India's recognition as the world's suicide capital, with over 2.6 lakh cases reported annually, starkly contrasts with the less than one per cent self-reporting rate for mental health issues. While this discrepancy reflects individuals reluctance to openly acknowledge and report their struggles due to societal judgment and stigma, a study by IIT, Jodhpur and USA's Ohio State University has found that those seeking help have to incur significant expenses largely due to reliance on the private sector.
Addressing this issue is crucial to fostering a more supportive environment where individuals feel comfortable seeking help for their mental health concerns, said the study published in the International Journal of Mental Health Systems and Co-authored by Dr Alok Ranjan, Assistant Professor, School of Liberal Arts (SoLA), IIT Jodhpur and Dr. Jewel Crasta, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, USA.
“ The study revealed that the self-reporting of mental illness was less than one per cent based on the 75th Round National Sample Survey, 2017-18. The survey completely relied on the self-reporting of the individuals," Ranjan said.
The data was collected from 5,55,115 individuals from randomly selected 8,077 villages and 6,181 urban areas, including 283 outpatient and 374 hospitalisation cases due to mental disorders in India.
"Stigma in society acts as a significant barrier to reporting mental health issues. In today's society, the reluctance to report mental health issues persists due to the prevailing stigma. Individuals, fearing social judgement, often choose silence over seeking help. Destigmatising mental health is crucial to fostering an environment where seeking support is embraced," he added.
The study also shed light on the significant out-of-pocket expenses incurred by individuals seeking mental health services, largely due to reliance on the private sector. There are also not enough mental health professionals in the public sector too to treat people who do seek help. This is especially true in rural parts of India.
Calling the observations as yet another wake up call, Dr Shweta Sharma, Clinical Psychologist and Joint Secretary of the Indian Association of Clinical Psychologists who is not related to the study said “Mental health has not been a significant focus in India, primarily because many issues are perceived to be resolved through psychotherapy, often dismissed as mere conversation.
“The value of trained professionals is underestimated. Unclear policies and a lack of awareness among the general population about mental health treatment contribute to confusion regarding whom to consult, when to seek help, and the importance of mental health check-ups.
This situation allows untrained practitioners to set fees arbitrarily, leading people to assume that private practitioners are expensive, and consulting psychologists is a waste of both money and time.”
She underscored the need for serious attention to mental health and licensed mental health professionals. “The rising number of suicides among aspiring engineers and medical students highlights the overwhelming stress they face. The government must prioritize policies, shape training programs, and provide health coverage for mental disorders. A well-structured plan, coupled with public awareness, is imperative at this juncture.”
The study echoed similar views as it also uncovered a socioeconomic divide, with self-reporting of mental disorders being 1.73 times higher among the richest income group population compared to the poorest in India. The private sector emerged as a major provider of mental health services, accounting for 66.1 pc of outpatient care and 59.2 pc of inpatient care.
"A mere 23 per cent of individuals hospitalised for mental disorders had health insurance coverage at the national level. The study revealed that average out-of-pocket expenditures for both hospitalisation and outpatient care were significantly higher in the private sector than in the public sector," Ranjan shared.
