Mental Health Care and Its Management

Standing Committee Report Summary

Mental Health Care and Its Management

• The Standing Committee on Health and Family Welfare (Chair: Mr. Bhubaneswar Kalita) submitted its report on ‘Mental Health Care and Its Management in Contemporary Times’ on August 4, 2023.  Mental health refers to a state of mental wellbeing that enables people to cope with the stresses of life.  The Committee noted that mental health-related issues are rising, and seeks to examine the status of infrastructure, regulatory structure, and causes behind its prevalence.  Key observations and recommendations include:

• Status of mental health in India: The Ministry of Health and Welfare had commissioned a mental health survey in 2015-16.  The Survey played a crucial role in highlighting the state of mental health in India, with high treatment gaps for most mental illnesses.  A treatment gap is the difference between the requirement and access to treatment.

• The Committee observed that the issues highlighted in the 2015-16 survey have remained the same in 2023.  It noted that there is considerable scope to improve the treatment gap.  Reasons for the gap include lack of mental health professionals, weak infrastructure, stigma.

• The Committee also observed that while the Survey was useful, it had several issues which can be addressed in subsequent iterations.  These include having a small sample, relying on self-reporting instead of clinical trials, and excluding specific vulnerable populations such as prisoners. 

• Impact of COVID on mental health:  The Committee highlighted the adverse impact of the COVID-19 pandemic on the psycho-social well-being of all groups, especially children, adolescents, and caregivers.  It noted the need for evidence-based intervention on developing infrastructure and other policies around mental health.  It recommended that the second round of the Survey on mental health be published expeditiously, to assess and address increased mental health risks caused by the pandemic.

• Mental health issues among children: The Committee highlighted the prevalence of mental health disorders amongst children and adolescents in India, especially in urban metros.  It noted the impact of socio-economic inequalities, violence and lack of access to essential services on mental illness amongst the youth.  The Committee recommended imparting mental health education and providing counselling to address this issue.  It also recommended that the second round of the Survey on mental health include provisions generating data on children, adolescents, and caregivers to understand specific trends. 

• Suicides: The Committee took note of the rising number of suicides in India, especially amongst students and unemployed youth.  It recommended starting a 24x7 helpline to reach out to students who failed to clear competitive exams.  It also recommended strengthening surveillance systems to track factors causing suicides and devise mitigation strategies against the same.

• Availability of mental health professionals:  India currently has 0.75 psychiatrists per lakh people, which is significantly low.  The Committee observed that if India targets having three psychiatrists per lakh people, it will need 27,000 more psychiatrists.  This scenario is similar for other professionals such as psychologists, psychiatric social workers, and nurses.  The Committee also suggested increasing the seats for MD Psychiatry courses. 

• Mental health services at the primary and secondary level:  The Committee acknowledged existing efforts of the Ministry and the further need to strengthen primary and secondary mental health services.  It recommended allying community-based care with bio-medical care to address mental health concerns.  Community-based care offers a person-centred and community-oriented approach to mental health and promotes accessibility, early intervention, holistic care, continuity of support.  

• Mental Healthcare Act, 2017: The 2017 Act mandates the centre to create a Central Mental Health Authority (CMHA) to regulate the standard of mental health services in India. Such authorities must be established at the state-level as well.  Under the Act, state-level Authorities must constitute a Mental Health Review Board (MHRB) to protect specified patient rights.  The Committee observed that several states are yet to fill crucial vacancies in their Mental Health Authorities and constitute the MHRBs.  It recommended that a tracker be developed to track the progress on both.