India honestly cooperated with WHO in sharing data for its World Mental Health Atlas, 2017. But China and Pakistan have hardly shared any data of status of mental health sector to WHO.
@prashanthamine
Mumbai: As the world observes World Mental Health Day on Saturday, October 10, the World Health Organisation (WHO) in a recent rapid assessment report has expressed concerns over the impact of Covid-19 pandemic on mental health. The impact of Covid-19 on mental health has been more acutely and seriously felt in countries coming under WHO regions of – Africa, America’s, Western Pacific, European, and Eastern Mediterranean countries.
In a related WHO survey on World Mental Health Atlas, 2017 (WMHA) reveals that while India has honestly cooperated and shared its data on state of mental health in India, the same cannot be said to be true of China and Pakistan. Both the countries have shared hardly any data about state of mental health in their respective countries.
While it may not be surprising for Pakistan not sharing any data, China not sharing any data with WHO is what further raises eyebrows. Following the outbreak of the Covid-19 pandemic from its own soil, countries have held China responsible for withholding crucial information to the world body. The WHO too has been accused by USA and other countries of turning a blind-eye towards the actions of China, even as the Covid-19 pandemic raged in the country before spreading across the world.
On October 5, the WHO released its report “The impact of Covid-19 on mental, neurological and substance use services: results of a rapid assessment”. A total of 130 WHO member states (67 %) had participated in the survey. Nearly 116 countries (89%) stated that they had Mental Health and Psychological Support Services (MHPSS) as part of their national Covid-19 response plans. Nearly, 93 percent of the countries admitted to disruption in services for Mental, Neurological and Substance use (MNS) disorders due to Covid-19 pandemic.
Many countries which reported disruption in mental health services attributed them to – decrease in out-patient volume due to patients not presenting themselves, travel restrictions hindering access and cancellation of elective care.
Nearly 70 percent of the countries have responded by using Telemedicine / Teletherapy to replace in-person consultations (telephone or video conferencing). More recent is the emergence of Mobile Medical Apps (MMAs) like Practo, 1mg, NetMeds, BookMeds, Yodawy, SmartMedics and others have brought consulting doctors, pharmacies and patients face to face.
According to the WHO report Covid-19 itself is associated with neurological and mental complications, such as delirium, encephalopathy, agitation, stroke, insomnia, loss of sense of taste and smell, anxiety, depression and Guillain-Barre syndrome. People with dementia have higher susceptibility to Covid-19 and higher rates of deaths associated with the disease.
Many people are afraid of dying and infection and of losing their incomes and livelihoods. Many people may be facing increased levels of alcohol and drug use or engaging in addictive behaviors. There may be long term mental or neurological consequences following Covid-19 infection, adds the WHO report.
The WHO in its report further warns that disruption in care for MNS can be life-threatening for treatment of epilepsy, unaddressed suicide risks, unmanaged opioid dependence leading to overdose, and severe alcohol withdrawal syndromes.
The WHO in its World Mental Health Atlas, 2017 points out that even before the Covid-19 pandemic, the levels of public expenditure on mental health care was minimally low in low, lower-middle and middle income countries, as low as US $1 per capita, as against US $80 per capita in high income countries.
What is important to note here is that the ratio of mental health workers to the population is very low in low income countries. In low and lower-middle income countries the ratio of mental health workers to the population is just two mental health care workers to per one lakh population. The same ratio in high income group countries is 70 mental health workers per lakh population.
As per the WHO’s World Mental Health Atlas, 2017 data for India, the suicide mortality rate is 16.3 percent. The country adopted a stand-alone law on mental health care only in 2017. The total expenditure on mental health care of the overall budget is just 1.30 percent. Whereas, the total number of mental health care workers per one lakh population is just 1.93.
The break-down of the total mental health care workers compared to per one lakh population is even more depressing – psychiatrists 0.29, child psychiatrists 0.00 (zero), other specialist doctors 0.15, mental health nurses 0.80, psychologists 0.07, social workers 0.06, occupational therapists 0.03, speech therapists 0.17, other paid mental health care workers 0.36.
Furthermore, the data on mental health care infrastructure is worse in India. As per the World Mental Health Atlas, 2017, there are just 136 hospitals catering to mental health care (more famous being at Agra and in Thane), 389 psychiatric units attached to hospitals, 15 forensic inpatient units, 223 residential care facilities and 45 Inpatient facilities for children and adolescents.
As per the World Mental Health Atlas, 2017, total reported cases of mental health in 2017 were 72,067, out of which total inpatients were 56,177 and involuntary admissions were 15,890. Out of the total inpatients, 68 percent were there for less than one year, 25.7 percent were in hospitals from one year to five years and 6.1 percent inpatients were in hospitals for more than five years.
