Shri Lav Agarwal (IAS), Joint Secretary, Ministry of Health and Family Welfare, Government of India. The author is an IAS officer of 1996 batch, currently associated with the National Mental Health Programme, MoHFW, GoI
— By Shri Lav Agarwal
Mental Health is vital for attaining a state of complete wellness of mind, body and soul, where an individual can grow to one’s full potential, lead a stress-free life and is able to make productive contributions to society. However, a host of mental problems or illnesses, depression, disorders and disabilities can impact wellness of an individual at any point in life. As per estimates, 6-7% population suffers from mental disorders. World Health Organisation claims that worldwide 10-20% of children and adolescents experience mental disorders.
In India, the burden of mental and behavioural disorders among children is high, with 12% children aged 4-16 years suffering from psychiatric disorders (ICMR). Also, 6% of children are born with birth defects, while 10% are affected with development delays. If left unaddressed, these conditions may hamper a child’s cognitive growth and in some cases, may even lead to irreversible, life-long physical or mental disabilities.
However, ignorance about symptoms of mental illnesses, myths & stigma associated with them and lack of knowledge regarding treatments & their potential benefits significantly contribute towards high treatment gap. Hence, there is a growing need for integrating mental health issues with general healthcare programmes, especially with child and adolescent healthcare, as they comprise the formative years of an individual’s life.
It is important that we invest in early identification and timely intervention of conditions that are a precursor to larger mental health concerns. A cohesive approach is needed whereby mental health becomes an integral aspect of child and adolescent healthcare as they comprise formative years of an individual’s life.
Addressing Development Delays, Learning & Cognitive Disabilities during childhood and Behavioral & Emotional issues during adolescence can effectively prevent larger mental health concerns later in life
Promotion and Universal Access to Mental Health Services are among key strategies highlighted under the National Mental Health Policy of India. They recommend to implement programmes for screening, early identification and treatment of mental health problems and mental illnesses. Further, they state that Anganwadi Centres to be re-designed to cater to development & emotional needs of children and offer an environment conducive for growth.
This finds resonance in the concept of District Early Intervention Centre (DEIC) under Rashtriya Bal Swasthya Karyakram (RBSK). A landmark initiative by the Ministry of Health & Family Welfare, DEIC calls for screening of children from birth-18 years for 4D’s – Diseases, Deficiencies, Disabilities and Developmental Delays – which are a precursor to larger health concerns, if left unaddressed. Among its core services are Psychological Services including evaluation of a child’s behaviour related to development, learning and mental health, as well as counseling, consultation, parent training and behaviour modification.
Moreover, the Rasthriya Kishore Swasthya Karyakram (RKSK) has included Mental Health in its Strategic Framework for Adolscent Healthcare. The significance of such an inclusion can be assessed through a study by Youth in India (2006-07) which states that almost 14% of young men and women reported symptoms of behaviours indicative of mental health disorders.
RKSK has made provisions for – Skills for dealing with stress & conflicts positively; Screening for anxiety, stress, depression, etc; Linkages & referrals to existing mental health services; Counselling; Adolescent clubs, etc.
The National Mental Health Policy has also laid due emphasis on Life Skills Education Programmes as an effective platform for addressing behavioural and emotional issues among adolescents. It states that signs & symptoms of many mental disorders such as mood disorders, depression, schizophrenia, etc, start appearing during adolescence. Hence, distress alleviation and individual attention by teachers trained on mental health promotion can act as a game changer.
Going by WHO prediction that by 2020, mental depression will be the largest cause of disability worldwide, it is time we start addressing mental health not in isolation, but in a in a comprehensive manner. This calls for dynamic engagement with medical and non-medical aspects alike.
The column originally appeared in Samvad Magazine (January 2017 issue)