– By Syed Mujtaba
here can be no health without mental health, despite this clear evidence nowhere in the world does mental health enjoy parity with physical health in budgets, policies and practice. According to World Health Organisation, Mental Health Atlas, Globally it is estimated that less than 7 percent of health budgets is allocated to address mental health. Persons with mental illness constitute a vulnerable section of society and families bear financial hardship, emotional and social burden of providing treatment and care for their Relatives with mental illness, therefore It has contributed to human rights violations. WHO defines health “As a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The International Covenant on Economic, Social and Cultural Rights provides a legally binding framework for the right to the highest attainable standard of mental health , same is complemented by International legal standards by the Convention on the Rights of Person with Disabilities, the Convention for the Elimination of All Forms of Discrimination against women, the Convention on the Rights of Children.
With the adoption of Sustainable Development Goals (2030)- Mental health is emerging as a Basic human rights . Goal 3 sustainable development- 2030 includes the promotion of mental health. India ratified the CRPD in 2007 and therefore the need to amend the Mental Health Act (1987) was felt as it could not protect the rights of person with mental illness and a new legislation Mental HealthCare Act 2017 was enacted. The Mental HealthCare Act 2017 provides to protect, promote and fulfil the rights of such persons, recovery, rehabilitation and full participation in society, now right to mental health also includes a right to integration and treatment in the community with support to live independently and to exercise legal capacity. In order to provide better mental healthcare there must be the obligation of International cooperation for the right to mental health which includes rights based mental health practices and policies, At the same time in the delivery of mental health care and services.
The effective realization of the right to mental health requires Participation, Non-discrimination, Accountability and Availability, accessibility, acceptability quality of mental health care and services.
Mental health in Kashmir
According to Mental health experts there has been an increase in the number of stress , PTSD , depression related cases in valley and these psychological problems have also given rise to general health problems like hypertension, cardiac arrests etc. The survey of 2015 revealed that around 1.8 million adults in Kashmir valley have significant symptoms of mental distress , nearly 1.6 million adults in the valley are loving with significant symptoms of depression, with 415,000 meeting with all the diagnostic criteria for severe depression. Approximately 1 Million adults in the valley are living with significant symptoms of anxiety related disorders. The survey also revealed high rates of co-morbidity in the kashmiri adult population, with nearly 90 percent of individuals identified as a probable case for PTSD. The evidence suggests that the prevalent of conflict has a powerful effect on the mental health of people in the valley. So there is a need to burden the evidence in conflict zones to examine all psychosocial dimensions of mental health.
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Furthermore due to the outbreak of COVID-19 crores of people has been pushed to the confinement of their houses across the world, but in kashmir the ongoing unrest since decades and now the present pandemic, has impacted the mental health of Kashmiris irrespective of gender and age group. Various survey have revealed that mental illnesses are on rise due to Covid-19 situation in Kashmir.
In 2013, the WHO comprehensive Mental Health Action plan recognised mental health as a global health priority. The right to mental health requires that mental health care be integrated in to all levels of general health care and services, professionally and practically. And same has been incorporated in New Legislation Mental Health care Act 2017. Despite having the legislation and schemes for mental health care
There is need to make provisions for more number of psychiatrists, psychologists, and mental health institutions. There is a need to increase in budget spend, and increase in investment in community based mental health initiative’s
There is also need for
a) Convergence of NMHP/DMHP and using existing PHC’s to provide mental health service.
b) Proper Implementation of Mental Health Care Act 2017.
c) Establishment of State Mental Health Authority and Mental Health Review Boards.
d) Capacity building of PHC doctors , ASHA workers , teachers , child care functionaries.
e) Awareness Campaigns.
g) Training for caregivers and relatives and other stakeholders
h) Invest in psychosocial services.
There is a need for greater push to advance the Prevention and care of mental illness and promotion of mental health and it is time for us to assert vigorously that health care, inclusive of mental health treatment is indeed a Human Right.
Writer is working as T/C at Child Guidance and Wellbeing Centre IMHANS-Kashmir