LET'S SLEEP & CRIB, LET OTHERS TAKE OVER "MENTAL HEALTH IN INDIA”

Recent Position statement of IACP is highly regressive and shows a lot of insecurity at the most crucial time in the history, where we need to take this profession to the next level, we are making it more unreachable to masses in India.

(For clarity I have just posted what I found on the web without editing) and have given the links for the same to read more for clarity.

https://static.businessworld.in/upload/GCX0sG_1551349353052.jpeg

Mental health in India: 7.5% of the country affected; less than 4,000 experts available

350 Million or 35 Crores. WHO predicted by 2020, we are already in 2020 and COVID-19 changing living circumstances and burdened more mental health problems. So, in my opinion, we already have around 45 crore people struggling with psychological issues in India. How do you think just 4000 Mental Health Professionals will take care of this burden.

Just wake up and seize the opportunity to set the profession straight, bring credibility and standards through inclusion rather than exclusion. Are we sensible in making our profession ready for the burden or just sitting in glass chambers and expect things to work out?

A report by the World Health Organisation (WHO) revealed that 7.5 percent of the Indian population suffers from some form of mental disorder. Mental illnesses constitute one-sixth of all health-related disorders, and India accounted for nearly 15% of the global mental, neurological, and substance abuse disorder burden. The treatment gap, which is defined as the prevalence of mental illnesses and the proportion of patients that get treatment, is over 70 percent. WHO also predicts that by 2020, roughly 20 percent of India will suffer from mental illnesses. And to cater to this demographic, we have less than 4,000 mental health professionals.

Read more at:

https://economictimes.indiatimes.com/magazines/panache/mental-health-in-india-7-5-of-country-affected-less-than-4000-experts-available/articleshow/71500130.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30475-4/fulltext

Findings

In 2017, 197·3 million (95% UI 178·4–216·4) people had mental disorders in India, including 45·7 million (42·4–49·8) with depressive disorders and 44·9 million (41·2–48·9) with anxiety disorders. We found a significant, but modest, correlation between the prevalence of depressive disorders and suicide death rate at the state level for females (r2=0·33, p=0·0009) and males (r2=0·19, p=0·015). The contribution of mental disorders to the total DALYs in India increased from 2·5% (2·0–3·1) in 1990 to 4·7% (3·7–5·6) in 2017. In 2017, depressive disorders contributed the most to the total mental disorders DALYs (33·8%, 29·5–38·5), followed by anxiety disorders (19·0%, 15·9–22·4), idiopathic developmental, intellectual disability (IDID; 10·8%, 6·3–15·9), schizophrenia (9·8%, 7·7–12·4), bipolar disorder (6·9%, 4·9–9·6), conduct disorder (5·9%, 4·0–8·1), autism spectrum disorders (3·2%, 2·7–3·8), eating disorders (2·2%, 1·7–2·8), and attention-deficit hyperactivity disorder (ADHD; 0·3%, 0·2–0·5); other mental disorders comprised 8·0% (6·1–10·1) of DALYs.

This report was out in 2017; Now we are in 2020 after COVID-19 pandemic throwing the world into absolute chaos, pushing people to the brink of breaking down, what might be the number of people struggling with psychological challenges requiring psychological help.

1 Million = 10 Lakhs; 10 Million = 1 Crore

100 Million = 10 Crores; 197.3 Million = 19.73 Crores

India is a country of 1.35 billion population, and roughly if you estimate the percentage of SMD's would be 7% means 19.73 crore people suffering from Severe Mental Health Disorders. What about issues like & challenges related to Relationship problems, Academic issues, work-related, stress, other health problems having psychological issues might be another 10% will consist of 15 crores. That means we have nearly 35 crore Indians out of 1.35 billion people who need some psychological help at different levels.

Remember one thing; if GOVT wants to change laws or amendments to support the growing demand for psychological help (Which we are not shouldering even a fraction of the growing burden in India) for the people who are suffering from mental health disorders, they can do without bothering IACP or any organization. That is already going on. As they tie-up with the institutes to train, support professionals who want to help in the times of pandemics, they will take their services. Can you tell them what they are doing is wrong? We cannot. Let us understand the situation and the opportunity to streamline everything mental health in India.

RCI also has conflicting guidelines of practice. One of the documents says that you need to be trained and qualified by RCI to work with children having mental health problems, and doesn’t mention about providing services to other issues like relationship problems, stress at work, related academic underachievement, etc. These areas we cannot even fight they are our work areas. Anybody can work with these areas, whether trained or untrained.

Having less than 10000 (This is a highly increased figure) actually, we have fewer mental health professionals for about 25 o 30 crore people suffering from mental health problems in India.

My straight question to mental health professionals is

How do we professionals can do justice?

Thinking of this making me fill with jitters sometimes. How are we going to tackle this impending problem?

Even if we work for 24 hours a day, every professional would have at least 22,000 patients to see, and if we have to support them, we need to see at least 1800 client's sessions in a month that comes to around 60 clients per day, without having Sundays and holidays. However, we have only 24 hours in a day & it is impossible to work and see more clients in a day. On average, a therapist can see 5-7 sessions if they want to maintain good quality in their therapy.

DOES ANY MENTAL HEALTH PROFESSIONAL HAS ANSWER TO THIS PROBLEM. IF YOU HAVE A ROBUST PLAN OR ANSWER, I WOULD LIKE TO CHANGE MY PERSPECTIVE.

Let’s do more math:

If we see eight clients per day for therapy, it will take 2750 days to see the first client again for the second session. (Roughly around 7.5 years) This is a HUGE Mental Health Calamity of Pandemic Scale, where India is going to lose its battle. We need to innovate and change our policies to be more inclusive, with strict guidelines so that we will ensure the quality and creditability of the mental health profession.

Come to the Position Statement of IACP.

YES, I DON’T WANT UNQUALIFIED PEOPLE TO PROVIDE SERVICES. BUT THEN...

Of course, I love my profession; I don’t know anything except providing psychotherapy. We can always say that others should not practice, but who will bell the cat until the client reaches the court against the psychologist. However, based on the case to case approach, it doesn’t make any change in the process. However, this will make people be more innovative to get out of the clutches of the law by ascertaining themselves as Babas, Spiritual Gurus, Coaches, Hypnotherapists, Life Coaches, Alternative Therapies, Homeopathy counselors, Yoga therapists, Ayurveda meditation experts, the art of living brothers, etc. Can we stop them from reaching out to people to help in terms of spirituality?

We need to bring most of these people under the ambit of IACP; we need to be more proactive than defending ourselves or being insecure; we need to provide guidelines and maintain quality and credibility. And we need to train them, provide supervision, ensure they maintain the highest quality in delivering services. These professionals can take care of initial work, like case managers, co-therapists & providing psychological first aid. They should refer if clients come with other challenges that are not in their ambit to work to clinical psychologists. Thus we can ensure the quality and reachability of our profession to every corner of India.

What do you think just because we make some policies and positional statements, people are going to stop practicing, never? As India is struggling with a lot of other challenges (economy, so many cases already), from policies to implementation, this is going to be a distant dream of taking anything legal. And some of the courses like diplomas are created to fill the gap of service providers by UGC I suppose. And if they are stopped from practicing, they can go to court asking the GOVT for an explanation, why they have started in premier institutes like IGNOU, NCERT, WHO Training, and wasting their time and money so far.

Remember one thing, most of these people are working very hard to create mass awareness about mental health through social media and doing programs in colleges, universities, markets, RWA's. I haven't seen many practicing clinical psychologists are doing so much work like these. The work done by these people is unparalleled. Do we take them along or kill the enthusiasm of these individuals.

Then what is the way forward?

I have a solution to go forward. Let’s everyone come on board so that we can move forward together, providing better services to people who need mental health services with the highest quality & integrity.

FINALLY, I ASK ANOTHER QUESTION.

WHAT ABOUT BOT’S, CAN WE REALLY STOP THEM FROM PROVIDING THERAPY?