Mental Health

Mental Health

Mental health is the capacity of a person to form good relations with others and contribute to society and environment. It is not just absence of mental illness — it includes feeling happy, handling stress, good self-esteem, strong family/friends relations, ability to work/study well, and adjust to changes.

Characteristics of Good Mental Health

• Happy most of the time
• Confident and positive self-view
• Handles problems without breaking
• Good sleep, eating, energy
• Helps others and enjoys life

Characteristics of Poor Mental Health

• Always worried, sad, angry
• No interest in activities
• Sleep/eating changes
• Feels worthless or hopeless
• Avoids people
• Thinks of self-harm or suicide

Epidemiology in India (Latest available data)

• Current prevalence: About 10.6% adults have mental disorders (NMHS 2015–16)
• Lifetime prevalence: 13.7%
• Higher in urban (13.5%) than rural (6.9%)
• Women higher in some disorders (depression, anxiety)
• Treatment gap: 70–92% do not get proper care
• Economic loss: Huge burden (WHO estimate 2012–2030 ~ USD 1.03 trillion)
• DALYs lost: High burden (around 2443 per 10,000 population)
• NMHS-2 ongoing (latest national full data awaited)

Suicide in India (NCRB 2023)

• Total suicides: 1,71,418 in 2023 (≈470 per day)
• Rate: Around 12–21 per lakh (age-adjusted ≈21.1)
• Males: 72.8%
• Females: 27.2%
• Common causes: Family problems, illness, love affairs, poverty, exam stress
• Student suicides increasing (academic pressure high)

Causes of Mental Illness (Multifactorial)

1. Biological / Organic

• Genetic factors / family history
• Brain chemical imbalance
• Brain injury, tumors
• Infections (including prenatal)
• Thyroid and chronic diseases

2. Psychological

• Stress
• Trauma
• Childhood abuse or rejection
• Poor parenting
• Personality traits

3. Environmental / Socio-economic

• Poverty
• Unemployment
• Overcrowding
• Discrimination
• Migration
• Substance abuse (alcohol, drugs, tobacco)

4. Other Factors

• Poor sleep
• Lack of exercise
• Cultural stigma (delays treatment)

Mnemonic: B-P-E-S (Biological, Psychological, Environmental, Substance/Social)

Types of Mental Disorders (ICD-based)

1. Neurotic / Stress-related

• Anxiety disorders
• Depression (very common)
• Phobias
• OCD
• PTSD

2. Psychotic

• Schizophrenia
• Bipolar disorder (mania + depression)

3. Substance Use Disorders

• Alcohol dependence
• Tobacco addiction
• Drug abuse

4. Organic Disorders

• Dementia
• Delirium

5. Personality Disorders

• Dissocial personality
• Emotionally unstable personality

6. Childhood / Neurodevelopmental

• Intellectual disability
• Autism
• ADHD

7. Others

• Eating disorders
• Somatoform disorders

(Common in India: Depression and anxiety most common; substance use significant; schizophrenia ~1%)

Prevention of Mental Illness

1. Primordial Prevention

• Promote good parenting
• School life skills education
• Reduce stigma early
• Healthy habits from childhood

2. Primary Prevention

• Stress management (yoga, meditation)
• Alcohol and tobacco control
• Awareness programs
• Social support systems

3. Secondary Prevention

• Early diagnosis
• Screening in clinics/schools
• Counselling services
• Free medicines
• Tele-mental health services

4. Tertiary Prevention

• Prevent relapse
• Rehabilitation
• Vocational training
• Family counselling
• Community-based care

National Mental Health Programme (NMHP)

Launched: 1982 Aim: Reduce burden and provide accessible mental health services.

Objectives

• Ensure availability of care for all
• Integrate mental health with primary care
• Reduce stigma
• Train manpower

Key Components

District Mental Health Programme (DMHP)

• Functional in 767 districts
• OPD services
• Outreach camps
• Counselling
• Free medicines

Manpower Development

• 25 Centres of Excellence
• PG training expansion

National Tele Mental Health Programme (Tele-MANAS)

• Launched 2022 (World Mental Health Day)
• 24×7 helpline: 14416 / 1-800-91-4416
• 53 cells in 36 States/UTs
• Services in 20 languages
• 29.82+ lakh calls handled (as of late 2025)
• Mobile app (launched 2024, upgraded 2025)
• Video consultation in some centres

Integration

• Integrated into Ayushman Bharat Health and Wellness Centres (1.75+ lakh HWCs)

Mental Healthcare Act 2017 (Rights-based Approach)

• Defines mental illness clearly
• Right to access care
• Right to dignity and confidentiality
• No discrimination
• Advance directive allowed
• Nominated representative allowed
• Decriminalizes suicide attempt
• No chaining or inhuman treatment
• Least restrictive and community-based care preferred

Quick Revision Points

• Mental health = Good relations + productivity + stress handling
• Prevalence: 10.6% current, 13.7% lifetime
• Suicide: 1.71 lakh (2023)
• Causes: Biological + Psychological + Environmental + Substance
• Prevention: Primordial → Tertiary
• NMHP: DMHP (767 districts), Tele-MANAS (53 cells, 29+ lakh calls)
• Act 2017: Rights, advance directive, no inhuman treatment