components of NMHP are:

* Treatment of mentally ill.

* Rehabilitation.

* Prevention and promotion of positive mental health.

The government is supporting implementation of the District Mental Health Programme (DMHP) in 517 districts of the country for detection, management and treatment of mental disorders/illness. 

At the district level, funds are provided to each district under the DMHP for sensitisation training of community health workers and elected representatives of community at district hospital/community health centre for awareness generation regarding early signs and community health seeking behavior for mental illness. 

Further, the Mental Health Care Act, 2017 says that the government shall take all measures to ensure that the government officials including police officers and other officers are given periodic sensitisation and awareness training.

According to a statement, there are 40 state-run mental health institutions in the country. Also, three central mental health institutions — National Institute of Mental Health and Neuro Sciences, Bengaluru, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur and Central Institute of Psychiatry, Ranchi have been strengthened for augmenting the human resources in the areas of mental health and to provide quality mental health services in the country.

Further, with a view to increase the number of qualified mental health professionals in the country, the government, under the NMHP, is implementing manpower development schemes for establishment of Centres of Excellence and strengthening/establishment of post graduate  departments in mental health specialties.

The ministry of health and family welfare regularly reviews and monitors the functioning of the three central mental health institutions and the institutions supported under manpower development schemes of NMHP.

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