Earlier this month, actor Deepika Padukone revealed that her past battles with depression have left her in constant fear of a relapse. This isn't the first time Padukone has spoken about mental health, but she's one of the few celebrities to openly discuss something that makes the majority of us squeamish. Mental health has always been a taboo topic in India, not to mention rife with misconceptions. For example, mental disorders are considered a largely urban phenomenon, despite the fact that they are equally prevalent in rural India. In fact, the situation in villages is far worse because mental disorders often go under the radar due to lower awareness and the lack of facilities to diagnose and treat them.
For some time now, India has been teetering on the brink of a mental health crisis. According to official estimates, 6-7% of India's population lives with minor to major mental health concerns (ranging from depression and anxiety, to schizophrenia, bipolar disorder and others). The actual numbers could be much higher, suggests a report released by NIMHANS last year, which puts the figure of mental health sufferers at a whopping 13.7% of India's adult population. The report adds that nearly 11% of people over 18 are suffering from a mental disorder necessitating "active interventions".
Sadly, most of them never get it. Only about 1 in 10 Indians with mental health disorders receive treatment. With less than 4000 psychiatrists in the country, and very low budgetary allocation to mental healthcare, the lack of treatment options and institutional support for victims has taken a heavy toll, particularly in India's rural regions.
Suffering in silence
Rural India is home to nearly 70% of India's population, but has dismally low mental healthcare treatment rates compared to urban India. There are a number of causes for this, and the lack of health infrastructure is just one among them.
Even where facilities are available, a major challenge to mental healthcare delivery in rural India is the mindset. A potent mix of superstition, notions of family 'honour', and reliance on 'faith healers' makes it nearly impossible for rural patients with mental disorders to get the care they need. The fear of being socially ostracized makes people chary of publicly discussing the mental health issues of a friend or family member, let alone seeking help on the latter's behalf.
Low literacy and awareness levels in rural areas also prevent people from coming forward to claim government benefits or facilities for those suffering from mental illnesses. Therefore, despite the best intentions of the authorities, welfare schemes like disability cards, pensions or free or subsidised medicines often never reach the intended beneficiaries.
Crushing poverty also takes a toll on mental health in rural India. Most agricultural suicides in India's villages occur due to sustained economic stress and indebtedness, which drives farmers and farm workers into extreme despair. This despair also manifests itself in alcohol or drug abuse, which only tends to exacerbate the problem.
And finally, distances and the lack of proper roads also compound the problem, since they hinder access to treatment centres, which are often located in larger towns several miles away from the villages.
So what is the solution?
Rural mental healthcare in India needs a whole new, grassroots-focused approach. The government's National Mental Health Programme and National Rural Health Mission have laid the ground for interventions by various organisations working in the field of mental health. One of them is The Live, Love, Laugh Foundation, which has partnered with The Association of People with Disability (APD) and Minds Foundation to run and also expand existing rural programmes. These community health programmes build on the existing infrastructure to identify patients, get them access to mental health care, and rehabilitate them socially and economically.
Efforts like these prove that it is possible to close the mental healthcare gap in rural India by increasing awareness, improving social acceptance of illnesses, and delivering solutions directly to the beneficiaries. Supporting more such initiatives is critical for enabling millions of rural Indians to overcome the dark and debilitating effects of mental disorders, and get back on the road to living happy, productive and fulfilled lives.
Millions of people with mental disorders in rural India never get the help they need. The Live, Love, Laugh Foundation (TLLLF), started by actor Deepika Padukone, has partnered with The Association of People with Disability (APD) to take mental healthcare to rural India.
The beneficiaries of this programme have typically been economically disadvantaged rural or slum dwellers in the age group of 16-60 in Davangere district, Karnataka. The foundation has supported this programme since 2016-17; during which the reach spread from 2 talukas to 6 talukas and from 200 patients to 800 patients. In the past, TLLLF has undertaken other initiatives, namely a school awareness programme, 'You Are Not Alone', a doctor awareness programme, 'Together Against Depression', and India's first public awareness campaign on mental health, 'Dobara Poocho'. To know more about their initiatives, click here.