Overview
Mental wellness is a major health concern worldwide. Mental health includes a person’s emotional, psychological and social well-being. It encompasses a wide range of issues, from clinically diagnosed mental disorders to substance abuse and addiction. Globally, ~800,000 people die by suicide each year (1 death in every 40 seconds), while over 264 million people (of all ages) suffer from depression.
Months of fighting a pandemic has drawn attention to the importance of mental health and India’s approach towards an often-ignored health issue. According to the WHO, at least 57 million people in India are depressed—the highest in the world. By 2030, the mental health crisis is estimated to cost India a trillion dollars in productivity losses. There are huge gaps in the preventive and curative care of these mental disorders. For instance, in India, mental health workforce comprises <4,000 psychiatrists. While the total healthcare budget increased by 7% in 2020, there was none in the budget for the National Mental Health Programme (the allocated amount is only 0.05% of the total healthcare budget). Current spending on implementing provisions of the Mental Healthcare Act, 2017, is a small proportion of the conservative estimate of 94,073 crore.
Mental Healthcare Act, 2017
The Mental Healthcare Act was passed in April 2017 and implemented from May 2018. The act effectively decriminalised attempted suicide, which was punishable under Section 309 of the Indian Penal Code. The law was described in its opening paragraph as an act to provide for mental healthcare and services for people with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto." This act superseded the former Mental Health Act, 1987.
The act ensures healthcare for people suffering from mental illnesses through government-funded health services. It decriminalises suicide, disallows sterilisation and solitary confinement of mentally unwell patients. The act entails setting up the Central and State Mental Health Authorities for training medical professionals. It also mandates insurance companies to provide mental health insurance.
Innovative Mental Health Programmes
In the last few decades, innovations have helped address gaps in the mental health service delivery in India. The innovative approach not only makes mental health services more accessible and affordable, but also empowers by encouraging community members in early detection & prevention of mental illnesses and appropriate treatment referrals. Most innovations can be broadly categorised into the following:
Categories |
Innovations |
Quality improvement in mental health programmes |
Use of WHOQR tool in Gujarat |
WHO's mhGAP in Kashmir |
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Mental healthcare pilots in Gujarat |
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Early interventions for psychosis in Tamil Nadu |
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Integration of mental healthcare models with primary and community care |
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Community-based mental health programmes |
A community-based rehabilitation programme for psychotic disorders in Madhya Pradesh |
Community mental health initiative in Tamil Nadu |
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Community-based mental health intervention for women in Karnataka |
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Community-based intervention for people with schizophrenia and their caregivers |
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Community mental health development projects in India |
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Dava–Dua project in Gujarat |
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Non-specialist mental health programme |
Atmiyata Intervention in Maharashtra |
Low-cost model for improving healthcare services in Kashmir |
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Health Activity Programme delivery by lay health counsellor in Goa |
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Lay health counsellor for brief psychological intervention in Goa |
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Programme for Improving Mental Healthcare (PRIME) in Madhya Pradesh (India) and four other countries |
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Mobile technology-based mental health programmes |
Mh2: Mobile for mental health in Gujarat |
Systematic Medical Appraisal, Referral and Treatment (SMART) mental health project in Andhra Pradesh |
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Digital technology (text and phone) for treating and preventing mental disorders in LMIC (including India) |
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Tele-mental health programmes |
Tele-psychiatry in Chennai, Tamil Nadu |
Mobile tele-psychiatry in Pudukkottai, Tamil Nadu |
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Tele-mentoring programme—NIMHANS ECHO in Chhattisgarh |
Corporate Scenario
The pandemic has also brought mental well-being to the forefront, even at workplaces in India. However, only 1,000 companies are estimated to have a structured employee assistance programme (EAP) for mental health, out of 1.1 million active registered companies, according to Optum Health International (a leading EAP service provider under the Minnesota-based UnitedHealth Group).
An EAP typically includes both preventive (workshops & awareness programmes on mental health) and counselling services (telephonic, face-to-face or online chat) for employees and their families.
Mental health disorders have a significant impact not only on the health of individuals and communities, but also pose economic challenges for corporates in terms of productivity losses. The WHO points out that for every $1 invested in treating common mental disorders, there is a $4 return in improved health and productivity; hence, it makes sense for corporates to foster employee mental wellness—not just from an ethical perspective, but also economical.
With a sizable population working from home, some corporates are making efforts to create a safe environment for employees to freely talk about their worries and anxieties. Many of them offer free counselling services through tie-ups with external service providers. Corporate houses such as JSW Group, Capgemini India and Mahindra & Mahindra have EAPs including free counselling to employees and their families. Oyo, Uber, Google, Mondelez, American Express and Panasonic are a few companies in India providing similar services. According to Optum Health International, the number of companies seeking EAP or mental health programmes has increased by 45–55% YoY.
Preventive measures that can be taken by corporates:
The Road Ahead…
Given the rising incidences of mental health issues, corporates must have mental health policies. Only a few companies are found to be practicing it at present. Such policies should entail creating awareness or reducing stigma around mental health as well as providing access to mental health services. Interventions should be designed as part of an integrated health and well-being strategy including prevention, early identification, support and rehabilitation. Corporates should foster healthy lifestyle practices including exercise, proper nutrition, work–life balance and yoga & meditation that are known to improve mental health.
India is gradually moving towards the mental health epidemic; hence, it is important for corporates to support employees and invest in programmes for emotional well-being. Corporates will play a crucial role in our society’s overall mental well-being as much of our time and energy is spent in the workplace. The workplace is often the source of stress, but it can also be the source of solution.