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Wednesday, January 7, 2015

India's Mental Health Crisis

This is an editorial that appeared in New York Times

EDITORIAL

India's Mental Health Crisis

BY THE EDITORIAL BOARD
On Oct. 10, the government of India announced an ambitious new policy to provide universal mental health services. The policy, the country’s first on mental health, is admirable for its focus on the needs of the country’s poor, on lifting widespread stigma around mental health disorders and on preventing suicide. A bill to make the new policy law is awaiting approval by Parliament.
India has the highest number of suicides in the world. According to the World Health Organization, of 804,000 suicides recorded worldwide in 2012, 258,000 were in India. Indian youths between 15 and 29 years old kill themselves at a rate of 35.5 deaths per 100,000 — the highest in the world — and suicide has surpassed maternal mortality as the leading cause of death of young Indian women. A report from Human Rights Watch released in December exposed the horrific conditions in institutions where too many Indian women with mental and intellectual disabilities are confined, many against their will, and where some are subject to physical and sexual abuse and electric-shock therapy.
Unfortunately, the new policy may be almost impossible to translate into action. On Dec. 23, the government ordered cuts in the health budget of nearly 20 percent, from $5 billion to a little more than $4 billion. Given other serious health needs, the “fresh funds” promised by the government to pay for new mental health services and train qualified mental-health professionals are unlikely to materialize.
This is a pity. There is only one psychiatrist for every 343,000 Indians currently, too few to reduce the shameful suicide rate. Among other problems are depression, acute economic insecurity, anxiety among youths over educational success, and distress among young women caught in a bind between the opportunities of a changing India and pressure from traditionally minded families to marry.
Unless Prime Minister Narendra Modi reverses course, his impressive new policies will end up exactly like the development projects of the past administrations he excoriated during his campaign: high-minded pronouncements on paper with zero delivery in practice.

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