April
7 of each year marks the celebration of World Health Day. From its inception at
the First Health Assembly in 1948 and since taking effect in 1950, the
celebration has aimed to create awareness of a specific health theme to
highlight a priority area of concern for the World Health Organization (WHO).
Mental
health is an integral and essential component of health. The WHO constitution
states: "Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity." An
important implication of this definition is that mental health is more than
just the absence of mental disorders or disabilities. Mental health is one of
the most neglected areas of health globally. This was true before COVID-19
(coronavirus), but the pandemic has further worsened the status of mental
health.
Mental
health is not just the absence of mental disorder. It is defined as a state of
well-being in which individuals realise their own abilities, can cope with the
normal stresses of life, can work productively and fruitfully, and are able to
make a positive contribution to their community. Mental health refers to a
broad array of activities directly or indirectly related to mental wellbeing.
Mental health is also related to promotion of mental well-being, prevention of
mental disorders, and treatment and rehabilitation of people affected by mental
disorders.
The
numbers are staggering. Today, nearly one billion people live with a mental
disorder and in low-income countries, more than 75% of people with the disorder
do not receive treatment. Every year, close to 3 million people die due to
substance abuse. Every 40 seconds, a person dies by suicide. About 50% of
mental health disorders start by the age of 14. It is estimated that over 160 million
people need humanitarian assistance because of conflicts, natural disasters,
and other emergencies. The rates of mental disorders can double during such
crises. 1 in 5 individuals affected by conflict is estimated to have a mental
health condition.
There
are several reasons why mental health has been ignored. The first one is an
associated stigma. The second is a perception of mental health disorders as a
"luxury good", as opposed to actual illnesses. The additional top
reasons include a fragmented and outdated service model. Some of these include
the provision of mental health services mainly in psychiatric hospitals, severe
lack of preventative mental health service; lagging policy changes and also a
shortage of human resources.
Determinants
of mental health and mental disorders include not only individual attributes
such as the ability to manage one's thoughts, emotions, behaviours and
interactions with others, but also social, cultural, economic, political and
environmental factors such as national policies, social protection, standards
of living, working conditions, and community support.
Mental
health is an integral part of our overall health endeavour. Thus, a holistic
approach that recognises strong linkage of body, mind, and soul is necessary.
To address the burden of mental disorders, including depression, the Department
of Health and Family Welfare has been implementing the National Mental Health
Programme (NMHP) since 1982.
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