Photo: Branimir Balogović/Unsplash.
This year’s World Mental Health Day, today, comes at a crucial time. There has been a paradigm shift in our lives thanks to the ongoing pandemic. COVID-19 has posed several challenges on several fronts. Healthcare workers have been working in tough conditions. Students are struggling to adapt to learning online. People are fearful of going out. And a vast majority of people are steeped in poverty or have been exposed to fragile humanitarian settings, with very little protection from the virus, its disease and the state response to it.
This pandemic has also been a disaster for people with preexisting mental illnesses. COVID-19 has added fresh uncertainty in their lives. Many people today are afraid of losing a loved one without getting a chance to say a proper goodbye. The ramifications of the pandemic are manifold, and the economic consequences of the ongoing health crisis have already become evident. There has been an acute global recession; many firms have let staff go in an effort to save their businesses. There are extremely high levels of stress, which in turn has contributed to a sharp spike in the number of people presenting to hospitals’ emergency wards with cardiovascular problems.
Given the scale and nature of this crisis, it is natural that there will be a substantial increase in the demand for mental health support systems and psychosocial support as well, in the next few months and years. The pandemic has changed the mental health landscape worldwide, and efforts must be made to tackle this crisis head-on. Globally, investment in mental health has always been suboptimal, and quite frankly the numbers are discouraging. Chronic underfunding in the realm of mental health runs the risk of a global collapse of mental health systems. Investment in mental health has never been this important. And this is why one of the goals of this year’s World Mental Health Day is increased investment in mental health.
To encourage public action around the world, a World Mental Health Day campaign was kicked off in September. WHO director-general Dr Tedros Adhanom Ghebreyesus recently said, ”World Mental Health Day is an opportunity for the world to come together and begin redressing the historic neglect of mental health. We are already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching.”
The vast majority of mental health needs remain unaddressed owing to the scale and nature of the problem. Efforts to change this narrative are hampered by chronic under-funding and under-investment in mental health. Countries around the world spend just 2% of their health budgets on mental health, on average. International funding for mental health has never exceeded 1% of all development funding for health. This is despite the fact that for every $1 invested in scaled-up treatment for common mental disorders, there is a return of $4 in terms of enhanced health and productivity.
This year’s World Mental Health Day should encourage all of us to do something life-affirming: as individuals, to take concrete actions in support of our own mental health, and to support friends and family who are coping with mental health problems. Employers should take concerted steps to facilitate employee-wellness programmes. Governments around the world should commit to establish or scale-up existing mental healthcare services. The media also has a pivotal role to play – in spreading awareness about mental health. Journalists, editors and commentators should assume the additional responsibility of busting common myths around mental health. This is possible if conversations around mental health are widely encouraged, and best-practices are adopted in creating awareness about its issues.
Although public conversations have been increasingly acknowledging the importance of mental health, chronic under-investment continues to be a problem. Systemic and concerted efforts are required to be able to build mental health systems that would cater to a diverse population. India’s National Mental Health Survey 2015 identified a 70-92% mental health treatment gap. These are staggering numbers for a country with 1.3 billion people. With so many people lacking access to appropriate good-quality mental health services, investment is needed now more than ever.
Let us all pledge to do our bit in enhancing awareness about mental health. There is no health without mental health.
Dr Alok Vinod Kulkarni is a consultant psychiatrist at the Manas Institute of Mental Health, Hubli.