Lets talk about Mental Healthcare amidst Lockdown

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This post has been written by Anjali Krishnan, a 2nd year student pursuing B.B.A.,LL.B. from JEMTEC School of Law.

The ongoing pandemic is hitting life across the globe – toppling structures and economies globally. This blog highlights the Indian overview of the of the pandemic on the Mental healthcare amid nationwide lockdown. According to India’s National Mental Health Survey 2015-16, 10.6 percent of India’s 1.3 billion population suffers from mental health disorders. The report notes that 80 percent of such patients are not under medical treatment. Specifically, a societal stigma as a constraint delivering a big blow, jeopardizing prospectus of mental illness with the social and economic unrest of the economic sector. The Magnitude of the impact of a complete social and economic shutdown may not be easy to estimate arithmetically. According to recent CMIE data, the unemployment rate for the first week of April spiked to 23%. This scale of joblessness is the largest ever recorded, including even during the great depression. This article analysis the impact of nationwide lockdown in consonance with mental healthcare.

According to World Health Organization, who coined the definition of “health” in 1946 in their constitution[i] and introduced to the world the concept of it “as a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity.” The definition of health given by WHO was criticized due to its limitation of understanding and new definitions were coined which could cover all the dimensions of health. The reformative approach of the legislature in systematizing the mental healthcare sector of India has resulted in several changes in the society including the perspective of the people in acknowledging mental illness, providing the basic amenities necessary for attending the problem includes creating awareness amongst people, giving rights to patients to direct the way of treatment and the right to disclose their problems. Novel coronavirus may not be the only dangerous disease sweeping the globe — mental illness could also reach alarming levels during the coronavirus lockdown if not kept in check because India as a growing economy is facing a catastrophic rise in unemployment following the forced shutdown of businesses across the country to stop the spread of Covid-19 – and experts are warning it could trigger a severe mental health crisis. Those hardest hit are likely to be the poorest, including many people of color, and those who benefited least from the last economic boom But beyond the dollar signs, worriedness is floating over the long-term effects that being unemployed will have on India’s mental health – a problem that will further highlight the cracks in the country’s safety net and healthcare system.

A large body of scientific literature have reiterated that there’s a close relationship between so-called macro-economic indicators, like unemployment and employment, and mental health and suicide. The effects of unemployment on mental health are long-lasting. An Association for Psychological Science study published in September 2019 found that those who experienced financial, housing or job-related hardship during the Great Recession and other economic downturns, which led a one-per-cent increase in the unemployment rate which resulted noxiously in a one-per-cent uptick in the rate of suicides because they were more likely to have depression, anxiety or substance abuse as many as three years after the recession[ii]. CRPD does not mention mental illness, it is likely to fall within the definition of “psychosocial disability” used by the Convention. Phrasing general principles of human rights, the UN-CRPD is completely applicable to the situation of people with mental illnesses as well as with other kinds of disabilities. Mental illness is not necessarily associated with disability; however, a clear distinction is not required since the UN-CRPD phrases principles which should be valid for all human beings, disabled or not[iii]. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.[iv] The studies during the SARS epidemic expounds that quarantine has a serious effect on the mental health of health care workers. It predicted symptoms of acute stress disorder, depression, and alcohol abuse. Even three years later, quarantine was associated with post-traumatic stress symptoms, which were, again, more severe in health care workers. As a result, many experienced avoidance behaviors and sought to minimize contact with patients. Some didn’t report back to work at all[v]. Some health care workers who are frontline warriors battling the pandemic are using words like betrayal and coercion and moral injury to describe this experience. They feel betrayed by their employers, the health care system, and the government, all of which were woefully unprepared for a pandemic. According to a study conducted by the National Institute of Mental Health and Neurosciences, India, in 2016, across 12 different states, the prevalence of depression for both current and lifetime is 2.7% and 5.2% respectively. Approximately 1 in 40 and 1 in 20 are suffering from past and current episodes of depression all over the country[vi].

As per article 39(f) which was added to the constitution through the 42nd amendment act, 1976 of Directive Principles of State Policy(DPSP) which reiterates that “children are given opportunities and facilities to develop in a healthy manner and in conditions of freedom and dignity and that childhood and youth are protected against exploitation and against moral and material abandonment.” Meaning thereby is to provide a sustainable living for the children of our nation. This refers to better integration of mental health care into primary care services, but also greater financial protection. International bodies have reiterated that the integration of mental health care in primary services is important in ensuring available, accessible, affordable, acceptable and accommodation services to people with mental health problems and their families. In Conclusion, Mental health issues can only be curbed by annihilating social stigma towards mental health as it’s normal for people to be anxious and worried amid a highly disruptive health emergency that is shot through with uncertainties.

[i] United Nations Economic and Social Council, Constitution of World Health Organisation, Res. WHA26.37, WHA29.38, WHA39.6 and WHA51.23, Sess.  2, Off. Rec. Wld Hlth Org. 2/100, 1, (11/01/2020), available at: https://www.who.int/governance/eb/who_constitution_en.pdf

[ii] Lauran Aratani, Experts warn of mental health fallout from mass US unemployment, The Guardian (April 3, 2020), available at:  https://www.theguardian.com/world/2020/apr/03/mental-health-coronavirus-mass-unemployment-us-experts

[iii] Teinert, C., Steinert, T., Flammer, E. et al. Impact of the UN convention on the rights of persons with disabilities (UN-CRPD) on mental health care research – a systematic reviewBMC Psychiatry 16, 166 (2016). available at: https://doi.org/10.1186/s12888-016-0862-1

[iv] Mental health: strengthening our response, World Health Organisation available at https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

[v] Jessica Gold, The Covid-19 crisis too few are talking about: health care workers’ mental health, The Stat News. ( April 3, 2020), available at: https://www.statnews.com/2020/04/03/the-covid-19-crisis-too-few-are-talking-about-health-care-workers-mental-health/

[vi] R. S. Murthy; National Mental Health Survey of India 2015–2016, 59 Indian J Psychiatry 21–26 (2017), available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419008/

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