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Following the announcement in the Union Budget 2022-23, India launched a national tele mental health programme, called Tele Mental Health Assistance and Networking Across States (Tele-MANAS), in October 2022 to provide free 24*7 teleconsultation service for mental health concerns. No doubt, the Indian government is taking cognizance of the alarmingly increasing mental health problems in the country, especially among younger population, and making efforts to address it. This year too, health experts are expecting more funds for mental health in the Union Budget 2023-24. But the question is: How to use the budget wisely and tackle the mental health crisis effectively?
Dr Neerja Birla, Founder & Chairperson, MPower, an initiative of Aditya Birla Education Trust, remarks, "As we await the 2023 Union Budget to see what funds are allocated to mental health, we need to broaden our perspective and clearly evaluate what we need those funds for exactly."
In a tete-a-tete with the HealthSite, the mental health evangelist talks about the 'brain strain' among the youth in the post-pandemic world and shares her thoughts on what India must do to solve this mental health crisis for its younger burnt-out generation.
The country's youth is feeling down and out burnt-out like never before, says Dr Birla adding, "There was a time when we worried about the 'brain drain'. Now, it's time to worry about the 'brain strain'."
According to her, stress, anxiety and depression have reportedly gone up by 35 per cent after the COVID-19 pandemic.
Further highlighting the impact of pandemic on the country's mental health, Dr Birla says, "As the post-pandemic world struggles to re-stabilize economies, the youth is worried about their careers and future. Stagnation at work, job or financial insecurity and loss of income are a major concern today. Pressures in the workplace are leading to the burnout syndrome. The pandemic isolated us like never before. The issue of loneliness has now seeped into the very constitution of the youth. Many are not able to connect with or open up to anyone. The rise in relationship or family issues is making matters worse."
"The stressors of this burnout must be scrutinized minutely. Only then can we establish supportive mechanisms for them. This mental health burnout crisis needs to be tackled holistically, including how the solutions are appended to the mental health budget. In addition to policy-making, we need clear-cut directives and their implementation," she adds.
Budget allocation to mental health has been a key concern over the years. In 2022, from the 86,200 crores allocated to healthcare, only 670 crores were allocated to direct expenditure towards mental health.
"Out of this, 630 crores went to National Institute of Mental Health and Neuro-Sciences (NIMHANS) and another mental health institution LGBRI, leaving only 40 crores for the National Mental Health Program (NMHP), which delivers 90 per cent of mental health services to the country," Dr Birla points out.
She adds, "An escalated allocation of funds can give wings to mental-health-related plans and programs. However, in 2020-21 as per several published reports, NMHP utilized less than half of the 40 crores allocated to them. This is a worrying factor. Armed with the mandates of the National Mental Health Act 2017, NMHP should've gone into overdrive and asked for more funds to create awareness and increase the reach of mental healthcare. It means that the directives given to NMHP must become more defined."
Dr Birla believes that mental health literacy holds the key to solving the country's mental health crisis and digital platforms can play a big role here.
The expert suggests, "Since the youth is more tech-savvy, digital platforms must be encouraged to not only create awareness, but also provide mental health support to them at the click of a button. In October 2022, 23 Tele MANAS centres were set up to provide free-of-cost mental health counselling across India. By way of the 2023 Union budget, more funds and efforts can be allocated towards creating greater awareness about the Tele MANAS Helpline among the masses."
Citing another major challenge in tackling mental health crisis in the country, Dr Birla says that while the youth is far more open to seeking help, the cost of mental health treatment is a major deterrent.
She elaborates, "At roughly 1000-1500 rupees per session, the average person cannot afford the 10-20 sessions that are required for potential recovery."
To solve this problem, she suggests, "Out-patient mental healthcare needs to become available at all primary healthcare centres, especially in rural areas. Like treatment for physical health, it should be offered free-of-cost in all government hospitals. This needs budgetary allocation on a monumental scale, way beyond the scope of the allocations so far. This is an area that needs major work."
Stigma towards mental illnesses is still very common and rampant. People hide their mental health issues from the fear of being ostracized. "This is not just prevalent in the more rural areas, but it is also common amongst the educated and in the corporate world," reveals Dr Birla.
Suggesting a solution to this problem, the expert says, "A directive to NMHP to create a nationwide campaign on a war footing towards the de-stigmatization of mental health has to be undertaken."
According to Dr Birla, 14 per cent of India reportedly suffers from mental health issues, but the country only has 0.75 psychiatrists for every one lakh people to cater to this vast demographic.
"Capacity building is critical. However, currently there is an extremely limited curriculum of mental health and psychiatry stems in medical colleges. This is where grants by the government will make the difference. Mental-health studies as a stream have to be given more importance in our medical colleges. Funds and directives are needed to make this happen with a sense of urgency. This will provide the much-needed manpower to reduce the treatment gap," the expert suggests.
Concluding the conversation, she says, "The youth are our future. Our progress is directly connected to their mental well-being. Helping them emerge from this burnout is crucial and all stakeholders have to pitch in to turn the tide."