Despite bringing in mental health laws and giving attention to the medical condition, government’s funding towards mental health remains low. In the pre-Budget recommendations, mental health experts have called for more funding to mental health institutions in the country to improve their infrastructure, build capacities of mental health professionals and a behaviour change campaign to destigmatise mental health.
The government has made important strides on mental health law and policy in the past 5 years - from the Mental Health Care Act 2017 to the recently launched National Suicide Prevention Policy. “I hope to see the budget reflect the same forward thinking - which is a commitment to a network of services ranging from primary care outpatient care at primary health centres (PHCs) and general hospitals to low cost community based mental health care. This would be a welcome and significant departure from previous budgets where the bulk of the mental health budget goes to two mental institutions,” said Raj Mariwala, Director, Mariwala Health Initiative, a funding agency with a focus on making mental health accessible to marginalized persons and communities.
“Such budgetary allocations would signal government action towards a holistic planning of an optimal mix of services. This must include strengthening the existing District Mental Health program and ensuring that the Health & Wellness centres offer mental health services, as planned. Finally, we hope to see the National Suicide Prevention Policy also being a key part of the budget as it is a critical issue facing India today,” said Mariwala.
The government has been taking cognizance of the mental health issues in every budget session in the last few years. Indicating a gradual transition in the Indian health ecosystem from the traditional focus on physical health to mental health, the government has been urged by the experts to increase proportionally the budget allocation for mental health programs.
“From the last couple of years, the total budget allocation towards the National mental health programme (NMHP) has remained unchanged at Rs 40 crores. Besides the apex institutes like AIIMS, NIMHANS and PGI, a more balanced budget should be allocated to peripheral centres and medical colleges for the better management of the complexity and diversity of mental health needs,” said Dr Jyoti Kapoor, Founder & Director, Manasthali Wellness.
Vandrevala Foundation, a non-profit that partners with organisations to help communities thrive by providing education and healthcare has recommended government should aim to provide INR 1000 crores per year to mental health institutions in the country to improve their infrastructure, build capacities of mental health professionals and a behaviour change campaign to destigmatize mental health.
Vandrevala Foundation launched a mental health helpline in India in 2009 to offer free psychological counselling and crisis mediation to anyone who is experiencing distress due to depression, trauma, mood disorders, chronic illness, and relationship conflict, to name a few.
“The government should focus on the equal distribution of sufficient manpower in hospitals across the country. We have seen that new hospitals have come up in many places, including in rural and remote areas, but there is not enough manpower there. So manpower is a big concern and these healthcare professionals should be well-trained so that they can use the latest technology and be a part of the digitalization process,” said Pritika Singh, CEO of Prayag Hospitals Group.
Singh argued that in that direction, private hospitals should be allowed to provide paramedical courses so that this manpower shortage can be met. She argued that the price list that was fixed under the Ayushman Bharat scheme is not satisfactory and it ends up in losses for private hospitals. “We expect a further revision of the rate list under PMJAY. Another crucial aspect is the setting up of more dedicated mental health hospitals across the country. Mental health is still a taboo in our country and people should know the difference between mental hospitals and mental health institutions,” said Singh.
Many burgeoning start-ups and companies providing mental health services to be zero taxed for at least 10 years to encourage the ‘for profit’ industry to grow. The other recommendations from the mental health experts are that the government should judiciously consider providing a double tax write off to the corporates who provide mental health support to their employees. This will give impetus to organizations to take responsibility for their own employees. The government should mandate that all government hospitals and those that have any government subsidy should have 10 per cent of beds reserved for patients suffering from mental illnesses. Currently, there are very few facilities to serve these populations. Patients who have recovered, lack social support and need caregiving.
“Given the fact that the vast majority of people still don't access expert care to deal with mental health issues, for reasons like stigma associated around it, the government can allocate some fund towards building an Information Education and Communication (IEC) campaign towards making a sincere attempt at bringing an end to this challenge of mental health in the country,” Dr. Rishi Gautam, Assistant Professor of Psychiatry, The GW School of Medicine & Health Sciences in Washington DC, USA.
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