BY JITAMANYU SAHOO and MUJTABA HUSSAIN
One of the biggest challenges modern society is facing today is mental illness. According to the Institute of Health Metrics and Evaluation around one billion people are currently showing symptoms of mental health. These estimates will only rise further. For instance, studies show how the use of social media today by people to influence, maintain and interact with their peers over digital networks have statistically increased the burden on mental health. The significant amount of time children and youth spend on social networking sites have led to a culture of exclusion. Beyond the immediate effects of family, mental health has pierced into the spheres of public life ranging from employment, education and into our justice system.
The ongoing COVID-19 pandemic and the never-ending lockdowns have limited access to social interactions globally. This has led to increase in substance abuse, rise in depression and increased in suicide which has triggered sudden public interest and awareness around various facets of mental health. In spite of the rise of mental health interests, any discussion pertaining to it is considered as a taboo, India being no different. This stigma underpins the mental health access hesitancy in our society. Despite costing billions of dollars in loss due on health services, mental health remains under financed and under-resourced. In addition to underfunding, the fragmented access to mental health services has become a rule rather than an exception.
How can the current state of mental health be strengthened? There is a need to place stronger impetus on the progress and development of mental health services to enable people a dignified life. The absence of understanding of mental health problems which emerge in childhood and adolescence is a key challenge before us. But to advance this scientific understanding of mental health needs strategic support and an early interventionist approach. For a philanthropist seeking to lend support in the mental health space and achieve social impact, it is important to be able to access current, evidence-based and scientifically accurate information.
Rationale for Supporting Mental Health
Firstly, despite mental health being one of the largest causes of disability, its history of underfunding still continues. The World Health Organization (WHO) in its report ‘Investing in Mental Health’ states ‘many low- and middle-income countries currently allocate less than 2% or even 1% of the health budget to the treatment and prevention of mental disorders’. This is not remotely proportionate to the burden mental health cause, and appears to place a very low value on the psychological or emotional wellbeing of populations. The funds which are allocated by the State are made available as operational costs of specialized but increasingly outdated mental hospitals (that are commonly associated with isolation, human rights violations and poor outcomes). This inevitably curbs the development of more equitable and cost-effective community-based services.
Similarly in India the Union Budget 2021-22, proposed a corpus of Rs 71,269 crore for the Ministry of Health and Family Welfare. For a change it included a budget of Rs 597 crore for mental healthcare. But out of this only 40 crore same as the last year budget has been allotted for the National Mental Health Programme’ while a majority of the budget around Rs 500 crore was allotted to for Bengaluru based National Institute of Mental Health and Sciences (NIMHANS) and Rs 57 crore for LokpriyaGopinathBordoloi Regional Institute of Mental Health in Tezpur. The funding disparity is clearly visible in our accessibility of care.
Secondly, the incentive for mobilising philanthropic capital for mental health is interlinked in the financial loss due to mental ill health on the individual and the society. Taking the loss of productivity as the largest driver of increasing economic burden, WHO and the United Nations Development Programme recommended using Return of Investment, a financial metric, to measure the profitability of investment in mental health at societal level. A study published in the Lancet Psychiatry on “Scaling-up treatment of depression and anxiety: a global return on investment analysis.” found that ‘every US$1 invested in scaling up treatment for depression and anxiety could yield returns of US$4 in better health and ability to work’.
Although recent years have seen a growing number of funders focusing on mental health working in capacity building and accessibility but mainstreaming mental health as a field of intervention needs philanthropic engagement.
Building a Philanthropic Agenda
The decisions which the philanthropists will take surface between finite resources on one hand and impact factor on the other. There is no ‘one size fits all’ strategy for philanthropic engagement in the field of mental health, but for those who seek evidence-based improvements, we suggest proceeding in three steps which are only indicative:
Step 1- Philanthropic intervention programme and its design- The vast field of mental health often intersecting and interacting within itself and other disciplines needs design. There is always a certain level of emotion which draws specific aspects of the problem. But placing reliance on evidence and data analysis, figuring out the intervention sections, budgeting the finance over a period of time would be critical in developing a philanthropic design leading to mental health equity.
Step 2- The field of work should be defined- The multi-faceted and complex field as mental health needs engagement with different specialists holding an array of views. The philanthropic direction must gather information on the area it will focus its effort and money on. For instance, an organisation could work on with the public’s mental health literacy through anti stigma campaigns, researching on youth mental health problems or focus on equipping the digital mental health care.
Step 3- Improving through Pilot Projects- Mental health issues cannot be solved through societal distance. Appropriate planning and putting it into practice are where it will all begin such as supporting the community mental health programmes and working with persons of lived experience. But as with any new experience philanthropy should also provide space for learning, adapting and improving and being part of the difference.
Today there is a compelling case to mobilize capital for mental health. The pandemic has opened up fissures in our mental health care services. The socio-economic costs of individuals suffering from mental illness and not receiving care is staggering. We need to act with a new level of ambition.
JitamanyuSahoo is a lawyer and founder of Centre for Commons. He writes onpublic health, health justice constitutional law, and urban governance.
MujtabaHussain is working as Child Rights Lawyer at Child Guidance & Wellbeing Centre -Institute of Mental Health and Neurosciences Kashmir .
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author. The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.