Making a significant investment in improving mental health services, particularly for those suffering from depression and anxiety disorders, makes business sense, according to a paper by World Health Organisation professionals published in the medical journal, Lancet Psychiatry.
While recognising that depression and anxiety disorders are debilitating and result in an “enormous amount of human misery and lost health,” the paper titled – Scaling-up treatment of depression and anxiety: A global return on investment analysis – focuses on lost economic output, particularly the loss of man hours. It was published online on April 12.
Mental health issues often affect a person’s ability to study or work for long periods. Dr Arun John from the Vandrewala Foundation, which runs the Mental Health Helpline 18602662345 in India, said that the loss of man-hours starts early in life for persons suffering from mental health issues.
“Mental health affects people the most between the ages of 18 and 35, which is the most productive time of a person’s life,” said Dr John. “If the person is mentally challenged and is not diagnosed, then the disorder graduates into a disease. It needs to be treated with more drugs, which are powerful and will require more counselling. That affects the mental, intellectual and bodily functions of the individual.”
Investing in the future
The authors of the Lancet paper studied investment patterns on mental health infrastructure in 36 countries, including India. They concluded that a scaled-up response to the public health problem gave substantial returns economically, and also increased the number of healthy years in a population. Scaling up mental health operations could include building awareness about mental health and illness, providing better health and social care services, better social and financial protection for persons with mental disorders, and better legislative protection and social support for persons, families and communities adversely affected by mental disorders, as recommended by the WHO.
Effective depression treatments can get people back to work. The Lancet study quotes programme evaluation data provided by the non-profit, Basic Needs, for livelihoods from four countries including India. The data showed that effective treatment of patients suffering from depression led to a 50% rise in the proportion of patients undertaking income-generating activities. This figure was 30% among those with anxiety.
The investments in intervention could be offset by a reduction in hospital-based inpatient episodes, outpatient visits, and even the reduced use of informal or indigenous healthcare providers such as faith healers, the paper said.
Such interventions will not only lead to an improvement in the overall health of a mentally-challenged person, and restore that person’s ability to do paid work, it could also lead to improved opportunities for individuals and households to pursue leisure interests and participate in more social and community activities.
“If a person is mentally challenged, it affects the family and the community,” said Dr Rudresh Vyas, head of the department of Psychology, MTB Arts College, Surat. “For instance, I have seen in government schools that there are some people who suffer from mental disabilities. If he or she is treated well, then it will benefit the students too.”
The legislations related to mental health in India are quite outdated and don’t put the rights of the patient first. For instance, The Mental Health Act, 1987, allows the state to place people with mental disabilities in mental institutions.
Amba Salelkar, of the Chennai-based advocacy group, Equals Centre for Promotion of Social Justice, said that the mentally ill had rights that should not be suspended. “The Act speaks of different ways in which people are sent to mental hospitals – either voluntarily, or through a magisterial order or via police orders,” said Salelkar. “But the patients are not released unless they have someone to take care of them. So, they end up being locked up for a long time. We should not be depriving people of their rights and force them into treatment.”
Many disabled people are discriminated against socially, lose their jobs, and face poverty and homelessness. Some countries have laws to prevent that from happening. For instance, the United Kingdom’s Equality Act 2010 aims to end discrimination of disabled people in a range of circumstances including employment, education, provision of goods and services. According to this Act, a mental health condition is a disability if it has a long-term effect on a person’s normal day-to-day activity.
India needs a similar law, say mental health experts.
“If you seek treatment for mental health, your rights need to be protected,” said Salelkar. “People diagnosed with a mental illness have no rights. We need an anti-discrimination law that protects them.”