Mental Health – Issues and Challenges

Why in News?

Recently, the World Health Organization (WHO) report revealed that, more than 1 billion people are living with mental health disorders.

What is mental health?

• Mental health – The World Health Organization (WHO) defines mental health as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
• Mental health is a public and global health topic that is not discussed as much as physical health.

• Causes

• Issues – The issues and impacts of mental health are
  • Impacts everyone – Mental health conditions adversely affect people of all ages and income levels.
  • Reason for disability – They represent the second biggest reason for long-term disability, contributing to loss of healthy life.
  • Increases health care costs – They drive up health-care costs for affected people and families while inflicting substantial economic losses on a global scale.
  • Transforming mental health services is one of the most pressing public health challenges.
  • Stigma and reluctance – The hesitancy to seek help and treatment and lack of manpower remain the major concerns in the sector.
• Lifestyle components

What are the key findings of the report?

• Report – The new findings published in two reports
  • World mental health today
  • Mental Health Atlas 2024
• These highlight some areas of progress while exposing significant gaps in addressing mental health conditions worldwide.
• Status of women – The report shows that while prevalence of mental health disorders can vary by sex, women are disproportionately impacted overall.
• Anxiety and depressive disorders – These are the most common types of mental health disorders among both men and women.
• Suicide – It remains a devastating outcome, claiming an estimated 7,27,000 lives in 2021 alone.
• It is a leading cause of death among young people across all countries and socioeconomic contexts.
• Despite global efforts, progress in reducing suicide mortality is too low to meet the United Nations Sustainable Development Goal (SDG) of a one-third reduction in suicide rates by 2030.
• On the current trajectory, only a 12% reduction will be achieved by that deadline.
• Economic impact – While health-care costs are substantial, the indirect costs – particularly in lost productivity – are far greater.
• Depression and anxiety alone cost the global economy an estimated $1 trillion each year.
• Global Efforts – The 2024 Mental Health Atlas found that since 2020, countries have been making significant strides in strengthening their mental health policies and planning.
• The report states that most countries have functional mental health promotion initiatives such as early childhood development, school-based mental health and suicide prevention programmes.
• Over 80% of countries now offer mental health and psychosocial support as part of emergency responses, up from 39% in 2020.
• Outpatient mental health services and tele-health are becoming more available, though access remains uneven.
• Measures to be taken – The WHO has said that, greater investment and action are needed globally to scale up services to protect and promote people’s mental health.
• The findings also underscore the urgent need for sustained investment, stronger prioritization.
• Multi-sectoral collaboration to expand access to mental health care, reduce stigma, and tackle the root causes of mental health conditions.

What are the flaws in the mental care environment?

• Absence of legal reforms – While many countries have updated their policies, adopted rights-based approaches, and enhanced preparedness for mental health and psychosocial support during health emergencies, this momentum has not translated into legal reform.
• Countries remain off track to achieve the targets set in WHO’s Comprehensive Mental Health Action Plan.
• Fewer countries have adopted or enforced rights-based mental health legislation, and only 45% of countries evaluated laws in full compliance with international human rights standards.
• Reduced investments – The report reveals a concerning stagnation in mental health investment.
• Median government spending on mental health remains at just 2% of total health budgets, unchanged since 2017.
• Disparities in investments – While high-income countries spend up to $65 per person on mental health, low-income countries spend as little as $0.04.
• Less availability of mental health experts – The global median number of mental health workers stands at 13 per 100,000 people, with extreme shortages in low- and middle-income countries.
• Less Reforms and development of mental health services – Fewer than 10% of countries have fully transitioned to community-based care models, with most countries still in the early stages of transition.
• Inpatient care continues to rely heavily on psychiatric hospitals, with nearly half of admissions occurring involuntarily and over 20% lasting longer than a year.
• Integration of mental health into primary care is advancing, with 71% of countries meeting at least three of five WHO criteria.
• Gaps in data – Only 22 countries provided sufficient data to estimate service coverage for psychosis.
• Lack of care – In low-income countries fewer than 10% of affected individuals receive care, compared to over 50% in higher-income nations, highlighting an urgent need to expand access and strengthen service delivery.

What is India’s status on mental health?

• Progress made – There has been significant infrastructure development, the national tele-mental health programme has expanded.
• The educational development is happening at a fast pace and focused work is being done to create awareness about mental health and the treatment.
• Insufficient budget – India’s direct mental health budget has remained at roughly Rs.1,000 crore for recent fiscal years, with FY 2025-26 allocating Rs.1,004 crore.
• This constitutes just over 1% of the Ministry’s budget, with significant portions going to central institutions and programmes.
• Adequate funding for community-based programmes and the effective utilisation of allocated funds is still a concern.
• Lack of experts – India has a significant shortfall of mental health professionals, with roughly 0.7 psychiatrists per 100,000 people, far below the WHO’s recommended ratio of 3 per 100,000 people.

What is the way ahead?

• Governments and global partners could urgently intensify efforts toward systemic transformation of mental health systems worldwide.
• Equitable financing of mental health services, legal and policy reform to uphold human rights, can be carried out.
• Sustained investment in the mental health workforce and expansion of community-based, person-centered care could be done.

If you are in distress, please reach out to MANAS at 14416 or 18008914416 and Sanjivini Society for Mental Health at 011-40769002

Reference

The Hindu| Mental health