Mind the Treatment Gap

India must prepare for a growing mental-health epidemic

ILLUSTRATIONS BY SUKRUTI ANAH STANELEY
30 June 2020
One in every ten Indians suffers from a mental-health disorder, but the country has fewer than four thousand psychiatrists. As a result, 83 percent of people with mental-health disorders do not get treatment.
One in every ten Indians suffers from a mental-health disorder, but the country has fewer than four thousand psychiatrists. As a result, 83 percent of people with mental-health disorders do not get treatment.

THE 18-YEAR-OLD felt an indescribable sense of peace and comfort as he sat in a bus for hours at a time. The chaotic traffic mirrored the barrage of thoughts in his head. Every once in a while, the incessant honking would jolt him back to reality, but, often, aimlessly circling the streets of Delhi was a more attractive proposition than getting off at his university bus stop.

It was around this time, in 2004, that his mother began noticing changes in his behaviour. The once ambitious and studious young man had grown increasingly distracted while he was still in high school, and his downward spiral accelerated once he started university. He began withdrawing from daily activities and was uninterested in spending time with family and friends. Sometimes unable to sleep, he would climb to the roof of his parents’ tiny home and spend hours panicking about his lacklustre academic performance. The only thing that seemed to settle his nerves was running through the city streets at night.

By 2008, having watched his behaviour deteriorate and unsure what she could do to help, his mother decided it was time to get him professional help. She did not know exactly what was wrong, but each time he had what seemed to be a depressive episode or a prolonged bout of restlessness—a few times a year—she would take him to a hospital or a local doctor. “I kept taking him to different hospitals, different doctors, trying to get help,” she told me in March 2019. “Some would tell me, ‘Go here.’ Others would say, ‘Go there.’ We were running in circles. I felt my mind was going to explode.”

Over six years, she said, the family went to six general physicians, and even visited faith healers. No one could tell them what was wrong. In the absence of a diagnosis, the family chalked up his behaviour to stress. His life had always been difficult—they were poor, his father was abusive—and the trauma from his childhood was likely catching up to him.

The endless search for help only worsened his restlessness and depression. His illness caused frequent breaks in his education, and he twice dropped out of college to work in his father’s grocery shop. In 2014, at the age of 28, he suffered a panic attack. His heart was racing, and once the doctor treating him ascertained that he did not have a heart disease, he was finally referred to a psychiatrist. He was admitted to the Vidyasagar Institute of Mental Health, Neuro and Applied Sciences, or VIMHANS, a non-profit Delhi hospital. Nearly a dozen years after his symptoms first appeared, he was diagnosed with bipolar affective disorder.

Keywords: mental health health policy World Health Organisation
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