India’s great medical challenge: Talking about mental health

The mental health impact of the pandemic has arguably been greater than the episodes of physical illness. Apart from those who tested positive for COVID-19, fear of the virus, uncertainty and apprehension among all, illness and death of loved ones, low sources of income, cost of treatment and many other factors affected mental health. Is. Of all A study published in the journal The Lancet reported that in 2020, depression and anxiety disorders increased by about 25% globally and 35% in India.

increased needs

In 2021, hospitals and healthcare providers across India have reported an increase in the number of people seeking counseling and needing admission-based treatment for mental health conditions. We have personally seen this growth in our medical practice. Cases included re-emergence of old problems and new complaints, ranging from very mild to severe conditions. Omicron’s arrival has created fresh tension, apprehension and anxiety among people.

How do we respond to the challenge of mental health? Short answer: On an individual level, raise awareness of the various aspects of mental health and commit to self-care. Initiate concrete policy interventions at the societal level to increase access to mental health services.

a pledge for self-care

The first thing to remember is that self-care is not a selfish but the right approach to mental health. One needs to remember that if you have good mental health and are calm and calm, you are likely to be more productive in your personal life and be an effective care provider for others.

Again, each of us needs to be aware of the mental health red-flag signs. As an example, anxiety and depression are common mental health problems. In both, changes in sleep and eating patterns provide important early clues. excessive sleeping or trouble sleeping; Waking up at odd hours of the night and then being unable to sleep; Overeating or not feeling like eating should all be a matter of concern.

Other common mental health red-flags are loss of interest in a previously pleasurable activity, difficulty concentrating, repeated negative thoughts, persistent and widespread sadness that lasts throughout the day, and persistently low energy levels. If any or more of these symptoms persist for 10 days or more, it is advisable to consult a health care professional.

Feelings and thoughts of helplessness and hopelessness can be a precursor to suicidal thoughts and attempts, and should be taken seriously and professional help sought immediately.

Prevention is better than cure is a saying that applies to both physical and mental health. Therefore, whatever is good for physical health is good for mental health and vice versa.

Regular exercise or physical activity, eating healthy, setting a bedtime and allotting enough hours to sleep, all help to fight and reduce stress. limiting screen time; Pranayama, yoga and meditation of any kind, and staying connected with family and friends are other proven preventive health approaches. We need to make proactive efforts to deal with stressful situations.

One of the sub-groups disproportionately affected in the pandemic are parents and children. Parents, especially women, had additional responsibility as caregivers of children who were at home due to the closure of schools. It was stressful for both of them.

Children often take emotional cues from adults – primarily from parents and teachers – so it is important for adults to manage their emotions well. Parents need to remain calm and active in their interactions with children. Children and adolescents need to be encouraged to talk about their feelings and reach out to trusted family members and friends.

Amidst all the challenges associated with the pandemic, there is some hope. One, people are more open to discussing mental health issues. Second, the stigma traditionally associated with mental health problems and seeking care has been reduced.

It is time to debunk the myths that mental health issues are an urban or big city phenomenon. The pandemic has shown that mental health issues affect people across the country, including in small towns and rural areas. In the absence of discussion about mental health, the burden has not been fully recognized.

back to the basics

This is also an opportunity to consider some of the basics. First, for all illnesses—physical or mental—it is important to seek prevention and early help. If we don’t pay attention to stress, anxiety or depression in real time, these can turn out to be more serious health problems.

Second, just as most physical ailments can be treated, mental illnesses can also be treated. Third, not every disease requires specialist care. Six out of seven people with mental health needs may initially be attended by trained non-specialist doctors. Referral to specialist care is required in a small fraction of diseases.

Physical and mental health are intertwined. It has been scientifically proven that stress, anxiety, depression can lead to physiological changes and result in diseases like obesity, diabetes and high blood pressure. Therefore, health care providers also need to change their approach. Mental health care has to be integrated with general health care services.

When people visit a health care center, they are routinely asked about their feelings, their sleeping patterns, their moods and feelings.

policy change

At the policy level, there is an urgent need for all state governments and municipal corporations to focus on making mental health services easily accessible to all in every part of the country. Tele and video counseling for mental health needs can increase access to mental health services. Outreach programs on mental health should be initiated at the community level.

All these changes will change our attitude towards mental health. People should eventually be as comfortable talking about their mental health as they are discussing their high blood sugar or blood pressure at dinner or a party.

It has been widely documented that after the 1918–20 influenza pandemic, psychological effects, including depression, persisted for decades. If there is one lesson to be learned from that pandemic of a century ago, it is that India needs to be prepared to face the mental health challenges in the years to come.

Dr Chandrakant Laharia is a physician-epidemiologist affiliated with the Foundation for People-Centric Health Systems, New Delhi. Pratima Murthy is a psychiatrist and director of the National Institute of Mental Health and Allied Sciences, Bangalore.