The traditional approach to health has always been focused on the physical health and hence, the development of medicines and treatments were focused on the care and cure for the body. Historically,mental illnesses on the other hand were believed to be the caused by demonic possessions, witchcraft or other supernatural reasons. Such an attitude towards mental health is still deeply rooted in the mindset of men and women today.

WHO says one in four people will be affected by mental or neurological disorders at some point in their lifetime. And about 450 million people suffer from some mental disorder at any given point. According to the World Economic Forum (WEF), around one billion people are affected by anxiety in the world, nearly 300 million people suffer from depression and 60 million are affected by bipolar affective disorder. Interestingly, the statistical data showed that countries in North and south-East Asia had fewer cases of mental health problems as compared to other regions of the world. Arguably, this could either be because of strong family ties or under reporting due to deep inherent stigma revolving mental health.

As per estimates from WHO, the burden of mental health problems in India is 2443 disability adjusted life years (DALYs) per 10,000 population. The age-adjusted suicide rate per 100000 population is 21.1. The economic loss for India due to mental health conditions, between 2012-2030, is estimated at USD 1.03 trillion.

Mental Health during COVID-19

As the pandemic of COVID-19 began, governments across the world hurriedly implemented the lockdown leaving a vast majority of the population stuck up where they were, away from their families, without proper access to the basic necessities. Many lost their jobs temporarily or permanently. The most vulnerable group during the pandemic were children, pregnant women, senior citizens, persons with disability, homeless individuals/ poor socioeconomic status, marginalized community, people with history of severe mental illness and people with chronic life-threatening conditions like cancer, chronic renal failure, immunocompromised patients, etc. due to lack of access to proper therapy, help groups, timely access to treatment, loss of income, hygiene and sanitization. Western cultures of isolated families, live-in relationships, a false sense of independence and security further create a social void among individuals who go through isolation, neglect and loneliness. Lockdowns just magnify the already existing void.

The fear of COVID-19 itself affected the psychological and general well-being of the people. The prevalence of psychological morbidities among the health care workers, COVID patients and the general public amidst COVID-19 pandemic as reported by a systematic review and meta-analysis showed that the psychological impact of the COVID-19 pandemic has affected about half the population.^[2] Poor sleep quality (40%), stress (34%), psychological distress (34%) were the most commonly reported problems.^[3][1]  The pandemic also saw an increase in issues such as domestic violence, alcohol use and withdrawal syndrome, suicides, etc.

Mental Health Pandemic

The mental health pandemic has been here even before the COVID-19, but the fact that it is not infectious in nature has made it the silent killer. COVID-19 has just made the signs of this secret pandemic of mental health evident. The ever changing and ever growing modern life has made man less human and a mere being. Greed, show-biz and an illusionary sense of possessions have made this generation a generation of weak thought.  Digitalization and technology gave birth to the fast paced, instant life and also made man addicted to it which proved that too much, really is too bad. Studies have shown that sedentary lifestyle, excessive screen time, lack of sleep etc are some of the factors that gives rise to several physical and mental disorders.

Role of Public Health in Mental Health crisis

The first wave of crisis affected the physical health, the second wave of crisis affected the economy and the third and the biggest wave is affecting the mental health. The warning signs before the tsunami are evident, but the bigger question is are we prepared? How do we tackle the next big crisis?

Unlike COVID-19, mental illnesses do not discriminate. No amount of money, can buy happiness and peace.

As much as the mental health professionals like psychiatrists, psychologists, counsellors, are important, so are the public health professionals. Few steps to reduce the burden of mental illnesses is implementation of laws and policies focusing on de-stigmatization, education and awareness about mental health and well-being at educational institutions at all levels, work places, establishing community outreach programs, making mental health care affordable and accessible to all, establishing and collaborating with institutions and organizations and NGOs to increase the number of mental health professionals by providing funds, aids and scholarships. With Public Health Professionals at the helm of affairs, the road to securing and safeguarding  mental health care will be reached faster.

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Disclaimer: Views expressed are the authors own. CHD Group takes no liability on behalf or for the contents expressed.

Quick References:

1. Dalal P K, Roy D, Choudhary P, Kar SK, Tripathi A. Emerging mental health issues during the COVID-19 pandemic: An Indian perspective. Indian J Psychiatry 2020;62, Suppl S3:354-64  

2. Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the