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Mental health and depression have been crucial topics during the pandemic and lockdown, but Budget 2021 shows that Mental Health is not a priority for the government.
According to the World Health Organisation (WHO) the ongoing COVID-19 pandemic has increased the global burden on health care, and disrupted critical mental health services in 93 percent of the countries globally. On 10th October 2020, World Mental Health Day, WHO highlighted the urgent need to increase investment in the chronically underfunded sector of mental health.
In the latest India Budget 2021, an increase in overall health care expenditure by 137% has been indicated and is noteworthy, but sadly there has been no indication of any allocation or increase of funds for Mental Health Services. One of the six pillars on which this budget was placed is inclusive development for aspirational India, however it was disappointing that the Finance Minister’s speech didn’t even mention ‘mental health’.
Along with death and illness the pandemic and the resulting lockdowns led to isolation, social strife, economic uncertainty and fear of the disease. This caused an alarming rise in instances of stress and anxiety among all age- groups. This was the reason why in 2020 mental health and emotional well-being became topics of discussion everywhere. However, this focus did not translate to policy in the budget.
Several countries like the UK now measure their national rate of well-being. New Zealand is the first country that designed an entire budget focused on well-being and mental health in 2019. They allocated the biggest funding and investment for frontline service for mental health and suicide prevention.
Dr. Satendra Singh, Disability Rights Activist, has tweeted –
WHO statistics indicate that about 7.5 per cent Indians suffer from some form of mental disorder, 56 million suffer from depression while 38 million have anxiety disorders. India has 36.6 per cent of share in death by suicides globally. These numbers should have been prompting enough to focus more on mental health than ever before.
COVID-19 has had a further significant effect on people’s mental health and has revealed the serious treatment and access gaps in our mental health system. Our services are now stretched further than ever. Another factor is that all frontline workers engaged in pandemic services for almost an year now might also require some amount of psychosocial care and support now.
The Ministry of Health and Family Welfare’s expenditure towards mental health is indicated to be INR 597 crore, but 93% of it is towards just 2 institutions (Department of Mental Health education NIMHANS and Lokpriya Gopinath Bordoloi Regional Institute of Mental Health) and only 7% towards the National Mental Health Programme that is meant to ensure availability and accessibility of mental health services for all.
Graphic source: Centre for Mental Health Law & Policy
This allocation is unequal and skewed. Where the Atmanirbhar Swasth Bharat Yojana focusses on developing capacities of primary, secondary, & tertiary care health systems, the key component of primary mental health care stands neglected.
An issue relevant to accessible and available mental health care is the tremendous shortage of mental healthcare workers at all levels in the country.
The average availability of psychiatrists in India is 0.75 per 100,000 people and it is variable across the states. It ranges from 0.05 per 100,000 people in Madhya Pradesh to 1.2 per 100,000 in Kerala. Majority of these concentrated in the Tier 1 cities, leading to almost no access to mental healthcare in smaller cities, towns or rural areas. This ratio in some countries in the West is up to 6 psychiatrists per 100,000 people, higher than the global recommended average of 3 psychiatrists per 100,000 people.
India produces only about 700 new psychiatry-graduate per year, this is clearly not even enough to maintain the current average, let alone increasing it. Training and education facilities for mental health professionals, Mental Health social workers, Mental health first-aiders also remain abysmal and the budget doesn’t address this.
WHO data indicates that India will suffer economic losses of a staggering 1.03 trillion due to mental health between 2012 and 2030. Education has suffered in the pandemic year with further cuts in the education budget, along with working mothers who have had to cope between work, housework, care work, family relationships, and overseeing the education of children at home; non-earning mothers haven’t fared much better. Mental health is at an abysmal low.
Policymakers need to take into account this socioeconomic impact of mental health on the economy and society. There needs to be investment in creating awareness, education and accessible infrastructure.
Budget 2021 cannot be truly inclusive without including mental health as a key component. Mental health services need to be prioritised and made as priority of COVID-19 recovery planning and long-term economic agenda.
Image source: YouTube & ArmOrozco on pixabay
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Pooja Priyamvada is a columnist, professional translator and an online content and Social Media consultant.
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