Mental Health Day was celebrated globally on October 10. The World Federation for Mental Health promotes this day all over the world. The theme for this year is 'Mental health in primary care'.
Mental Health Day was celebrated globally on October 10. The World Federation for Mental Health promotes this day all over the world. The theme for this year is 'Mental health in primary care'. The goal is to spread an awareness campaign to promote the critical need to bring mental health care to a higher level of importance.
WHO has defined Health as 'A state of complete physical, mental and social well-being, and not merely the absence of disease'. Mental disorders do not occur in isolation but with other medical problems such as heart disease, diabetes, cancer and stroke. According to World Health Organisation (WHO) statistics, nearly one per cent of the global population suffers from some mental illness. We are witnessing increasing stress levels in general population along with changing lifestyles, reduced physical activity and altered dietary habits. Mental disorders can have an effect on physical health and many physical ailments can induce more mental health issues. They are inter-related and ideally should not be treated in isolation.
What is primary care?
It is the care to be provided to general population which is easily accessible. This care needs to be provided by physicians who should be able to establish a sustained relationship and address all healthcare needs of the family and community. In short, it should be provided by community-based general practitioners and local hospitals.
How can this be provided?
Screening of general population for behavioural issues is important when they primarily consult for medical problems. This is also true the other way. In short, everybody needs to be screened for both medical and behaviour health issues. It would also be important train physicians providing the primary care on identifying and treating behavioural health disorders.
Why integrate behavioural health into primary care?
Most people consult for behavioural issues in primary health settings. One more important reason is that currently behavioural issues often go undetected and hence remain untreated. India is the hub of diabetes and diabetics do have behavioural issues which remain untreated.
Some vital points about mental illnesses:
- The burden of mental disorders is great - they affect individuals, families and societies as a whole.
- Mental physical health problems are interrelated. Healthy mind rests in a healthy body and vice versa.
- There is a treatment gap for mental disorders- difference between people suffering from mental disorders and people actually taking treatment for the same.
- There is lot of stigma attached to mental disorders in India.
- Primary care will ensure easy access that people can reach out for mental health services closer to their homes.
- The majority of people with mental disorders treated in primary care have good outcomes. In India, efforts have already been made to integrate mental disorders at the level of primary care.
People with mental disorders are identified and directed to these facilities by:
- Anganwadi workers
- Primary care centre staff - junior public health nurses and accredited social health assistants
- Mental hospitals and private clinics
- Non-governmental organizations and rehabilitation centres
- Community-based social workers and volunteers
- Panchayat members
- District mental health programme team members
- School teachers In India, at a given point of time, nearly 15 million people suffer from serious psychiatric illness, and another 30 million from mild psychiatric problems.
With a population of a billion, India has very limited number of mental health facilities and professionals in providing mental health care to people. More needs to be done by government agencies and also by grassroot-level health personnel to treat behavioural health issues. A holistic approach needs to be taken to achieve physical, mental and emotional wellness of the population. In a disordered mind, as in a disordered body, soundness of health is impossible.
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