As the first Indian to head the mental health directorate at the World Health Organisation, Shekhar Saxena has a task ahead that he says is both exciting, and intimidating.
“India has the inherent capacity to scale up the mental health programme in a very significant way. We have to see that all bodies that are capable of doing work in the sector come together to take this forward,” he says.
During a recent visit to India, Dr. Saxena, who has been a practitioner in India for 20 years before he joined the ranks of the global health bureaucracy, spoke exclusively to The Hindu.
“The needs of the world and India are large in terms of mental health care delivery. The potential for making a change is massive, but one has to get it right in terms of partnerships.”
In India, he says, the situation has changed for the better in a variety of ways. Now, there are opportunities to be utilised to make things work in a much better way.
“My objective in being in India this time is to understand better what NGOs (such as Sneha, and SCARF in Tamil Nadu) are doing and how we can involve them much more in achieving our objectives. We believe that NGOs do play a significant role now, but they have a much larger role in the future.”
Even as he commends the Government of India for assigning a much larger proportion of the budget for mental health this Five Year Plan compared to the last, Dr. Saxena is worried that the funds have been under utilised.
Dr. Saxena says it is heartening that the Indian government has shown a keen interest in implementing the WHO's Mental Health GAP programme to scale up services for those who suffer from mental, neurological and substance abuse disorders and bring a much larger number under treatment and care than has been done in the past.
This year, the global body has also released intervention guides to indicate broadly what must be done to achieve these objectives. These guides are being translated into Indian languages, and a set of culture-specific tools are being developed at the local level to facilitate implementation.
“It is a matter of collective shame for mental health professionals that 80 per cent of people with mental disorders do not receive care. We know what to do, but we are not able to translate the knowledge to practice. If someone gets a fever, he goes to the nearest government or private care practitioner to get treatment, but when a patient suffers from depression, that doesn't happen,” he says.
Specialist medical help is very limited, Dr. Saxena points out.
The solution, therefore, is to train general health human resources to identify and treat common mental disorders. Almost 90 per cent of people with common mental disorders can be treated by these people.