Mental health in India is a significant concern, with a substantial portion of the population affected by various mental health disorders. According to the National Mental Health Survey of India (2015-16), approximately 10.6% of the Indian population suffers from mental health disorders. This includes common mental disorders like depression and anxiety, as well as severe conditions like schizophrenia and bipolar disorder. Depression and anxiety are among the most common mental health issues in India.
The World Health Organization (WHO) estimates that about 56 million Indians suffer from depression and another 38 million suffer from anxiety disorders. India has one of the highest suicide rates in the world. According to the National Crime Records Bureau (NCRB) report, over 1,39,123 suicides were reported in India in 2019, indicating a significant mental health crisis. There is a considerable gap in mental health infrastructure and resources. India has a shortage of mental health professionals, with only about 0.3 % psychiatrists, 0.12 % psychologists, and 0.07% social workers per 1,00,000 people. This is far below the recommended levels by the WHO.
The stigma surrounding mental health remains a significant barrier to seeking help. Many individuals are reluctant to seek treatment due to fear of social ostracism and discrimination. Awareness and education about mental health issues are still lacking in many parts of the country. Madhya Pradesh, like many other states in India, faces significant challenges in addressing mental health issues. The prevalence of mental health disorders in Madhya Pradesh is consistent with national trends. Madhya Pradesh has a high suicide rate, contributing significantly to the national statistics Mental health stigma is prevalent in Madhya Pradesh, as in many other parts of India. This stigma often prevents individuals from seeking help and discussing their mental health issues openly. Awareness campaigns and educational programs about mental health are still limited, contributing to the ongoing challenges.
Socio-economic factors, including poverty, unemployment, and lack of education, play a significant role in the mental health landscape of Madhya Pradesh. These factors contribute to stress and anxiety among the population, exacerbating mental health issues.
To address these issues The Mental Health Unit of NHM, MP developed the Mental Health Screening App- “Mannhit” to offer mental health self-assessment by providing accessibility to people at their hand, and accordingly, establish their linkage with Tele-MANAS, District Mental Health Units (Man-Kaksh) / Mental health Institutions. Mannhit is an Android-based app available on the Play Store. Mental health self-screening assistance is available for children and adults as well. Parents may use this app and assess the status of their children, and based on the assessment one can visit to Mental health professional for further counseling and management. The app is based on scientific mental health assessment tools. The main objective of Mannhit is to:
• Develop an understanding of mental health literacy.
• Self-assess of short-term and long-term mental health symptoms.
• Develop awareness about their mental health symptoms.
• Generate awareness about the availability of Mental health services in the public health domain.
Mannhit App is divided into three sections viz.
1. Self-Assessment: Under the Self-Assessment section persons (or his/her parent or caregivers) belonging to under 18 years and above age will be able to screen his/her behavioral issues through reliable screening tools. If persons score under the normal range under such reliable tools, then App will link them with mental/emotional health awareness generation material and provide tips for good mental health. Based on the score of such preliminary screening tools the App will guide the users for further mental issues like stress, anxiety, depression, psychosis, substance use disorders, psychosexual problems, childhood mental problems, etc.
2. Awareness material/videos: The screening app links its users with awareness material for mental health literacy developed by the department
3. Linkages with mental health facilities: simultaneously establish their linkages with Tele-Manas and Mankaksh or other tertiary-level mental health facilities available in the state of MP
Online mental health self-assessment tools have the potential to positively impact communities by increasing access to mental health resources and promoting early intervention, it’s important to address potential limitations and risks to ensure their effectiveness and responsible use.
Mannhit: An App to Address Mental Health Issues
Despite various interventions and activities, there is a need for a comprehensive approach that includes increasing public awareness and education about mental health, improving accessibility and affordability of mental health services, reducing stigma through community engagement and support, and ensuring that health systems are equipped with the necessary resources and trained professionals to provide effective mental health care to address the barriers like Stigma, Cultural, Beliefs, Lack of Awareness, Misinformation, Geographical Barriers, and Economic Barriers. Confidentiality Concerns, Fear of Medications Fear of Institutionalisation, etc.
The tool increases access to mental health resources for individuals who may not otherwise seek help due to stigma or lack of access to traditional mental health services. Further, by providing individuals with the opportunity to self-assess their mental health, this tool facilitates early identification of potential issues and encourages people to seek professional help sooner. The self-assessment tools empower individuals to take control of their mental health by providing them with information and resources to better understand their mental well-being. This tool is capable of educating communities about mental health issues, symptoms, and available resources, thereby reducing stigma and increasing awareness and is cost-effective compared to traditional mental health services, making them more accessible to a wider range of people.
Importance of Self-Assessment for Mental Wellbeing
1. Early Detection: Self-assessment helps in identifying early signs of mental health issues. Early detection can lead to timely intervention, which can prevent the condition from worsening.
2. Self-awareness: It promotes self-awareness about one’s mental state, helping individuals recognize patterns in their thoughts, emotions, and behaviours. This awareness can be the first step towards making positive changes.
3. Empowerment: By understanding their mental health, individuals can take proactive steps towards managing it. This can include seeking professional help, practising self-care, or making lifestyle changes.
4. Stress Management: Regular self-assessment can help in identifying sources of stress and anxiety, allowing individuals to address them more effectively and reduce their impact on daily life.
5. Improved Communication: Understanding one’s mental health can facilitate better communication with healthcare providers, family, and friends. It enables individuals to articulate their feelings and needs more clearly.
6. Prevention of Crisis: By regularly monitoring mental health, individuals can recognize when they are approaching a crisis point and take steps to mitigate it, potentially avoiding severe mental health episodes.
7. Personalised Care: Self-assessment allows individuals to tailor their mental health care to their specific needs. They can identify what works best for them in managing their mental health.
8. Reducing Stigma: Regular self-assessment can normalize conversations about mental health, contributing to reducing the stigma associated with mental health issues.
9. Goal Setting: Understanding one’s mental health status can aid in setting realistic goals for improvement and personal growth.
10. Monitoring Progress: Self-assessment helps in tracking changes over time, which can be motivating and provide insight into what strategies are effective.
Mental health assessment tools play a crucial role in identifying appropriate mental health interventions by providing structured, evidence-based ways to evaluate age-specific, gender-based, and individual psychological well-being, symptoms, and functional abilities. Mental health assessment tools are integral to the process of identifying the most appropriate interventions and ensuring that treatment is targeted, effective, and responsive to the individual needs of the patient.
The data is used for:
1. Standardised Evaluation: These tools offer a standardised method for assessing symptoms, ensuring that evaluations are consistent across different users. This consistency helps in accurately identifying the severity and nature of mental health issues.
2. Symptom Identification: Assessment tools often target specific symptoms or disorders (e.g., depression, anxiety, PTSD). By identifying specific symptoms, clinicians can tailor interventions to address the most pressing issues.
3. Guiding Intervention Planning: The results from these assessments can guide the development of personalized treatment plans. For example, if a tool identifies high levels of anxiety, the intervention might focus on anxiety management techniques, such as cognitive-behavioral therapy (CBT) or medication.
4. Monitoring Progress: Repeated use of assessment tools can track changes in symptoms over time, providing objective data on how well the intervention is working. This can inform decisions about continuing, altering, or discontinuing a particular treatment approach. If progress is not as expected, the results can signal the need for a change in the intervention strategy, such as adjusting medication, adding therapy sessions, or exploring alternative treatments.
5. Research and Evidence-Based Practice: Mental health assessment tools contribute to data collection that supports research, leading to an improved understanding of mental health conditions and the effectiveness of different interventions. The evidence gathered through the use of these tools informs best practices and the development of new, more effective interventions.
Other interventions by the department to the provision of Mental Health Services in public health facilities
The Indian government has taken steps to address mental health issues, such as the introduction of the Mental Healthcare Act 2017, which aims to provide mental health care and services for people with mental illness. The act also decriminalises attempted suicide and ensures the rights of people with mental illnesses. There is a growing recognition of the need to improve mental health services in India, including increasing the number of mental health professionals, integrating mental health services into primary healthcare, and enhancing community-based care and support systems
National Health Mission Madhya Pradesh has initiated various programs to address mental health issues. Efforts are being made to integrate mental health services into primary health care and to increase the availability of mental health professionals. However, the implementation and reach of these initiatives need to be expanded and strengthened. There is a growing recognition of the need for community-based mental health support systems in Madhya Pradesh. Enhancing community awareness, training community health workers, and providing accessible mental health services at the grassroots level are essential steps to improve mental health outcomes in the state. National Health Mission Madhya Pradesh has initiated various interventions to provide services on mental health at the facility and community level as well.
The COVID-19 pandemic significantly impacted mental health worldwide, with many individuals experiencing increased levels of stress, anxiety, depression, and other mental health issues. Lockdowns, social distancing, and quarantines led to reduced social interactions, causing feelings of loneliness and isolation. The loss of loved ones to COVID-19 and the inability to mourn properly due to restrictions on gatherings exacerbated feelings of grief and sadness, further, job losses, financial instability, and economic downturns increased stress and anxiety related to financial security. Addressing all these issues distantly is a challenge for the department, still, the department has carried out various activities under the National Mental Health Programme.
