Mental health in India is still a fairly new topic and the mental health myths and taboos attached to this subject are prevalent to this date. 1 in 10 individuals have some emotional and behavioral problems.
Close to 60 to 70 million people in the country suffer from common and severe mental disorders. India has the highest suicide rate in the South-East Asian region, according to the World Health Organization’s latest report says over 2.6 lakh cases of suicide in a year. WHO statistics say the average suicide rate in India is 12.70 for every lakh people.
A study conducted by the name of Depression in Children and Adolescents in PUBMED shows, point prevalence of depression/affective disorders ranges from 1.2% to 21% in the clinic-based studies; 3%–68% in school-based studies and 0.1%–6.94% in community studies.
There has been only one incidence study from India which estimated the incidence to be 1.6%. With respect to the risk factors for depression, studies have reported various education-related difficulties; relationship issues with parents or at home, family-related issues, economic difficulties, and other factors.
A number of studies of college and school going students have evaluated the symptom profile, and the commonly reported symptoms include depressed mood, diminished interest in play activities, concentration difficulties, behavior problems in the form of anger and aggression, pessimism, decreased appetite, decreased sleep, anhedonia, and somatic symptoms. None of the studies from India has evaluated the efficacy/effectiveness of various antidepressants in children and adolescents with depression.
A survey conducted by UNICEF and Gallup in early 2021 with 20,000 children and adults in 21 countries found that the young in India seem reticent to seek support for mental stress. Only 41 per cent of 15 -24 years age group in India said it is good to get support for mental health problems, compared to an average of 83 per cent for 21 countries, the State of the World’s Children 2021 report stated.
How to address this Age Group
The young people in the age group of 10-24 yr in India constitutes one of the precious resources of India characterized by growth and development and is a phase of vulnerability often influenced by several intrinsic and extrinsic factors that affect their health and safety.
Nearly 10-30 per cent of young people suffer from health impacting behaviours and conditions that need urgent attention of policy makers and public health professionals.
Nutritional disorders (both malnutrition and over-nutrition), tobacco use, harmful alcohol use, other substance use, high risk sexual behaviours, stress, common mental disorders, and injuries (road traffic injuries, suicides, violence of different types) specifically affect this population and have long lasting impact.
Multiple behaviours and conditions often coexist in the same individual adding a cumulative risk for their poor health. Many of these being precursors and determinants of non communicable diseases (NCDs) including mental and neurological disorders and injuries place a heavy burden on Indian society in terms of mortality, morbidity, disability and socio-economic losses.
Many health policies and programmes have focused on prioritized individual health problems and integrated (both vertical and horizontal) coordinated approaches are found lacking.
Healthy life-style and health promotion policies and programmes that are central for health of youth, driven by robust population-based studies are required in India which will also address the growing tide of NCDs and injuries . Moreover this age group rarely agrees to consult a doctor especially a mental health professional considering the Taboo Associated with it.
Tele Manas as a Reprise
The National Tele Mental Health Programme Tele MANAS was launched in India by Ministry of Health and Family welfare in association with NIMHANS Bangaluru in the month of November 2022.
In J&K Tele MANAS was officially launched by Hon’ble LG J&K on 4th November 2022 which envisages to work as a comprehensive, integrated and inclusive 24X7 tele-mental health facility with the aim to provide universal access to equitable, accessible, affordable and quality mental health care through 24X7 tele-mental health counselling services.
One Tele Manas UT level Cell and one Mentoring Institute has been established at IMHANS, Psychiatric Diseases Hospital, GMC Srinagar, which is providing services 24*7 to the people of J&K.
Till now 26500 calls have been received and many distress situations/ suicides have been averted. J&K stands second in terms of the total no. of calls received in the Country .
Triaging of calls is being done and around 2854 distress calls, 1206 relationship issues 2200 calls related to severe stress and anxiety and also 800 self harm / Suicidal calls received and have been averted by the team of Tele manas IMHANS Sgr through counseling , Tele manas cell has received 3000 follow up calls in last 2 months.
Ist Tele Manas Chat Bot in India
NHM J&K conceptualized the first of its kind Chat bot (Whatsapp based) for Tele- MANAS in the Country to improve the accessibility to Mental Health Services.
Tele MANAS CHATBOT was launched in J&K on 5th July 2023 by Hon’ble LG,UT of J&K.
The objective of this concept was to reach out to the youth of the UT. As the youth of today is more Tech Savvy/Text Savvy and prone to chatting, the chatbot was developed so that anyone can consult the counselors and Psychiatrists using this chat bot for any Mental Health related help. Also, this is the first CHAT BOT in India which is both AI based and has the provision of Two- Way Communication with the experts.
There is also a plan to provide access to this CHAT BOT in the local/regional languages i.e Urdu and Hindi so as to cater to the rural and the far-flung population of the UT of J&K.
Once the user accesses the CHAT BOT on Whatsapp, there is an interface which assists the user regarding the various issues pertaining to mental health. The 6 responses incorporated in the Tele MANAS CHATBOT are the frequent reasons for which the beneficiaries commonly sought help and these responses are:
Feeling Sad or Low
Anxiety Issues
Sleeping Troubles
Suicidal Thoughts
Physical Intimacy Issues
Addiction Problems
On clicking upon any of the issue, there are further a set of questions which help in identifying the underlying cause. In case of urgent issues related to suicidal thoughts, the user is immediately directly directed to consult a psychiatrist. It also provides solutions/suggestions and ways (like Meditation, Yoga and Breathing Exercises) to deal with the issues.
In case the user is not satisfied with the pre-fabricated set of questions and suggestions, he/she has an option for chatting with the counsellor or calling directly on the Tele MANAS Cell and speaking to the counsellor regarding the issues. Depending on the severity of the issues of the individual, call is forwarded to the counselor/psychologist/psychiatrist.
Link for Chatbot: https://wa.me/919797600601?text=/telemanas
Whatsapp No: 9797600601
There have been 212 conversations till now. Anxiety related issues, depression, substance abuse and relationship issues predominate the reasons for using the CHATBOT.
Communication Strategy and Promotion
Due to the commitment at the highest level especially personal interest and suggestions of Administrative Secretary Health and Medical education J&K massive sensitization drive is being conducted in the form of IEC campaign in all Primary, Secondary and tertiary care hospitals even at the level of HWC s and involvement and training at the gross root level i.e., Asha s, MLHPS/Supportive staff MOs etc , Inter-sectoral coordination with other departments, Involvement of social , print and electronic media , workshops in schools and colleges have led to increase in daily no of calls and more and more people especially young population have opened up to both Tele Manas and Tele Manas Chat Bot thus proving to be an vent and reprise as directly consulting a mental health specialist and going to mental health institutions is still considered to be an anomaly and taboo. This Chat bot can be a game changer in mental health assistance and need of the hour is to disseminate and propagate about its functioning to masses.
Lets all propagate the helpline numbers of Tele Manas cell and Tele Manas Chat Bot so that people facing problems both in urban and especially in rural settings ( Hard to reach Areas) can get help with just one touch of their phones not leaving homes .
Tele Manas Help line no: 144416/1-800-891-4416
Tele Manas Chat Bot Whats app no : 9797600601
The writer is Programme Manager Mental Health NHM J&K/DNO Kashmir.