The Indian Council of Medical Research (ICMR) has started working to develop a mechanism that ensures integrated interventions addressing the Non Communicable Diseases (NCDs) and mental health at all levels of healthcare delivery, especially at the primary care level. The move follows concerns that patients with mental disorders are at an increased risk of exposure to the chronic diseases and vice versa particularly post Covid-pandemic era.
This is for the first time that the Government has felt the need to invest in research in NCDs and mental health which was has long been overlooked whenever NCDs were discussed or seen as being separate.
To begin with, the ICMR is seeking proposals from researchers in this regard with an aim to offer integrated mental health care to reduce health burden due to mental disorders including substance use disorders and NCDs in India.
The researchers have also been asked to suggest ways to overcome the difficulties in integrating screening and treatment for mental disorders (anxiety, depression, psychosis and substance use disorders) with NCD care into all outpatients’ visits to health & wellness centres, primary health centres, CHCs and district hospitals.
A senior official from the ICMR explained the need for such integration as NCDs and mental health disorders take a toll on the population.
“In India, the burden of non-communicable diseases (NCDs) is huge. At the same time, patients with mental disorders also carry risk factors for NCDs like cancer and diabetes due to smoking, poor nutrition. In addition, people living with mental health disorders are less likely to seek healthcare and may be less able to adhere to treatment, with consequent adverse treatment outcomes, including morbidity, mortality, drug resistance and ongoing NCDs.”
The proposals have to focus on outcomes that are translatable into policy, he said.
Various recent studies have revealed that mental health and wellbeing are central to reducing the global burden of NCDs. Case in point is a study in 2019 in BMJ which noted that the strong associations and inter-related causal mechanisms of mental health disorders and other NCDs argue for a joint approach to care. Collaborative care has emerged as a key evidence based approach for integrating mental health care into primary care.
Moreover, say yet another study, “…the synergies across all NCDs including mental health mean it makes sense for governments to address the common risk factors and systems barriers to reduce premature and preventable suffering and death. “In alignment with target 3.4 of the Sustainable Development Goals (SDGs), “by 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being”, mental health must be integrated into the response to NCDs,” according to a Global Health Community of Global Innovators.