Why urban mental health must be the focus today

October 10 is observed as World Mental Health Day. Based on estimates, globally, 1 in 4 people experience some form of mental health concerns and mental health disorders account for more than 7.4% of the disease burden and is also one of the causes of long term disability worldwide.

What does it mean to those who seek assistance, what does this mean to professionals who work in the space and how do we as a community treat those who are in need of help? It is that time of the day when we must begin to see a human life beyond those numbers. It is that time of the day when we must attach human emotions to human existence.

World Health Organization, through this evidence base, labelled India as the most depressed country in the world. People dealing with depression, anxiety, bipolar disorders and schizophrenia were maximum in India and much of them underreported. Rather than being annoyed with this label, it is also our moment of opportunity to infuse fresh energies into Mental Health Services.

People today live more in cities than in rural spaces, technology is pushing us to such an extent, that we guide missiles and misguides men, we are e-connected and emotionally disconnected and our time spent on gadgets is also exponentially high.

Urban mental health today influences a large chunk of community health. Rise in lifestyle diseases and changing lifestyle parameters in the form of social isolation, nuclear families and lesser engagement among people is impacting urban mental health in a big way. Living conditions, urban congestion, workplace stressors build a cumulative impact on individual health conditions today.

The number of psychiatrists available in India is abysmally low for a 1.2 billion population. Among those that are available, the major concentration is in urban areas. Many Indian states have even less than 10 psychiatrists which is more than just a sad story.

As a solution, the Indian government must urgently do the following:

  • Create a 2-year fellowship course for MD – community medicine specialists to engage in treatment of mental health issues and MD – community medicine specialists must practice as community physician cum psychiatrist
  • Encourage medical officers in all states to go through a 6-month screening & training programme in mental health
  • To radically change primary healthcare approaches with the availability of basic level medicines for mental health
  • To add counsellors in all taluk level hospitals and selected primary healthcare centres based on mapping of greater disease burden
  • Make it mandatory for all companies having a turnover of Rs 100 crore to appoint minimum 1 counsellor who is expert in family counselling, marriage counselling, single parent counselling and who are well versed with the local mental health available options for further care
  • Make it mandatory for schools having over 300 children to at least appoint a part-time counsellor who maintains a monthly engagement with school children
  • All district health officers must be tasked to prepare a district mental health report and this may be done with the assistance of local NGOs. Efforts such as these will be a small spark in the big story of addressing India’s mental health and can also serve as an inspiration for the rest of the world.

Edmond Fernandes

Dr. Edmond Fernandes is a community health physician leading efforts for CHD Group which is a global public health organization, headquartered in Mangalore, India. He is also a Non Resident Senior Fellow of the Atlantic Council and the US State Department Alumni. He is a Member – Health Task Force, DDMA, Government of Karnataka. Dr. Edmond has authored 2 books, got over 18 research publications and travels around the world for engagements related to global health, policy and humanitarian emergencies. He can be reached for feedback and discussions on office@edmond.in 



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