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by Dr. Nachiket Mol & Iti Bhargava

It is estimated that more than 200 million people in India are living with a mental health condition. The problem is exacerbated by the fact that 8 out of 10 people do not receive treatment. Over the next decade, this burden is expected to double, with at least one person in every Indian household trying to cope with mental illness. Additionally, the number of suicides increased by 7% from 2020 to 2021, with daily wage workers, the self-employed, students and the unemployed most at risk. Amazingly, the proportion of students has increased by 70% in the last 10 years.

Recent research suggests that the origins of mental health problems may also lie in childhood. Adverse childhood experiences (ACEs) can increase the risk of alcohol dependence by seven times and the risk of suicide by more than 12 times. There is also a close relationship between chronic illness and mental health, with people with diabetes two to three times more likely to develop depression. It is estimated that over 100 million people in India currently have diabetes and another 136 million have pre-diabetes.

Given the scale of the problem and the speed at which it is growing, we risk being crushed under its weight unless we act urgently. We must first focus on reducing the burden of disease by addressing the underlying risk factors and building individual resilience to withstand them. Unless we stem the tide, even the best health systems will not be able to respond adequately.

Evidence suggests that building natural plasticity in a critical part of the human brain, the prefrontal cortex (PFC), can improve resilience and protect against mental illness. For example, the Good Behavior Game (GBG) is a simple classroom management tool that does this in early childhood, when PFC is most flexible. When these children reach adulthood, their levels of drug and alcohol abuse, smoking, criminal behavior, and suicidal ideation have been found to decline sharply. Even among older adults, programs such as Experience Corps, which encourage participation in activities such as volunteering at local schools, have been shown to slow some decline in PFC function.

Efforts related to patient care require accurate and timely information. The Royal College of General Practitioners Research and Surveillance Center (RSC) runs a surveillance network. The purpose of the Sentinel Network is to be an active research and monitoring unit, collecting pseudonymized and encrypted data from over 2,000 of her clinics in England and Wales. There is an urgent need to establish a dedicated mental health surveillance network that reports anonymized data to a central repository, as no similar network exists in India.

Given the pervasive nature of mental illness, it is important to build primary care systems. No such system yet exists in India, but his more than 3 million health care providers include government health workers, pharmacists, and traditional and faith healers. A first approach could be to educate this group about the nature of common and severe mental disorders and provide access to tools such as standardized videos and printed materials that can be shared. They could also refer people to higher levels of care if necessary.programs like Atomiyata shows that such an approach, if implemented carefully, can be effective at scale.

For more advanced treatments, Collaborative Care Models (CoCM) provide behavioral and It is a systematic approach to treating health conditions. CoCM can be used to provide an appropriate standard of care even when the number of specialized healthcare providers is relatively small. For example, Nepal uses his CoCM to provide outpatient care in remote areas. For inpatient care, a similar CoCM should be established between the specialized inpatient care provider and the general hospital close to the patient’s residence. Tools such as tele-ICU services will be used to provide real-time guidance from more central experts. to non-specialist doctors in these general hospitals. With these arrangements in place, tertiary care centers will be able to focus on research, protocols, and developing new models rather than the large patient volumes they currently do.

Post-discharge care model, etc. home again It has proven to be highly effective in supporting patients’ continued recovery and full reintegration into the larger society. Special long-term accommodation arrangements are made for patients with degenerative diseases such as Alzheimer’s disease and Parkinson’s disease, including: dementia village Perhaps we should consider the city of Hogewijk in the Netherlands or other more commercial urban plans.

Independent Directors of Schoon Health Dr. Nachiket Mol and Dr. Iti Bhargava
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