Great depression

The time has come to take mental health out of the asylum. New World Health Organisation figures show that by 2020, after cardiovascular diseases, depression is likely to be the biggest health problem facing the world.

It currently affects 120 million people worldwide and is shown to be the primary cause of disability. However, less than 25 per cent of sufferers have access to treatment, although research shows that primary care can be very effective. In the Indian context, we might conjecture that depression is not even accepted as a form of illness in most quarters.

It has taken us years to come out of our social distaste for all forms of mental illness. People with psychiatric or psychological disorders are either forgotten in mental asylums or denied treatment altogether. This social stigma adds to the disability in India and creates a hidden medical cost.

The figures from the WHO should act as a wake-up call and it is heartening that the Maharashtra government has asked the Centre for Rs 120cr to upgrade the mental health hospitals at Thane and Yerwada. The figures for mental health in India are dismal — there are only about 3,000 practising psychiatrists in India, of whom 300 are in Mumbai. The numbers are scarcely enough for a country of one billion people and for a slew of diseases which affect so many.

As much as government has to take action to treat depression, society must also play a part. The reluctance to treat mental diseases and the shyness about them must vanish. Indian society tends to put an unfair emphasis on marriageability, for instance, and so mental health concerns must take second place to that. This is cruel and dangerous.

In the United States, it is estimated that one in 20 people above the age of 12 suffer from depression. In the UK, the cost of mental health to the economy is about 100 billion pounds, and even in both those advanced societies, access to medical attention for depression is hard to come by.

Our focus has so far been on physical disease, mainly because its symptoms are immediately visible. But apart from the tremendous suffering that mental health patients go through — which can lead to physical disability —  and the pressure on their families and support groups, there is also the strain that society bears by carrying so many unproductive victims along. Access to mental health care can reduce these burdens significantly.

In this changing world, it is time to move ahead to a better understanding of human frailties and use our progress to treat all diseases on an equal footing — mental and physical both. That would be a sign of true civilisation.