Stressed man / Photograph by Daniel Reche

Mental healthcare for the underprivileged

Access to adequate mental healthcare is difficult for many due to high costs. Prohibitive prices for counselling sessions make it available only to the socially and economically-privileged class of society. This calls for administrative attention for the introduction of new reforms in mental healthcare.

A person’s overall well-being is primarily associated with their mental health. During one of my cab rides, I conversed with the driver about how the recent pandemic has impacted our overall well-being. Ahmed Khan is a peppy young man in his late-20s, who has been in the driving profession for almost five years. Before the pandemic, he used to drive a cab for one of the Multinational Corporations (MNCs) in Hyderabad. Ahmed joined a ridesharing service after being fired from a MNC’s fleet during the lockdown.

During the conversation, he mentioned that he comes across several people throughout the day, and with each of them, he has to behave in a particular manner. Sometimes, he comes across people who treat him with no respect because of his profession. At other times, he comes across exceptionally well-behaved people. He discussed how coming across insolent people impacts his mental health. Several times, he feels like he should vent out; however, he has no one to discuss these things with. The conversation made me realise that access to professional quality mental healthcare is a facility available only for the privileged.

Access to mental healthcare is one of the most significant issues in the country post-Covid-19. The pandemic has enormously impacted most people's mental health. According to World Health Organization (WHO), during the pandemic cases of anxiety and depression increased by 25% across the world. Loss of jobs, lack of adequate access to education, illnesses, and lockdowns have mainly contributed to poor mental health. Several people were diagnosed with depression, anxiety, and insomnia.

News of death everywhere has led to prolonged grief among several individuals. Lack of social interaction during the pandemic has created several drawbacks not just in adults but also in children. Their playground time was taken away due to fear of the virus, and they were forced to adopt a virtual mode of education. After two years of online education, children are now facing issues with social interaction in a physical environment.

Related link: COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide

Healthcare professionals crisis

Individuals with mental health issues face discrimination in many ways. Often their families are reluctant to seek professional help. This happens because they are either afraid to recognise their condition as a genuine medical issue or are fearful of the treatment costs. The average price of counselling per session varies anywhere between rupees Rs. 300 to Rs. 5000 depending on the facility set-up, and the counsellor's qualifications. Often this is more expensive than the average income of a daily wage worker in India.

According to an article released in January 2019 by the Indian Journal of Psychiatry, India faces a massive health crisis with just 0.75 psychiatrists per 100,000 patients. Growing trends indicate that consultation for therapy has moved to a more online and telephone-based approach. The rise in domestic violence, sexual abuse, and suicides were some of the other issues that were noted in several news reports at the onset of the pandemic and during the lockdowns. Consequently, promotions of online therapy sessions is on the rise. Several partially trained therapists came up with their social-media-based settings to provide therapy to the individuals. The underprivileged may not be aware of such platforms. Some may not even have resources that could connect them to virtual-based therapy sessions.

Role of the government

Among the vision of India's National Mental Health Policy by Ministry of Health and Family Welfare, Government of India, is to "provide accessible, affordable, and quality health and social care to all persons through their lifespan, within a rights-based framework." However, the policy was introduced in October 2014, and since then, the mental health research framework has reached new horizons, and several unique aspects have been discovered. This calls for our government to update the policy, introduce reforms, and make adequate mental healthcare facilities available for all sections of society. The new policy should at the most work towards making counselling sessions free for people who cannot afford them. There is no specific administrative body to monitor the mental health of individuals. Initiatives to develop programs promoting free access to mental healthcare should be taken by the state and the central governments. Counselling should be made available from a very early age, especially in schools, to promote good mental health amongst children.