A year has gone by after two devastating waves of Covid-19; there is much before us to deal with. We seldom, if ever, ponder over the impact of mental health on our society. The death of a promising new actor, who appeared to have a history of mental illness, was a topic of conversation in many drawing rooms across the country on June 14, allowing for the moment the despicable display of depravity by modern news media, which is fully aided in its pursuit by social media.
The incident evoked a pensive mood across the nation. The news came as an awakening from the dazzle of celebrity glamour to the grim realities of India. It is not that the real picture of Indian healthcare was shockingly revealed by the news. The news broadened the perspective, especially for the need for urgency. Mental health is still a luxury, even for those at the top. And, after passing a year with two waves of the Covid-19 pandemic, Indian healthcare has laid bare all its appearances.
In 2016, the World Health Organisation (WHO) estimated the impact of depression and anxiety disorders on the global economy at a whopping one trillion dollars—a third of the Indian economy. In a country where the average Indian earns about $2,000 per year, providing basic mental healthcare to nearly 1.4 billion people has always been considered nearly impossible. To its credit, the Modi government implemented a progressive change by enacting the Mental Health Act, 2017 (which replaced the previous act from 1987). Apart from making access to mental healthcare a statutory right (Section 18), the Act goes a step further; with Section 115, attempts to commit suicide have been decriminalised.
The section presumes that a person attempting suicide is reeling under severe stress and debars the State from initiating prosecution under Section 309 of the Indian Penal Code. Hence, the Act offers welcome relief to mental health patients. Likewise, other provisions— legal aid, statutory reliefs, mandatory check-ups—are big positives. But we still lack quality healthcare infrastructure. In light of our harsh economic realities, our best hope is to focus on other viable alternatives. It is worth considering as community healthcare services, with a combination of localised services—community healthcare centres, clubhouses, self-help groups, etc.—are proven to be more accessible and less exclusionary. These approaches are essential where the cost of erecting brick-and-mortar infrastructure is unbearable. These are, of course, starting points for a wider debate. (All in the hope that after the Covid-19 recession, there will be a desire to have the debate!)
Another sad chapter that revealed its face in this pandemic was social media. Our “online” modern lives are brimming with digital acquaintances. This demonstrates a significant lack of genuine relationships. Sooner rather than later, we will come to realise the baneful effects of excessive consumption of online material. We know what is going on in the world better than anyone in the history of mankind, and yet we have never been this alone before.
Some revel in the anonymity of their being, especially when they are young, which works fine for sometime. But traditional bonds of family and society offer much-needed respite to a lonely heart. Studies have supported the quintessential need for social interaction, and most institutions that facilitate such interactions are not State-owned. The UK government established the “Ministry of Loneliness” with the best of intentions to combat the negative effects of prolonged isolation. The results of such initiatives are yet to be scientifically established.
That being said, in India, we do not have such resources. The nitty-gritty of financial allocation will deserve a long essay to be effectively assessed. In short, where do we go from here? The media will again pounce on the tragedy of the dead actor. Armed with salacious material, the upcoming days will be a feast for social media. All of it puts the onus on the shoulders of responsible stakeholders, public health experts being one of them. For some people in dire need, the motto can be: “It is better to burn out than to fade away” (from the song, Hey Hey, My My (Into the Black)).
Unfortunately, that can’t be the recourse for public health professionals.
(The writers are advocates at the Delhi High Court.)