Healthcare

GLOBAL INVESTOR 2.12 — 41
Mental health in India
The neglected
cousin
In India, longer lifetimes, growing rural-urban migration, smaller families and rapid economic
change all represent stress factors that pose an increasing challenge to mental health with
consequences that are both personal and far-reaching. Although policy makers agree on a broad
strategy for addressing the problem, previous inattention to it and a lack of human resources
mean that implementation will not be easy.
Ajay Mahal, health economist, Monash University, Australia, and Victoria Fan, research fellow, Center for Global Development, Washington, D. C.
According to a recent study in the medical journal “Lancet,” nearly
187,000 suicides occur in India annually. Suicides, particularly among
rural Indian households, have attracted much attention as an unintended
side effect of the Indian growth story and are often linked to loss of
livelihood and indebtedness. Less well appreciated is the broader
public health challenge of mental illness, an important underlying risk
factor for such deaths. In fact, excessive attention to mortality may
have detracted attention from morbidity – departures from a state of
good health and normal functioning – where the impact of mental
illness is mostly felt. Available data suggest that impaired cognitive
7.5% and
11% of Indians aged 60 years and over. But dementia isn’t the only
problem in this sector of the population. In some parts of the country
depression among the elderly has reached rates in excess of 50%.
An illness burden second only to cardiovascular disease
Among younger adults, various types of “mood disorders,” including
depression, are common. Rapid increases in alcohol sales and household-level
studies showing high frequency of alcohol consumption on
a daily basis suggest that alcohol dependence is on the rise. Children
Research found that nearly 13% of children below 15 years of age
suffer from mental retardation and behavioral problems. Recent efforts
to collect nationally representative information on the state of mental
health in India’s population have been marred by controversy, but
there is little disagreement among mental health experts about its
growing significance. The World Health Organization estimates that
mental health conditions account for around 10% of India’s burden of
ill health and death, second only to cardiovascular disease among
non-communicable conditions.
Health outcomes are not the only casualty of mental illness. Research
for developed countries also points to serious adverse economic
consequences. One recent study for Europe concluded that
mental health problems would cost every European household roughly
USD 2,800 in costs of treatment and productivity losses. Similar
data are unavailable for India, but three factors suggest that economic
outcomes of mental illness in India could be comparatively
worse. First, either many people with mental illness belong to the
most economically productive age-groups, or these disorders occur
among children, with implications for the future quality of the labor
force. Second, stigma attached to mental illness and smaller family
are also at risk. One 1990s study of the Indian Council for Medical sizes increase the risk that the emotional and economic burden of >