By Benjamin Lyngdoh
The World Health Organization (WHO) describes mental health as ‘a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their community’. Further, it states that ‘it has intrinsic and instrumental value and is a basic human right’. The term ‘instrumental value’ means that mental health is the ultimate factor which determines behaviour and overall well-being of a person. It goes with the saying ‘health is wealth’. It also means that one can predict future behaviour/actions of a person who possesses positive/good mental health. Therefore, mental health is the precursor to a responsible and productive human being and society. The problem is that in actual practice mental health is never viewed from the prism of being an ‘instrumental value’. The result is a society where wealth/money is considered to be more important than mental health. The outcome of this is the rise in mental disorders amongst both the young and old.
Global data
The year 2019 WHO data record that 970 million people live with a mental disorder. That makes roughly ‘1 in every 7 persons globally’. Anxiety and depression is the most prevalent of the mental disorders. The majority of such persons are concentrated in Western Pacific and South-East Asia Region which includes India. This also means that the majority of the prevalence is in the developing economies. These are economies that comprise a large population with limited employment opportunities, and lacking urban infrastructure which together ultimately contributes to the high prevalence of mental disorders. A progressing nation needs a mentally healthy population. In its absence, the thoughts, cognitive processes and actions of the people would be hindered thereby leading to lower productivity with the most extreme being self-harm/suicide.
In response to the seriousness of the subject-matter, WHO member states committed to implement the ‘comprehensive mental health action plan 2013-30’. It aims to improve mental health through strengthening governance, focussing on community-based care, formulation and implementation of promotion and prevention strategies, strong information systems, evidence and research. India has blended the elements of the action plan into strategies like District Mental Health Programme (DMHP), National Suicide Prevention Strategy, and Tele MANAS for 24/7 virtual counselling. In particular, The Mental Healthcare Act, 2017 underlines access to mental healthcare and empathetic treatment of such people.
India data
The 2015-16 National Mental Health Survey (NMHS) conducted by National Institute of Mental Health and Neurosciences (NIMHANS) found that around 10.6% of Indian adults (11 out of every 100) lived with a diagnosable mental health disorder. The survey also highlights that the lifetime prevalence of mental disorders was 13.7% which means that 14 out of every 100 persons have experienced a mental disorder at some point in their life. Further, mental disorders are more prevalent in urban areas (13.5%) as compared to rural areas (6.9%). Significantly, according to the 2023 National Crime Records Bureau (NCRB) report on ‘Accidental Deaths and Suicides in India’, 171418 suicides were reported in 2023 with a wide gender disparity with males accounting for 72.8% of all suicides, and females at 27.2%. Further, WHO highlights that the economic loss to the Indian economy due to mental health conditions for 2012-2030 is estimated at US$ 1.03 trillion. These are glaring figures that need attention as mental disorder reflects upon ‘stability of thoughts and actions’ and ultimately productivity and safety and security of the nation.
Meghalaya picture
The Meghalaya Mental Health and Social Care Policy, 2022 highlights that depressive and anxiety disorders feature in the top 15 causes of YLDs (years of healthy life lost due to disability). The state reported 226 deaths by suicide in 2021 which accounts for 6 persons for every 10000 people. Further, Meghalaya has seen a significant rise in substance misuse which is assessed as being three times the national average. A study conducted by Sagar, et al published in 2020 in The Lancet Psychiatry found that the prevalence of depression mental disorder (per 100000 people) in Meghalaya stood at 3340 which is higher than the national figure of 3310. The study is indicative of the gravity of the problem and its cascading effects. At the very top is the tendency of the sufferer to gradually fall into bad habits such as alcohol, drugs, and other forms of substance misuse.
Political perspective
According to the United Nations, globally 15% of adolescents live with a mental disorder with depression, anxiety, and behavioural disorders being the leading causes of illness and disability. Further, some studies indicate that 40% to 50% of higher education students experience at least one mental health issue while at university-level studies with anxiety and depression being highly prevalent.
In the case of Meghalaya, it can be conservatively stated that the statistics on mental disorders would be a lot more and hence even more alarming. It is based on the premise of the nature of the local economy where the state GDP has been increasing over the years, but, multidimensional poverty hovers around 30% of the population. In addition, the gap between the rich and poor is ever increasing combined with the wide gap between urban wealth and rural neglect. Black money generation through illegal coal mining continues while nepotism and favouritism in employment opportunities continue unabated. In such a situation, how can the youth be expected to not have at least one form of mental disorder? The issue that should concern society is what this mental disorder amongst the youth would do to law and order, and peace and security. If society has an answer to it, then one need not worry; or else.
As a micro intervention, mental disorder is to be addressed at the home, community, school, college, university, religious institutions level, etc. At the macro perspective, it is all about political leadership. It is about the government of the day and its nature of governance. The fact to be acknowledged is that no matter how much and how successful micro interventions can be; they will not be sustainable unless it is spearheaded by a mental disorder problem conscious political leadership.
Till date, there is yet to be a political party in Meghalaya that has extensively talked about mental disorders and suggested tangible mitigation measures. The increase of substance misuse is an outcome of mental disorder which in turn is an outcome of corruption, the need to bribe, nepotism, unfair means, deceit, and all the unfairness of unfair governance. Unless there is a political leadership that would systematically understand and deal with the issue; mental disorder will in due course of time ultimately turn into a social disorder.
(The writer can be reached at benjamin@nehu.ac.in)
