During a visit to Tender Minds psychiatric clinic on a summer afternoon, one of my colleagues was interested in interviewing Dr. Attur, a physician who specialized in child psychiatry and had previously introduced the psychiatry profession during a global health lecture at the Public Health Research Institute of India (PHRI). While on a tour around the clinic, I encountered Dr. Dr. Krishna K.R., who specializes in Adult Psychiatry. While my colleague was interviewing Dr. Attur in private, I had the opportunity to have a conversation with Dr. Krishna and discussed some of the issues regarding mental illness that occur in India.

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Dr. Krishna believes key challenges to addressing mental health needs include cost of services, shortage of professionals, availability, low capacity to provide quality services and the stigma associated with a mental disorder. There are 1-3 psychiatrists available for every 100,000 people and at least 1 out of 10 individuals are left untreated (Attur, R., 2017). Sometimes people may have to travel over 10 km to reach a center that has mental health services available. The low capacity to provide the quality service necessary is affected due to the great number of citizens in need of mental health and the shortage of professionals that are interested in working with these disorders. Lastly, stigma is one of the main key challenges to mental health care in India (Patel, V. 2007). Stigma that has been shaped by sociocultural factors can affect the health, welfare and quality of life of people with mental health problems (Patel, V. 2007). These key challenges support current research findings because over 50% of the cases go unreported, insurance do not cover mental disorders (Hindustan Times, 2016). The WHO Mental Health Atlas of 2011 states the government's expenditure on mental health was only 0.06% of the total health budget (Hindustan Times, 2016).

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Learning the unique Indian belief system is important to understand the differences associated with mental health across in a global context. Stigma against mental disorders have been part of the Indian culture for many decades. In the early years of the 20th century, mental illness was considered a criminal act and people would be taken to prison if they went to a hospital feeling suicidal (Krishna, K.R., 2017). According to the Indian society, a mentally disturbed person would be considered a disability, violent, a burden, or a weakness. In rural communities, schizophrenia or bipolar disorders are viewed as cases of evil spirits who possessed the individual. Most the cases, the member of the community would ignore the symptoms or be taken to a faith healer to “fix” the problem.

 

As previously mentioned, mental illness in India was considered a crime or disability. The Mental Healthcare Bill was recently passed, which focuses to protect and restore property rights of mentally ill persons (Attur, R., 2017). Every person will have the right to access mental health care that are funded by the government (Krishna, K.R., 2017). One of the features of the bill is that it seeks proper health-care, treatment and rehabilitation of mentally ill persons in a manner that does not intrude on their rights and dignity. Dr. Krishna believes this one of the first steps the government of India has taken into accepting mental disorders as a serious health concern that need immediate attention.

 

There are more opportunities for the community to have a role in addressing mental disorder. For example, Tender Minds is the only clinic in the city of Mysore that provides psychiatric services for children. Dr. Krishna (Adult Psychiatry) works together with Dr. Attur (Child and Adolescent Psychiatry) to provide resources and services to the mental health community. This clinic provides free services the first Wednesday of every month to every person, and they advertise the services though newspaper ads, websites, and physician referrals. These resources will help the community be more engaged and supportive of mental illnesses. Families can bring a relative or a friend to this clinic who need mental health care and are not able to afford it. The community can play a large role by supporting the individuals that need medical treatment while their symptoms are mild, instead of seeking medical care when their symptoms are severe.

 

Individuals like me can also play a role in making an impact on global mental health issues. Dr. Krishna states that we should try to understand more about mental illness by reading on a regular basis to stay informed on updated information. If there is someone close to us that has a mental illness, then it is necessary to provide support for them and treat them the same way as you would treat others. There should be no discrimination against people with mental illness that can contribute to the development of their environments. I believe this is a realistic way to play a role in addressing these issues as it is crucial to help these individuals realize their potential and the resources that are available for support. People should have awareness and an increase in knowledge regarding mental health issues to be applied in a global aspect.

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