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#WorldHealthDay: WHO endorses PM Narendra Modi's 'Mann Ki Baat' speech on depression and mental health

The World Health Organisation has praised India for passing the mental health bill, but says it's important for everyone to talk

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Four days ago, Arjun Bharadwaj, an engineering student, jumped off a window at the Taj Land’s End hotel in Mumbai. Before taking the fatal step, Bharadwaj said that he was depressed and shared a Facebook video where he demonstrated what he called ‘a suicide tutorial’ where he smoked, drank, and said that it was nobody’s fault.

On Thursday, Humans of Bombay shared the story of comedian Anmol Sachar, who spoke of how he came out of depression, which was a culmination of anxiety and Obsessive Compulsive Disorder (OCD). “I know a lot of times these will seem like empty words, but if you’re undergoing depression you’re not alone… it will get better. You’re hearing it from someone who’s been there for 8 years…I hit rock bottom for that long and got out of it. Hold on a bit longer, talk to your loved ones and know that there will be one day when the switch will happen and you will be happy again…you will learn to love yourself again,” he said.

Between these two stories, the World Health Organisation has reported that more than 300 million people are now living with depression in the world, an increase of more than 18% between 2005 and 2015.

Speaking to DNA, Dr Henk Bekedam, the World Health Organisation representative to India, said that 56 million Indians suffered from depression in 2015. “That is 4.5% of the country’s population,” he added.

According to the National Mental Health Survey of India, 2015-16, conducted by the National institute of mental health and neurosciences (NIMHANS Bangalore), the prevalence of depression among the urban working population was found to be 7.07%; with a lifetime prevalence of 13.13% “Work conditions like poor work life balance, stress about the job role, and also many internal issues like low self-esteem leads to disturbed mental- framework which also impacts the productivity of the employee,” said Rajesh Mundra - Founder & CEO Truworth Wellness, a digital wellness company based out of Mumbai.

Urgent need for increased investment in mental health

In a March 31 release, the WHO said that on an average, just 3% of government budgets are invested in mental health, varying from less than 1% in low-income countries to 5% in high-income countries.

Citing the advantages of investing in mental health, WHO said that for every $1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work.

Four days prior to the WHO press release, the Lok Sabha in India passed the Mental Health Bill and decriminalised suicide attempts. Describing it as patient-centric, Union Health Minister J P Nadda said the Bill provides for the right to better healthcare for people suffering from mental illnesses. It also focuses on community-based treatment and provides for special treatment for women.

“The Bill seeks to ensure health-care, treatment and rehabilitation of persons with mental illness “in a manner that does not intrude on their rights and dignity,” Nadda said in the Lok Sabha, just before it was passed by the House by a voice vote.

In his March 'Mann Ki Baat' speech, India’s Prime Minister Narendra Modi highlighted the need to recognise depression and spoke on the importance of people suffering from depression to talk about it. This speech wasn’t unnoticed by the WHO and Dr Bekedam praised the prime minister. “The theme this year is 'Depression: Let’s Talk' and it brings forth an opportunity to focus attention on mental health issues, especially depression, which is the single largest contributor to global morbidity,” he said.

While the thinking is progressive, facts state that only one of 10 individuals in the country gets treated for mental health. There are 0.3 psychiatrists per 100,000 people in India, according to a 2016 Lancet report. "India has 443 public mental hospitals, but six states, mainly in the northern and eastern regions with a combined population of 56 million people, are without a single mental hospital, whereas other states have several mental hospitals. NGOs that provide mental health services are also concentrated in the southern and western regions of the country," the report added.

The road ahead

As the WHO says, talking is the first step to getting treated. “Medication, depending on the extent of mental health, is necessary, but the root cause may still persist unless you don’t talk about it,” says Mundra, adding that physical activity such as exercise plays a role in releasing endorphins, dopamine and serotonin that lift an individual’s mood.

While the passing of the Mental Health Bill is a step taken in the right direction, the government needs to invest more in the field and it needs to start by specifying how much money India will spend to ensure proper expenditure for mental health. While the amount for the 2017-18 budget has not been determined, we can assess the general perception towards mental health to a 2014 Human Rights Watch report. As per that report, the 2011 Census data estimates that only 2.21 percent of the Indian population has a disability – including 1.5 million people with intellectual disabilities and a mere 722,826 people with psychosocial disabilities. However, the Indian Ministry of Health and Family Welfare claims over 6-7 percent of the population has psychosocial disabilities alone."Yet just 0.06% of India’s federal health budget is devoted to mental health and available data suggests that state spending is similarly negligible," the report said.

If we are to ensure mental health in India is taken seriously, we need to increase the health budget to focus on treating the 55 million people suffering in our country. Treatment here includes medical availability and sessions to counsel family and society to be more sensitive towards individuals who suffer.

It's time to break the culture of silence around mental health issues and start talking.

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