As much as 15-20 per cent of the population will have mental disorders that require professional intervention, according to an estimate.

However, the stigma of consulting a psychiatrist means 65-70 per cent of these patients go untreated.

There are 40-50 types of mental disorders, but most people are aware of only the cinematised versions and mentally ill persons roaming the streets with no one to attend to, C.J. John, psychiatrist, says.

People fear that taking treatment for mental disorders will cause disgrace and this keeps them from seeking help.

While the District Mental Health Programme of the State government falls short because of the inadequate number of professionals, the Malabar experience shows some good results.

The Institute of Mental Health and Neuro Sciences (IMHANS), in association with the Government Medical College, Kozhikode, has implemented a community mental health programme in the Malabar area with support from the National Rural Health Mission.

The programme in Kozhikode, Malappuram, and Kasaragod (earlier in Wayanad too) that provides mental health intervention at the level of the community health centre has, by and large, reduced the number of inpatients at the medical college hospital and the cost of treatment, P. Krishnakumar, Director, IMHANS, says.

As the programme involved participation at the grassroots level, problems can be managed outside the hospital.

The follow-up programmes are easy, drug compliance by patients is better, and as a result, the “revolving door” syndrome or reappearance of symptoms has come down, Dr. Krishnakumar says.

The World Federation of Mental Health says 13 per cent of global health disorders are mental health disorders.

WHO warning

The World Health Organisation says the number of people with depressive mental disorders will be more than those with cardiac diseases and cancer by 2030. The warning calls for planning and preventive steps, Dr. John says.

Apart from the economic burden caused by mental illnesses, many psycho-social issues are involved, he adds.

The Malabar experience shows that the stigma can be reduced to a great extent, he says. Investment in mental health treatment do not require large sums. Existing facilities can be augmented and general practitioners can be brought into the first-stage treatment, Dr. John says. Already the general practitioners are doing it, but many a time, inadequate dosage and absence of psychotherapy brief (talking therapy) come in the way.

A programme can be devised to make the general practitioners identify mental health disorders and provide therapy in some cases.

A preventive intervention strategy bodes well for adults and children, Dr. John says. In the case of children, a paper by the World Federation of Mental Health says, treatment leads to 83 times the returns on investment.

Dr. John says emotional issues and child sexual abuse are some of the core areas that need to be handled in the right manner to prevent mental health disorders.

The story of suicides in Wayanad that attracted a lot of attention is a case in point, Dr. John says.

With intervention at the level of the government and the non-governmental organisations, there has been a positive outcome as the figures for the past six or seven years suggest, he says.

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