Mental health is a key part of our overall well-being. The World Health Organization (WHO) states that there is no health without mental health. It is the source of our collective and individual ability as people to reach our full potential.

Mental health refers to the way in which we are aware of our own abilities and can cope relatively well with the ups and downs of life. Someone with good emotional well-being is capable of working productively and making a contribution to his or her community.

A range of factors can impact our emotional well-being. These include genetics, prolonged stress, physical illness and traumatic events. Environmental issues such as the economic, political and social climate can also have an impact.

Current figures suggest that one in four people in the UK will experience a mental health problem each year. The most common types include depression and anxiety. Both can greatly affect things like work productivity, physical health and the wider economy.

Talking therapies such as psychotherapy and counselling are considered effective forms of mental health support. This page will explore mental health in more detail and will look into key mental health statistics. It will also cover how counselling can help. 

 

Mental health statistics

At least 60 million Indians — a number more than the population of South Africa — suffer from mental disorders, even as the country lags the world in medical professionals and spending on mental-health issues.

 

Nearly 10-20 million Indians (1-2 per cent of the population) suffered from severe mental disorders such as schizophrenia and bipolar disorder, and nearly 50 million (5 per cent of population) suffered from common mental disorders like depression and anxiety at the end of 2005, Health and Family Welfare Minister J.P. Nadda informed the Lok Sabha (lower house of Parliament) in May 2016, quoting data from the National Commission on Macroeconomics and Health, 2005, the last report available.

 

India spends 0.06 per cent of its health budget on mental health care. This is less than Bangladesh (0.44 per cent). Most developed nations spend above four per cent of their budgets on mental health research, infrastructure, frameworks and talent pool, according to a 2011 World Health Organisation (WHO) report.

 

The government has commissioned a national mental health survey through the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, to estimate the number of mental patients and utilisation patterns of mental health services.

 

Started on June 1, 2015, the study interviewed 27,000 respondents by April 5, 2016, according to a reply in the Lok Sabha from the Ministry of Health and Family Welfare.  India is short of health professionals to address mental issues, particularly at the district and sub-district level.

 

There are 3,800 psychiatrists, 898 clinical psychologists, 850 psychiatric social workers and 1,500 psychiatric nurses nationwide, according to a reply by the Ministry of Health and Family Welfare in the Lok Sabha in December 2015.

 

This means there were three psychiatrists per million people, according to data from WHO, 18 times fewer than the commonwealth norm of 5.6 psychiatrists per 100,000 people.  By this estimate, India is short of 66,200 psychiatrists. Similarly, based on the global average of 21.7 psychiatric nurses per 100,000 people, India needs 269,750 nurses.

 

The Mental Health Care Bill, 2013, which provides for protection and promotion of rights of persons with mental illness during the delivery of health care in institutions and in the community, was passed unanimously by a voice vote in the Rajya Sabha (upper house of Parliament) on August 8, 2016.

 

The new Bill has increased the funding to centres of excellence in mental health, from Rs 30 crore to Rs 33.70 crore per centre.  As many as 15 centres of excellence in mental health and 35 post-graduate training departments in mental health specialties have been funded to address the shortage of mental health professionals nationwide.

 

The mental health statistics listed below offer insight into the nature of the problem worldwide. Please note: this list is not exhaustive.

 

• Mental health problems affect 450 million people worldwide.
• 1 in 6 adults in the UK experience a significant mental health problem each year.
• 1 in 10 children and young people between ages five and 16 have a clinically diagnosed mental health disorder.
• Depression affects 2.6 in 100 people.
• Anxiety affects 4.7 in 100 people.
• Mixed anxiety and depression is the most common disorder in Britain (affecting 9.7 in 100 people).
• More women than men are diagnosed with depression (1 in 4 compared to 1 in 10 men). 
• Male mental health is a growing concern in the UK as suicide is currently the leading cause of death in men under the age of 50.

 

In 2014, concerned over the growing problem of mental health in India, the Union Minister of Health and Family Welfare had appointed NIMHANS to study mental health status in the country.

 

A major concern in the findings, which were recently submitted to the Union Health Ministry, is that despite of three out of four persons experiencing severe mental disorders, there are huge gaps in treatment.

 

Due to the stigma associated with mental disorder, nearly 80 per cent of those with mental disorders had not received any treatment despite being ill for over 12 months, the study says.  Poor implementation of the scheme under the national Mental Health Programme is largely responsible for this. 

 

The following is the list of facts and observations by the study, which highlights on the prevalence of mental health and the nature of the problem in India.

 

• Common mental health disorders such as depression, anxiety and substance use are as high as 10 per cent in the total population;
• Almost 1 in 20 suffers from depression: it is found to be higher in females in the age group of 40-49;
• 22.4 per cent of the population above 18 years suffers from substance use disorders.  The highest was contributed by tobacco and alcohol use disorder;
• Nearly 1.9 per cent of the population is affected by severe mental disorders.  These are detected more among males in urban areas;
• While prevalence of mental illness is higher among males (13.9 per cent) as compared to females (7.5 per cent), certain specific mental illnesses like mood disorders (depression, neurotic disorders, phobic anxiety disorders etc) are more in females;
• Neurosis and stress related illness is seen to be more in women;
• Prevalence in teenagers aged between 13 and 17 years in 7.3 per cent

Types of mental health issues

Mental health issues can have a profound impact on how we think, feel and behave. They can range from the daily worries we all have from time to time, to serious long-term problems that require treatment to manage effectively.

According to professionals, there are two main types of mental health problems. The categories are neurotic or psychotic symptoms. These definitions can help professionals with diagnosis and treatment. However, some people may experience a combination of the neuroses and psychosis. Therefore distinguishing between the two may not always be useful.

Neurotic symptoms

Individuals that have 'common mental health issues' are very likely to have neurotic symptoms. These are severe versions of 'normal' emotions, such as stress, sadness and anxiety. We all feel down or worried every now and then, but if those emotions start impacting daily life, it may be a sign of a mental health problem.

If mental health issues are ignored or dismissed as character traits it can lead to further problems. For example, some people may no longer feel able to lead an enjoyable and productive life. This is why it is so important to seek support as soon as your problems overcome your ability to cope.

Mental health issues with neurotic symptoms include:

• depression
• anxiety
• obsessive compulsive disorder (OCD)
• phobias
• post-traumatic stress disorder (PTSD)
• panic disorders

Psychotic symptoms

Mental health issues with psychotic symptoms are less common. Psychotic symptoms interfere with a person's perception of reality and may include hallucinations. These include seeing, smelling, hearing or feeling things that no one else can. People experiencing psychosis may also form unrealistic views about themselves, other people and the world around them.

If you are concerned about yourself or someone else, it is advisable to speak to your Doctor.  They will be able to diagnose your condition and recommend treatment options. Medication and counselling are among the types of mental health support that should be offered.

Mental health issues with psychotic symptoms include:

• schizophrenia
• eating disorders
• substance abuse
• bipolar disorder
• personality disorder

 

Signs

When you get a physical illness like a cold, you may experience symptoms such as a sore throat and blocked nose. These signs tell you that something is wrong so you can take medication, or rest in bed for a few days. When it comes to our emotional well-being the signs aren't always so obvious. They are often hidden or mistaken for other things.

There is no set list when it comes to the signs and symptoms of mental health problems. Each condition varies and of course each individual is different, too.  If you think you might have an issue with your emotional well-being, you should visit your Doctor.

Some very general signs to look out for include:

• Withdrawing from society - Feeling the need to hide away by avoiding social contact.
• Teary - Crying a lot or constantly feeling like you're about to cry.
• Drop in productivity - Your grades go down or you stop performing so well at work.
• Weight-loss or weight gain - Weight changes indicate a change in eating patterns, symptomatic of underlying emotions.
• Dirty or untidy - Spending a lot of time in your 'comfy clothes', or failing to keep on top of your hygiene.
• Tired - Feeling drained, dopey or lethargic.
• Difficulty speaking - Getting your words jumbled up, forgetting the right word for something, or talking too quickly or slowly.
• Spending too much - Being reckless with money

Causes

As aforementioned, mental health issues can have a wide range of causes. Often it is not known exactly why someone develops symptoms. There are, however, certain factors that are thought to play a role in triggering problems. These are:

• psychological
• physical
• social and environmental

Psychological causes

A 'psychological cause' is something that affects the mind or emotional state. Traumatic experiences such as the loss of a loved one or a serious road accident can trigger mental health issues. When something traumatic occurs, it can completely change a person's perception of the world. This can result in feelings of anger, helplessness, fear and guilt. These may persist long after the event has happened. As a person tries to deal with and contain their negative feelings, unhealthy behaviours can emerge. Examples include self-harm, drug abuse, bulimia and suicidal thoughts.

Physical causes

A 'physical cause' is something that affects the body on a biological level. Physical causes of some mental health issues include:

• Genetics - Experts believe some people are more at risk than others. They have a genetic 'predisposition' because of genes passed down from parents.
• Early development - Some studies suggest a baby is at greater risk if his or her mother takes drugs or contracts a virus while she's pregnant.
• Head injuries - In some cases people develop psychotic symptoms after a serious head injury.
• Nutrition - Links have been found between certain vitamin and mineral deficiencies (e.g. Vitamin D, zinc and fatty acids) and our emotional well-being.

Social and environmental causes

The things that happen around us can have a big impact on mental health. Social and environmental causes include:

• where you live
• where you work
• the relationships you have with family and friends

 

Sometimes it is not possible to change these things but sometimes it is. If you can improve your social and physical environment somehow, then you may be able to improve your emotional well-being. Counselling is one means of mental health support that can help you make positive changes.

Living with mental health issues

Mental health issues are complex. Unlike a cold or cough, symptoms do not clear up after a course of antibiotics. Often people have to learn to live with their problems. They may find everyday situations such as work and socialising particularly difficult.

Some of the challenges faced include:

• social stigma
• going to work
• going to school
• relationships
• parenting
• physical health

Social stigma

Unfortunately social stigma attached to mental health still exists in Society.  According to the professional estimates, nine out of 10 people with mental health issues are affected by discrimination of some kind. Other people's ignorance and lack of understanding can make it hard for people with certain conditions to maintain stable relationships, find work or suitable housing. Some may find themselves socially excluded from mainstream society.

Research and greater understanding of some conditions has helped change views of mental health. However, sensationalised films, news articles and stories mean misconceptions still exist. Common misconceptions include:

• All people with mental health problems are dangerous and violent.
• Mental health issues are a character flaw and not an actual condition

 

In order to tackle these damaging stereotypes, more needs to be done to broaden communication between people with mental health issues and the wider community. This should help spread awareness that sufferers aren't 'mad', 'weak', or 'dangerous'. They are but normal people coping with challenging conditions.

Attending work and school

Mental health statistics show that one in six workers are dealing with a mental health issue at any one time. Certain problems can be caused by work (usually stress and anxiety), while some mental health conditions can impact our ability to work productively. Many people are reluctant to speak about mental health in the workplace. This is because they fear they may be penalised or judged for it.

Young people in school worry they'll face criticism, alienation or bullying if their peers know they have mental health issues. While it can be difficult to talk about their emotional well-being with peers, colleagues and bosses, keeping an open dialogue in school and the workplace is important. This is because it could help alleviate stigma and prevent problems from escalating.

Relationships

Some mental health issues can make it difficult for people to build healthy relationships. When problems emerge after a couple has been together for some time, the new challenges can lead to difficulties. Frustration and lack of understanding can cause tension and arguments. Many relationships do not survive this. Couples counselling is helpful for those who are keen to open up and make space for change in their relationship. This type of mental health support can help couples to learn ways of coping with mental health issues together.

Parenting

Having children can make it even more challenging living with mental health issues. Parents need to be stable and supportive to provide the best care for their children. Unfortunately, some mental health problems by nature make this difficult.  Social stigma, negative attitudes and discrimination associated with mental health illness is still a major obstacle in India, which further compounds this difficulty for parents.  The ups and downs, bad days and good days can be difficult for children to deal with. Having the right mental health support in place is important. Talking therapies such as mental health counselling can help families overcome the challenges together.

Mental health support

If you are concerned about your emotional well-being you should visit your Doctor. They will be able to diagnose any problems and recommend treatment. It is important to note that all appointments and topics discussed are completely (should be) confidential, and support is available to ensure the care of both female and male mental health.  

Mental health support covers a range of things designed to manage symptoms and improve quality of life. The most common types of treatments include:

• Prescribed medication to control symptoms (they are not a cure).
• Talking therapies including psychotherapy, counselling, group psychotherapy, psychoanalysis and other forms of mental health counselling

Medication

Medication is prescribed to help reduce the symptoms of some mental health issues. Sometimes drugs can help to improve quality of life and make people feel less overwhelmed by their condition. However they are not provided as a cure.  Depending on what type of problem you have, you might be prescribed:

• Antipsychotics to reduce symptoms of psychosis (i.e. hallucinations, distorted view of reality).
• Antidepressants to reduce the symptoms of depression (i.e. loss of emotion, low moods).
• Mood stabilisers to moderate extreme changes of mood.
• Benzodiazepines to reduce anxiety.

Mental health counselling 

Mental health counselling involves talking about your problems with a trained counsellor or a psychotherapist. Talking therapies can help you understand what may have caused your problems and how to manage them.  There are many different types of talking therapy that can help. These include:

• Cognitive behavioural therapy (CBT) - This type of mental health counselling focuses on the 'here and now'. It aims to change negative patterns of thinking and behaving.
• Cognitive analytical therapy (CAT) - Explores new ways for the client to cope with problems.
• Creative therapies - Art therapy and drama therapy can be used in counselling for mental health. Creative therapies explore ways of channelling emotions.
• Family intervention - Encourages the family to engage as a unit to solve problems that affect home life.
• Dialectical behaviour therapy (DBT) - Teaches clients how to react normally to emotional triggers.
• Psychotherapy - Encourages clients to use their own insight to solve problems.
• Counselling - Allows clients to talk freely without fear of criticism or judgement

 

What should I be looking for in a counsellor or psychotherapist?

Mental health covers a wide spectrum of issues, some of which require specialised treatment. To find out more about different mental health conditions and recommended courses of action, we recommend you contact your Doctor as a first port of call. You may also visit National Health Portal (NHP) for more information on services available in the country https://www.nhp.gov.in/disease-a-z.