Wednesday, May 29, 2024

Open discussions

For some time now, quite visibly since the COVID pandemic began, conversations around mental health have been accorded the space it deserves. Like most other things in Nagaland, it has indeed taken its time. The painstaking speed notwithstanding, it has finally arrived ~ slowly creeping into our consciousness and dialogues. Our social and even cultural practices are perhaps not best suited for acknowledging ~ forget discussing ~ mental breakdowns. It can be argued that many of the constrictive and conservative characters of our society are fertile grounds for mental trauma. But again, these very constrictive features are, perhaps, the stumbling blocks to acknowledgments and open discussions of the issue. In the meanwhile, the toll on mental health keeps accumulating. We, as a society, have mastered the seemingly convenient but dangerous art of tightening the lid at every sign of pressure hitting the limit. Ironically, it has taken a pandemic to prick open that valve and allow open conversations about mental health and its harmful effects on people as well as society. Mental illness is an amalgamation of biological, social, psychological, hereditary and environmental stressors. According to the World Health Organisation (WHO), mental health is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community. Although COVID contributed to bringing the topic of mental health out of the closet, the current crisis started developing well before the pandemic. Mental health problems have been growing rapidly over the last few decades but our infrastructure has remained woefully inadequate. Mental disorders are now among the top leading causes of health burden worldwide, with no evidence of global reduction since 1990. In 2017, an estimation of the burden of mental health conditions for the States across India revealed that as many as 197.3 million people required care for mental health conditions. This included around 45.7 million people with depressive disorders and 44.9 million people with anxiety disorders. In 2017, the WHO reported that there were about 9,000 psychiatrists practising in India, which equates to 0.75% per lakh of people. It estimates that the ideal ratio is three psychiatrists for every lakh of people. Similarly, India has 1.93 mental health care professionals per 10,000 residents, compared to the global average of 6.6. Data shows that an estimated 15% of working-age adults have a mental disorder at any point in time. Depression and anxiety are estimated to cost the global economy $1 trillion each year driven predominantly by lost productivity. There was a 25% increase in anxiety and depression among people. When COVID caught people off guard, they were all taken aback by the rising mortality rate; it was portrayed as a deadly disease with no effective treatment. Anxiety about one’s own and other family members’ health became a prominent cause of anxiety increase. Also, this was the first time we had been hit by a virus with such high mortality and people had never experienced lockdown before, at least not of that magnitude or scale. COVID increased people’s reliance on the digital world and social media and they were exposed to a lot of unverified information which resulted in a significant increase in anxiety and depressive disorders ~ an increase in anger and irritability in some people. Some people were so afraid of being infected by the virus that they went overboard to maintain hygiene, started washing their hands and using hand sanitizers excessively, which led to compulsive disorder in some people. Although Mental Health Act 2017 has granted patients the legal right to live with dignity without discrimination, coercion and harassment, the endeavour in this segment is too scattered and lacks focus and coordination, experts have argued. To address the mental health issue, promotion of awareness through campaigns, mobilising the support of NGOs and deeper engagement of local communities and local governments are some of the measures which could improve outcomes. At the base level, it all comes down to creating awareness and an environment that promotes open discussion.