Introduction
India was the first non-white independent country after colonialism to implement mental health reforms, reads a study published in the International Journal of Mental Health Systems. (Sanjeev Jain, 2014) Since 1947, the Indian government has undertaken many measures in the form of national and district-based mental health programs to provide people with affordable and accessible mental health services. Despite having varied strategies on paper and the distinction of being the first third-world country to implement mental health reforms, the lack of adequate finances for the mental health sector has remained consistent since then. Officials’ lack of commitment to effective policy execution weakened the government’s inadequate base for dealing with public mental health challenges. The budgets have constantly disappointed people for their lack of satisfactory focus on mental health, and as a result, the relevance of psychiatry as a medical specialty has not been evident. Despite a brief reference to mental health, the budget for 2022 has also not significantly changed.
Does the budget present better prospects for mental health in the near future?
The Budget 2022-2023 has become the highlight of discussions on mental health because of its subtle mention of mental health, which has turned into a debatable issue with major divisions forming between its proponents and critics. On the positive front, the Indian government, as part of the group of developed and developing nations, which have recognized the alarming trend of mental health issues post-pandemic, has intervened quickly by putting mental health on the budget. For example, the initiatives like digital health and a national telehealth program look promising since it has shown, to some extent, that mental health is somewhere there in the minds of the people making up the ruling government. However, on the negative front, despite a 16.6% increase in the total healthcare allocation in this year’s budget, the year-on-year increase in funds allocated to mental health was only 12.22% (approx. ₹670 crores vs approx. ₹597 crores) with its proportion in the healthcare budget dropping from around 0.8% to around 0.77%. Furthermore, all of the additional mental health funding has gone to centrally supported mental health institutes, with no additional funds going to the government's National Mental Health Programme (NMHP), an article on Business Insider notes. (Kapoor, 2022) As a result, without more financing in the budget, this extra launch of the teleconsultation program and digital health will add to the complexity of already existing services, as there is a lack of clarity concerning further funding provisions. The funding aspect was quite similar in the year 2020 as well. While the total healthcare budget increased by 7% in 2020, the funding for the national mental health program did not increase in tandem; the authorized amount was only 0.05% of the total healthcare budget. (Mathur, 2020) And also, for a project like Digital Health to succeed, there must be mechanisms in place to bridge the digital divide which exists in India. Unsurprisingly, India is not a country with a 100% digital literacy rate. So, more research is required than simply putting the policies on the document because any policy that does not address the public factor is simply a flawed short-term plan for the long-term consequences, and so a failure. It’s already unfortunate that it took the pandemic to bring mental health to the forefront, for example, the Indian Psychiatry Society reports a 20% rise in mental illnesses case since the pandemic began, (Niazi, 2021)and that, efforts are still inadequate in light of the huge part of the population impacted by mental health concerns. Furthermore, the fact that India's mental health crisis would cost the country a trillion dollars in lost productivity, argues for more meaningful and realistic measures to be taken by the government which can be implemented. The challenges in India are not merely financial; they also include significant but often disregarded issues such as a dearth of human resources in the field of psychiatry and a meager number of people choosing psychiatry as a medical specialty.
According to a study published in the Indian journal of psychiatry, there are only 0.75 psychiatrists per 100,000 people in India, which is way below the recommended level of at least three psychiatrists per 100,000 people. (Jakhar, 2022) These issues should also be taken into consideration while designing a policy so that we can have enough specialists to provide the services. Otherwise, the demand-supply relationship will stay unbalanced, preventing individuals from receiving appropriate mental health care.
Given the dismal success rate of mental health policies, it is reasonable to conclude that these policies are merely conceived without regard for the challenges that must be addressed for them to be effective. To put it another way, the policies require a better design that includes community participation so that people can understand and benefit from the policies. This puts to light one of the most overlooked issues in a policy design: a lack of awareness, which limits people's engagement in policies.
To begin, the government should establish a nationwide mental health literacy campaign. Other healthcare professionals should also be educated as part of the campaign to ensure quick recognition of symptoms. Furthermore, mental health programs should strive to incorporate lessons learned from other effective government programs around the world and implement necessary legislative changes. It should not be a slavish imitation but rather should be designed in such a way that it reflects the needs and aspirations of Indian society, an article on Business Insider suggests. For example, we can learn from the Australian National Mental Health Strategy that focuses more on community-based care rather than the institutional level of care thereby successfully reducing the need for in-patient care requirements in recent years. (Kapoor, 2022)
Given that India bears almost 15% of the world’s overall mental health burden, much more needs to be done to battle the problems, and its efforts must be matched to the extent of the problem. It is critical to build on the momentum that has been generated and focus on meaningful policy measures aimed at satisfying short-term needs while also developing long-term capacities, an article on Business Insider notes. (Kapoor, 2022)
Article published in the International Journal of Mental Health Systems, Nadja van Ginneken, Sanjeev Jain, Vikram Patel, and Virginia Berridge, 16 July 2014, the development of menta health services within primary care in India: learning from oral history, https://doi.org/10.1186/1752-4458-8-30
Article published on Business Insider, Charu Sehgal and Harsh Kapoor, Feb 10, 2022, India has taken a much-needed step towards mental health reforms, but it will be crucial how it builds on the momentum, https://www.thehindu.com/sci-tech/science/inhaling-polluted-air-can-lead-to-brain- damage/article32531724.ece
Article on The Hindu, Atish Mathur, November 30, 2020, Mind over matter: India’s mental health policy, https://www.thehindu.com/brandhub/mind-over-matter-indias-mental-health-policy/article33212760.ece
Article on AA, Shuriah Niazi, October 10, 2021, Coronavirus pandemic exacerbates India’s mental health crisis,https://www.aa.com.tr/en/asia-pacific/coronavirus-pandemic-exacerbates-indias-mental-health-crisis/2387887
Article on ET Government, Dr Jitender Jakhar, February 08, 2022, Mental health budget in 2022-23: There is hope, but the mind craves more, https://www.thehindu.com/brandhub/mind-over-matter-indias-mental-health- policy/article33212760.ece
Article on The Diplomat, Harshita Rathore, March 21, 2020, how committed is India to mental health? https://thediplomat.com/2020/03/how-committed-is-india-to-mental-health/
Article on the Financial Express, Prof Bejon Kumar Misra, May 20, 2021, India can do more to provide better mental healthcare services to its citizens, https://www-finncialexpress com.cdn.ampproject.rg/v/s/www.financialexpress.com/lifestyle/health/india-can-do-more-to-provide-better mental-healthcare-services-to-its-citizens/
References
1. Jakhar, D. J. (2022, February 08). Retrieved from ET Government: https://government-
economictimes-indiatimes-
com.cdn.ampproject.org/v/s/government.economictimes.indiatimes.com/amp/news/health
care/mental-health-budget-in-2022-2023-there-is-hope-but-the-the-mind-craves-for-
more/
2. Kapoor, C. S. (2022, February 10). Retrieved from Business Insider: https://www-
businessinsider-in.cdn.ampproject.org/v/s/www.businessinsider.in/india/news/opinion-
india-has-taken-a-much-needed-step-towards-mental-health-reforms-but-it-will-be-
crucial-how-it-builds-on-the-momentum/
3. Mathur, A. (2020, November 20). Retrieved from The Hindu: https://www-thehindu-
com.cdn.ampproject.org/v/s/www.thehindu.com/brandhub/mind-over-matter-indias-
mental-health-policy/
4. Misra, P. B. (2021, May 20). Retrieved from Financial Express: https://www-financialexpress-
com.cdn.ampproject.org/v/s/www.financialexpress.com/lifestyle/health/indi-can-do-
more-to-provide-mental-helthcare-services-to-its-citizens/
5. Niazi, S. (2021, October 10). Retrieved from AA: https://www.aa.com.tr/en/asia-
pacific/coronavirus-pandemic-exacerbates-indias-mental-health-crisis/
6. Rathore, H. (2020, March 21). Retrieved from TheDiplomat:
https://thediplomat.com/2020/03/how-committed-is-india-to-mental-health/