As World Health Day has depression as its core theme, Dr Achal Bhagat highlights four categories of mental health problems common in India
Mental health is not just an absence of mental illness. This subjective sense of well-being is possible when a person is able to think and feel in a manner that helps one accept and balance one’s strengths and limitations.
Mental health is a universal need. Many people live with mental disorders or illnesses. It is important to recognise the universality of mental health needs. If every one has mental health needs then it is not out of ordinary for some to have mental illnesses. Recognition of mental health needs decreases the stigma for mental illness.
There are nearly two hundred types of mental illnesses. It means that one or more processes of brain are disordered. These processes include behaviour, thoughts, mood, perception, cognitive functions and insight.
Most of these impairments of mental functioning are presented as behavioural difficulties and difficulties in social functioning. There are broadly four categories of mental health problems common in India.
Substance Abuse Disorders: These are disorders include addiction to substances like alcohol, cannabis, opiates and stimulants. Of these the most common are addiction to nicotine. Nearly 21 per cent people in India smoke or use tobacco.
Major Psychiatric Disorders: These are disorders of thoughts, perception, and mood. Many a time these disorders results in loss of contact with reality. These disorders may need to a gradual deterioration of personality and functioning. It cause significant distress, disorganisation and dysfunction. This makes up nearly two per cent of the population in India.
Minor Psychiatric Disorders: These disorders are common. They nearly form another four to six per cent of the population. These include unreasonable worry, repetitive doubt and indecision, persistent low mood, pre-occupation with physical symptoms.
Organic Disorders: These are disorders where the cognitive functions are more likely to be affected. There may be a structural change in the brain. There may be a metabolic change in the body that leads to a disordered mental functioning or there may be primarily a physical illness causing the disorder of mental functioning.
Common mental health issues
Disability Adjusted life Years
DAlYs are the sum of the number of years lost due to premature death and the years of life lived with a disability. The DAlYs due to neuropsychiatric disorders in India are significantly high and are higher than disability adjusted life years contributed to by cardiovascular illness, cancer, tuberculosis and diabetes.
About half the disability-adjusted life years are contributed to by health conditions and out of these nearly fifty percent are caused by neuropsychiatric disorders.
The commonest cause of disability amongst psychiatric disorders is Unipolar Depression followed by Bipolar Affective disorder and Schizophrenia. Even the common mental disorders like Generalised Anxiety and Obsessive Compulsive Disorder cause significant loss of life years due to disability.
Mental Health Resources
The current mental health resources in terms of psychiatric beds are abysmally low and with in that too most of the beds are available in mental hospitals. General Hospital Psychiatric beds are low and are limited to Medical Colleges. District level Hospitals do not have any or have minimal number of psychiatric beds. India has a total of around 20,000 beds for mental illness. The country hopes to reach its vast population through a District Mental health Program.
Dr Achal Bhagat, Senior Consultant Psychiatry and Psychotheraphy, Indraprastha Apollo Hospital