Updated: Apr 25
Its end of April 21’ the news is filled with cries from patients and their families, No Beds, No healthcare, No Oxygen, No medicine and most devastatingly, no time to mourn. The country was never prepared for this pandemic and today we see the consequences everywhere. It is estimated that over a million Indians might die in this pandemic! But what about those who survive? Healthline reports that 1 in every 5 people infected with Covid will end up developing at least one mental health condition. Covid cases today stand at 146 Million, this would mean the number of people with mental health conditions as a result of Covid would stand at around 30 Million at least! And what about the people who lost their loved ones?, The ones who lost jobs and livelihoods?, The people who couldn't get access to healthcare due to health-infrastructure being overwhelmed??
CDC in USA reported that the average share of adults reporting Anxiety or Depressive disorder has gone up from 11% between Jan-Jun 2019 to as high as 41% in January of 2021. This however is going to be much higher in India, as India is said to already top the Depression world ranking even before the pandemic began.
India is still a developing country with a conservative mindset. This has led to severe stigma and misconception around mental health. People suffering from serious mental health conditions are usually left out of functioning society and usually tagged as damaged goods. This has created a fear amongst the population in exploring their mental health issues. As soon as a psychiatrist or psychologist is mentioned, people fear being tagged as mad or psychotic. This means not only are they reluctant to get their mental disorders treated, they are also scared of them being diagnosed in the first place. This actually has lead to the current scenario in the country, as many lifestyle issues are turning into more severe clinical disorders.
Yes, social media and even news channels to some extent have helped spread awareness about mental health issues, the overall acceptance levels are far too low to make any difference! Even though the government has stepped up in creating and implementing mental health awareness programs, they seem as adequate a solution as forks for drinking soup.
“Poor” is the most apt way of describing the mental health infrastructure in India today. Not only does India lack awareness for Mental Health issues but it also severely lacks infrastructure to diagnose or treat them.
The field of medicine in India has been running with a ratio of 1 doctor to every 1456 population. This is around 45% higher than the WHO recommended ratio of 1:1000. This can easily be seen in the GP clinics and OPDs where patient waiting times for every appointment usually are not in minutes but hours. The case in small towns and villages is much worse where many people have to travel for hours to reach primary healthcare providers. (Important thing to note here is the ratio of Government (free) healthcare stands at somewhere around 1 doctor per 11,000 population.)
The same condition is much worse when it comes to the field of mental health, where the ratio of Psychiatrist is 3 per 1,000,000 population against recommendation of 3 per 100,000. For Psychologists this number is much worse at 7 for 10,000,000 vs recommended 3 per 100,000. This means we as a country are severely underprepared for a mental health pandemic that is already affecting at least a hundred million people in India!
Current Educational Infrastructure
Just like the mental healthcare infrastructure is lacking in the country, the educational infra has followed suit. Quick search of a popular website which lists college courses, leads to the result of around 500 courses around the country which provide postgraduate courses in Psychology and around 250 in Psychiatry. While the number of seats available for Psychology postgraduate courses are between 20-40 per college. This pales in comparison to courses such as MBA, where the number of colleges stands at more than 6500, with most colleges offering more than twice the number of seats as the psychology counterparts!
But lack of educational institutes is not only the problem, the courses available are at best outdated and at worst irrelevant in the field of mental health! Rote learning as always has given way to understanding the subjects and current relevance and skill of educators has given way to the usual style of hammering same old rules in the students minds. Worst of all, none of the courses try to implement job training and experience, even though many postgraduate courses will ask students to take part in research, internships and practicals, none of these offer sufficient training to students. When it comes to research the focus is on getting a pre-decided result and not exploring the given topic, rules are just guidelines and for higher level courses many times students are used as free research assistants for their guides and nothing more. In college based practicals the materials usually used such as tests and assessments or experiments are of very low quality and usually decades old, this happens as most colleges avoid investing in training courses and commercial packages offered by testing publishers. In internship, as for research, the same problems persist, focus is more on getting most of free or at times student paid labour, and not actually giving them practical training. The more renowned institutes have old faculty unwilling to move towards more modern theories and techniques and usually end up only offering students stories from their vast experience rather than empirical knowledge.
The old Guard!
Field of mental health is new and still developing, this means much of the old knowledge is regularly developed upon, changed or even discarded. This means it is important for the educators and trainers to keep an open mindset when it comes to changing their understanding of the subject matter. This becomes a little harder in a country like India dominated by a conservative approach, where we are still using unproved cures to diseases and disorders from thousands of years ago in favour of scientifically proven methods. Gurus and god men who claim to cure everything without side effects and consequences are favored over treatments with proven efficacy. And the mental health field suffers from the same, rather than looking for newer intervention and therapeutic options, the general population and even sometimes physicians will recommend lifestyle changes to mental health conditions. Older psychologists will offer older, long rejected therapies and older psychiatrists will offer medicines long discarded by western countries in favour of newer treatment options. This means many patients with treatable disorders still end up having poor outlooks.
Final Thoughts Covid 19 has had a severe impact on our country’s finances and it is currently suffering. It neither has the money nor the resources to handle another pandemic, especially a pandemic which will significantly alter productivity, efficiency and even society! The mental health of individuals plays a significant role in both their growth and also their physical health, this in turn plays a huge role in development of the country as a whole.
We are already too late, yet we still have time on our hands. We can still reduce the impact the current pandemic has on us, and consequently reduce the impact of the mental health crisis soon to reach its peak. We must create more awareness, we must stop treating our own mental health with disregard and we must contribute to the mental health of others! This is the only way out, the government is usually toothless when it comes to handling public issues, we however are not! You still have the power to change your own future, the future of your family and friends, and future of the society as whole. Come forward with your issues, support your friends and also support the mental health professionals who are dedicated to help you through your issues!
And for mental health professionals, my advice is to simply learn! Get yourself involved in CPD courses, training programs and programs that will help you learn a wider skill set. And guess what? We can help you there -
Cinq in is offering a training program for all mental health professionals and students who are soon to complete their courses, from Counsellors to Psychiatrist we are offering all mental health and healthcare professionals a chance to participate in a training program that will cover multiple areas of the mental health landscape. Most importantly we will be offering guaranteed interaction with clients / patients to help you learn first hand.
- Omkar Naik