It is time to bid farewell to 2016 and make some audacious resolution for upcoming year. Among my resolutions for the year 2017 knocking at the door, the one closest to heart is –
“It is time to Talk Mental Illness in India”.
In my lexicon it is time to talk “Of Madness and Sadness” (no pun intended it is part title of my own upcoming Autobiography-‘Of Madness and Sadness, Life and Times of a Manic Depressive Indian’.)
Mental Illnesses are notorious for genetic predisposition, scientists groping in dark about etiology and environmental trigger.
This post itself has two immediate environmental triggers-
First is the tragic demise hours before of Carrie Frances Fisher (born on Oct. 21, 1956, died December, 27, 2016) famous Stars Wars fame Hollywood Actor at premature age of 60 in the after math of heart attack in the flight from London to California.
Ms. Fisher was one of the original protagonists of openness about living a life laced with “wild ride of moods” (to quote her verbatim)- a life long battle with Bipolar Disorder and long brush with co-terminus substance abuse. In her untimely death the world of warriors of “De-Stigmatization of Mental Illness” has lost a “FIVE STAR DECORATED GENERAL”.
Ms. Fisher is prototype of brave hearts who conclusively proved to the world in her life and death that her mental illness neither defined her nor constricted her from achieving greatest successes in life and career. I call it Q.E.D.
Rest in Peace (RIP) immortal Princess Leia of Star Wars. We the Mental Health warriors lost our true HERO and WAR TIME GENERAL.
The second trigger is humbling to the core at personal level. An innocuous Tweet by me a couple of days on my twitter handle @akhileshlinky regarding year end confession of my long suffering from Bipolar Disorder and still being reasonably successful in life had an unintended effect- Sandeep Gautam (@sandygautam) an expert carrying many credible hats and prolific blogger in his own right came out with a beautiful confessional blog about “his Bipolar Disorder”. This was a bold act worth emulating on its own merit. But what gratified me most was his admission that his bold act was partly inspired by my confession on Tweeter.
I stand humbled Mr. Gautam.
I also stand vindicated that if I just needed one proof of “Efficacy of My Glasnost for last ten years about my own Bipolar Disorder” as a “potent medicine/weapon” against Stigma perpetuated in India against mental illnesses, you have just provided me with the same and it has pumped my Adrenalin like never before.
MY NEW-NEW BIG-BIG DREAM
Ms. Carrie Fisher your legacy will be humbly carried forward by thousands if not millions in the world.I too promise to be a persistent foot soldier.
And Mr. Gautam, your bold act makes me Dream Audaciously” to “Bring Mental Illness at the center of National Stage” in India and the principal tool being-
“Creating an ambiance in the country for people suffering from all hues of Mental Illness to open up and create a virtual chain of pressure group that forces stigma and discrimination to take back seat.”
It is a battle i have been fighting for a decade.
But it is about time now to catalyze unprecedented scaling up using Open-source collaboration to catapult mentally ill in India as the largest ever pressure group not only for just entitlements (which are a must for those needy) but also for sending a message to the Nation at Large-
“United we stand and individually we lead….
…Mentally Ill so What, We are We, our Mental Illness Does not Define us”.
TRAVESTY OF A NATION
In the seventieth year of Independence, talking about “Mental Illness” in India is taboo, for the sufferers of the illness “It is Darkness at Noon” and for near and dears of Mentally Ill “Caregivers Curse” is indescribable punishment.
STIGMA AGAINST MENTALLY ILL-BANE OF INDIAN SOCIETY
Apathy, stigma, discrimination and profiling of Mentally ill defines the present societal construct both in “Rural Bharat” and ” Urban India” despite that Mental Illness is an equal opportunity disease that impacts caste, class and religion alike though those at the bottom of the pyramid (poorest including homeless and beggars)suffer maximum collateral damage. Worst sufferers are adolescents and youth as severe illnesses like Depression, Bipolar Disorder and Schizophrenia strike early. Worse, the global finding establish beyond doubt that most common trigger for suicidal ideation, suicide attempt and completed suicide in youth is Mental Illness. All three “Depression, Bipolar Disorder and Schizophrenia” pro-bands are known for much higher completed suicide rates and suicide attempts than normative population and it is the tender age group of 14-28 that is most prone to suicide in India
INDIA HOME TO ONE OF LARGEST NOS OF MENTALLY ILL IN THE WORLD
No one knows precisely what is the actual number of Mentally Ill in India. National Mental Health Policy Group (of which yours truly was a Member), con-sensually put the number of people suffering from mental disorders at around 10% including 3% seriously mentally ill in need of hospitalization, intensive care and psycho-social-occupational rehabilitation.
FAMILIAL, SOCIAL AND NATIONAL COST OF INACTION ON MENTAL HEALTH IS HUMONGOUS
Make no mistake cost of Mental illness is humongous and collateral damage to us as a nation will soon be largest amongst galaxy of nations.
World Health Organization (WHO) reports that mental illnesses are leading causes of disability adjusted life years (DALYs)) worldwide, accounting for 37% of healthy years lost from NCDs. Depression alone accounts for one third of this disability. WHO alarmed by the growing curse of Mental Illness has declared “Depression” as the theme of next World Health Day (7th Apri, 2017) with the motto
“Depression; Let us Talk”
ECONOMIC COST OF MENTAL ILLNESS IS SKY ROCKETING
World Economic Forum (WEF) report has put the dooms-day alarm bell ticking- The global cost of mental illness from $2.5 trillion (two-thirds in indirect costs) in 2010, will gallop to over $ 6 trillion by 2030 and this is against the total global health spending of $5.1 trillion in 2009. Needless to say, we the “People of Indian Nation” are going to be worst sufferers of scourge with 1 in 4 likely to suffer from one or other mental illnesses in our life time.
And Our sufferings are going to be multi-dimensional- worse the Nation is already in vice like grip of stigma and discrimination against mentally ill. “Suffering in Silence” keeping the personal and familial pain bolted inside has become destiny of those suffering from (or caring for) Mental Illnesses in the country. The societal construct only takes the prevailing travails further downhill.
A lesser understood subject in the country is growing menace of suicidal ideation, suicide attempts and completed suicides in India’s generation-X and generation next (14-28 age group) triggered by growing incidence of mental illnesses. A large number of mentally ill who are alive face incarceration in asylums, prisons, beggars home, other institutions, dargahs and worse their own home in subhuman conditions.
MENTAL ILLNESS IS MANAGEABLE AND TREATABLE
Most live the life of base animals. Sadly this is despite the fact that Mental Illness, today is eminently manageable and treatable disease, notwithstanding the fact that in absence of etiological breakthrough full cure may be a distant dream. Nonetheless, with elongation of remission period with the help of medication, meditation, life style changes and support of family, friends, colleagues, peers, therapists, psychiatrists and perceptible changes in societal attitude (including changes at home, neighborhood, school, colleges, peers, colleagues and work place)the long war against mental illness can be fought resolutely and with reasonable degree of Success.
ABSENCE OF PRESSURE GROUP ENABLES THOSE IN POWER TO SLEEP
We as a Nation have failed mentally ill and care givers. Our seven decades “Balance Score Card” is pathetic. Constitution of India declares mentally ill as “of unsound mind” if so declared by court in 21st century where practically all mental illnesses can be effectively treated and those not cured can be effectively managed and made productive citizens of society. Annual budget for Mental Health is in foot note of health budget barely exceeding 1% of of total health budget which itself has been on decline. Travesty is almost 100% burden of direct and indirect expenditure of mental illness is out of pocket of families affected due to fault-line in the way government mental health budget is spent. A eleven member Mental Health Policy Group of which I was a member came out with a path breaking maiden Mental Health Policy (2014) of the country that was announced with fan-fare by present government on 10th October, 2014. Sadly nothing is heard of its implementation. Mental Health Care Bill, 2013 an unique con-sensually developed bill with widest possible five regional and two national consultations despite passage in August, 2016 by Rajya Sabha, languishes in Lok Sabha as law-makers turned biggest law-breakers of the country shamelessly grab all the salary and perks but refuse to work and do the legislative business. Country has severe shortage of psychiatrists, clinical psychologists, psychiatric nurses and other professionals. MBBS doctors who are taught barely 15 classes of psychiatry didactic lectures without a subject exam have no where withal to treat mentally ill. Three decade old District Mental Health Program has been a non starter.
To do list is long and getting longer.
Expenditure in mental health is no charity.
It is investment in country’s large untapped human resource with low pay-back period and high internal and economic rate of return. My favorite position is this in itself has potential to up the country’s G.D.P. by 1-2% per annum.
Time to Act was yesterday as ground realities are worsening fast.
Who says few people can not bring change.
American social-Anthropologist Margret Mead once famously said- ” It is few committed Persons who really change the world”.
Let the War against Mental Illness begin now.
Even if it is a battle of of “Aekala Chalo” for a while, Let it Be.
But the change has to start and it has to start now.