Two sisters in Noida shut themselves up in their flat for seven months in 2011. After being rescued by neighbours and the police, one of them died and the other, reduced to a bag of bones, was left to pick up the pieces of her life on her own.In a similar incident in 2007, Delhi Police rescued two sisters who had locked themselves up in their house in south Delhi's Kalkaji with the body of their youngest sibling.These are only some of the cases that have come to light: an indication of the difficulties involved in treating the mentally ill. There are many more in the country where an estimated 10-12 million, or one to two percent of the population, suffers from severe mental disorders such as schizophrenia and bipolar disorder.Also, nearly 50 million or five percent of the population suffers from common mental disorders such as depression and anxiety.A major stigma associated with mental illness, no medical insurance for the mentally ill and a crumbling family structure means a majority of those suffering do not even get basic healthcare and many, specially women, end up on the streets.
"The main problem is the stigma. Patients don't want to go to doctors even if they know the problem as they are afraid of the stigma," Ashish Mittal, consultant psychiatrist at Gurgaon's Columbia Asia Hospital, told IANS.
He said most people are diagnosed very late in life and they roam around with symptoms and come very late to psychiatrists. This makes it very difficult to treat them.The biggest problem according to Mittal is that in India, mental health treatment is not covered under insurance."This is creating hurdles in their treatment. So hospitals are not promoting mental health care."The government should ensure that mental illness is included in insurance. They can do this through the mental health act, he said.Tina Gupta, consulting psychiatrist, Primus Super Speciality Hospital, said: "The mental health care bill 2013 (that parliament is yet to pass) also says that all insurance companies will have to make provisions for medical insurance for the treatment of mental illness akin to physical illness."
"Considering estimates that nearly 100,000 people at the district level need mental health care facilities, insurance companies soon need to address this need. By introducing health cover for psychiatric illnesses the patients' access to treatment and recovery will increase," she added.Samir Parekh, director, department of mental health and behavioural sciences at Fortis Health care, said the focus has to be on removing myths and the stigma related to mental illness."Our focus has to be on removing the stigma and myths associated with mental illness," Parekh told IANS.He said another big problem is the lesser number of psychiatrists available in the country."As far as awareness is concerned, there are already some programmes and I think it will eventually increase," he said.
The mental health bill seeks to give mentally-ill patients the right to decide their mode of treatment, decriminalise suicides by them and ban electric shock treatment without anaesthesia. Once passed by parliament, the bill will repeal the Mental Health Act, 1987.If passed, it will make access to mental healthcare a right for all. Also, such services would be affordable, of good quality and available without discrimination."The government has also firmed up a national mental health policy, which will chalk out an action plan," a senior health ministry official told IANS.