World mental health day 2009

Courtesy to Dr. Samir Parikh, Max Health Care

       From faith healers, voodoo sciences, to psychoanalysis and Freud, and then to the anti-psychiatry movement, to now mental health as a medical science, psychiatry has gone through most ups and downs as compared to any other medical field. Even today, after mental health worldwide is an established medical sciences going through more advances and changes, the level of mental health care in developing countries is still poor. Stigmatization, discriminations, human right violations, lack of comprehensive care to most parts of the country, a lack of awareness about mental health, makes early treatment initiation a handicap, thus making it very difficult for the sufferer. I believe that denial of treatment to a patient, due to lack of awareness, or due to misinformation is also a violation of his human rights and needs to be seen with concern.

There has been an increase in self-proclaimed experts in the filed of mental health, from Gurus, to agony aunts, to media personalities solving others problems. What this does is to create all the more misconcepts related to psychiatry and psychology, that a famous person, or just anyone for that matter, could be a good counselor.


For skin problems one visits a dermatologist, for children a pediatrician, and for child birth a gynecologist. Its time that the educated, aware Indian realizes the role of the right expert in the field of mental health. To consult a psychiatrist for psychological, emotional and clinical problems is the key to problem solving.

The way ahead is also for the mental health expert to create more awareness about the field, its implications and services, and make it available to the society at large, and to educate about mental health issues to promote healthy living styles for well-being, effective coping for stress and problems, and scientific correction of illness.


The WHO estimates that at any one time, as many as one person in four in the world’s population suffers from different forms of mental, behavioral, and neurological disorders, and stress-related disorders.

More than one and a half billion people worldwide are estimated to be suffering today from some kind of psychiatric or behavioral disorder, including those related to the abuse of alcohol, illicit drugs, and tobacco. A third of the affected people suffer from more than one of these ailments. Three quarters of those affected live in developing countries. No more than 1 percent of people with mental disorders become psychiatric patients. Only this tip of the iceberg is dealt with by health services. The rest remain an invisible majority. And this ratio is even less in India.

At present, if we look at the Indian scenario we need to keep in mind the population of our country and the fact that maximal population resides not in the metropolitan cities but in the smaller cities, towns, and villages. Surveys have clearly reflected the predominant availability of mental health professionals – psychiatrists, psychologists, psychiatric social workers – in metropolitan cities. Thus there is a glaring disparity between the availability of mental health services in the larger cities and those available in other parts of the country; there is a 330% shortage of psychologists and a 200% shortage of psychiatrists in our country.

This year the theme of the World Mental Health Day is “Mental Health in Primary Care: Enhancing Treatment and Promoting Mental Health”.

The integration of mental health services within the purview of the primary health care setting be initiated. It is felt that this integration of services would help align diagnosis, treatment, care, and rehabilitation of the individual. This would also help ensure that the same amount of significance is accorded to both these aspects of overall health and the associated stigma is also alleviated with the passage of time. Furthermore, there is an understanding that both mental and physical health have a reciprocal interaction and influence each other. In our country, the maximum numbers of people tend to reach the general practitioners and medical professionals who work at the grassroots level. It is thus important for us to impart skills and competencies along with a good understanding to identify mental health related problems and provide the first line of treatment to the general practitioners who are working in the field of medicine. The recognition of the need for integration of services is particularly applicable within the context of a large and populous country like India, where due to the paucity of professionals there are millions of people who are not receiving the treatment that they urgently require. A step in the direction of integration would be beneficial to all – patients, their families, medical professionals, mental health professionals, non medical and non-governmental organizations working in the field for the promotion of the overall health and well-being of the individual and thus the community at large.

The end of the twentieth century has brought much progress in all fields of science related to mental health. Nevertheless, many challenges remain in these areas and they need to be overcome.

Mental health needs to be given its due importance by governing bodies, health care systems and the community at large.

Funding by government in health budget needs to be redefined as for mental health, and the private sector also needs to take in initiative. Its important to realize that in terms of morbidity, and cost burden on the society is very high due to metal illness. And this makes it very important for the society to realize the importance of a comprehensive care system for all populations of the society.

There is a significant difference between the profile of patients approaching psychiatrists in the urban, and rural areas, and there is a need to increase both the accessibility, and availability of mental health professionals to the population.


But one of the most important elements here is media. Education by media related to mental illness, and psychiatry can make a significant difference. Media is a powerful tool of education that can force change.

The definition of health, as given by WHO, includes physical, psychological, social, and emotional well being, three out of the four parameters are of mental health and in absence of a focus on psychiatry, this health cannot be given to the population.


October 10th, is World Mental Health Day, Its time we all put our individual and collective efforts to enhance the well being of our society.