The current coronavirus pandemic in India has brought the issue of mental health to the fore. According to a 2020 paper, Covid-19 has fuelled ‘infodemia’ and has created ‘coronaphobia’, which results in anxiety, fear, depression, increased substance-dependence, and PTSD.

Yet another research paper points out that there are a rising number of patients with COVID-19 who have been reported with mild (anosmia and ageusia) to severe (encephalopathy) neurological manifestations too. Some of the most vulnerable categories include older people, health care providers, caregivers, and psychiatric patients who need special attention.

According to the National Institute of Mental Health and Neuro-Sciences (NIMHANS), the leading national institution of education and healthcare in the field of mental health and neurosciences:

“Persons with pre-existing mental illnesses and substance use are particularly disadvantaged during the lockdowns. For persons with mental illness or epilepsy, reduced access to medication can lead to relapse of symptoms, as can the compounded stress.”

Need for mental health support on the rise

In an online survey conducted by Roy et al (2020), among 662 participants, perceived mental healthcare need was seen in more than 80 % of participants.

Chatterjee et al conducted a study with 152 health care professionals and found out that 34.9% were depressed and 39.5% and 32.9% were anxious and stressed, respectively.

There is also a fear about post corona economy, as many people stare at uncertain job futures and face sustenance challenge. This context has resulted in the need to relook at how mental health services are seen in India.

Lack of adequate services

The most important player in providing mental health care in India is the government. However, at present, these services are inadequate. It’s shocking to note that India spends less than 2% of its annual health budget on mental health (Mahajan et al 2019).

The WHO country office for India estimates the burden of mental health at 2,443 DALY (Disability Adjusted Life Years) per 100000 population, and age adjusted suicide rate at 21.1 per 100000 population. The mental health workforce in India currently is comprised of 0.3 psychiatrists, 0.12 nurses, 0.07 psychologists, and 0.07 social workers per 100000 population.

Due to meagre budget allocation in the mental health sector by the Government of India, a comprehensive cadre of mental health professionals is not available. Even after the enactment of the Mental Healthcare Act 2017, not enough was done to set up new Mental Health Establishments and upgrading mental health service. However, the COVID-19 epidemic has brought some much needed spotlight on the sector.

The tragic suicide of young and talented actor Sushant Singh Rajput during the lockdown triggered widespread public conversation on mental health in the country. There is a nascent movement which has emerged (mainly through social media channels) to acknowledge the struggles of people who are already facing mental health difficulties and the need to fill the gaps in the mental health infrastructure in the country.

Initiatives on mental health

There are many noteworthy initiatives by civil society organisations and social work academia in the field of tele-counselling services. Sangath (an NGO in India) in collaboration with the Harvard Medical School and Welcome Trust have launched a campaign named Its Ok to Talk (http://itsoktotalk.in/), mainly to address the mental health issues of adolescents and young people through online awareness and service provisioning.

The Indian Government through NIMHANS is offering a toll free number for mental health services for the people across the country. The service provides access to psychiatrists and mental health professionals to all individuals seeking clarification on COVID-19 and also psychological support. The University Grants Commission (2020) issued a directive to all educational institutions to provide psychosocial support to students during the COVID-19 crises scenario.

Tata Institute of Social Science (TISS) also provides psychosocial support through its helpline as part of their ‘i-call’ program (http://icallhelpline.org/) where professionals are trained to attend crises and provide referral services.

Some other schools of social work also have initiated helplines in this context. Thus, there has been some momentum in the development of mental health services in the wake of COVID-19.

The way forward

Voluntary organisations can take a lead in this: organising awareness campaigns on mental health and psychological distress; engaging in advocacy for establishment of new mental health institutions and upgrading mental health service; setting up tele-counselling units, etc.

India, given its demographic dividend, needs to create the right conditions for adolescent and youth interventions. Efforts in that direction must be integrated with the Rashtriya Kishor Swasthya Karyakram (National Adolescent Health Program), which has components such as outreach by counsellors, facility-based counselling, social and behavioural change communication.