Sustainability in health care has traditionally revolved around visible indicators such as green hospitals, adoption of renewable energy, waste management, and reduced carbon footprint. In the Indian context, there is an even greater sustainability concern, the ability to sustain the psychological, economic, and emotional well-being of its citizens. This starts with mental well-being.
With mental health concerns being one of the greatest unmet needs globally, there remains a lack of interest in addressing it within the scope of health care sustainability in India. The latest findings of the National Mental Health Survey reveal that 10.6% of adult Indians suffer from mental challenges, whereas close to 150 million citizens require mental health care services. What remains more concerning is the gap of up to 92% in this area.
While the effects of mental health issues go well beyond the patient, they secretly impact the families, workplaces, educational institutions, and ultimately the entire economy. Mental disorders such as depression, anxiety, addiction, trauma, and stress decrease mental focus, cloud judgement, cause absenteeism, and hamper productivity. The World Health Organization (WHO) reports India’s burden from mental disorders as 2,443 Disability Adjusted Life Years per 100,000 people with an age-adjusted suicide rate of 21.1 per 100,000. These are massive economic implications. WHO projections indicate that India may incur a loss of up to $ 1.03 trillion due to mental health illnesses between 2012 and 2030.
This must drastically change our perception of sustainability. A loss of a trillion dollars' worth of economy is not born out of hospitals only. This happens when young professionals give up on work because of their burnout, caregivers feel emotionally drained, employees suffer from depression or anxiety in silence, and families find no stability because of the unavailability of proper mental care. The Economic Survey 2023-24 itself states that poor mental health affects the nation's economy by causing absenteeism, disabilities, increased health care expenditure, and lack of productivity.
The problem also has a clear gender dimension. In India, women are usually responsible for taking up the emotional care of their family members even before seeking the help of doctors or mental health care professionals. Women have a way of spotting any kind of emotional turmoil in the family, but it is the last thing they attend to when it comes to themselves. They experience many things on the way like stress, pressure, and emotional trauma through their professional and personal life.
That makes untreated mental issues a public health problem as well as an economic and social structure problem. If sustainability means resilience, the crisis of mental health in India is an indication of the stress in the system. In today’s world, the workforce faces economic uncertainty, digital overload, social alienation, and pressure to perform. An untreated mental disorder also affects worker participation in terms of absenteeism and presenteeism, the hidden drop in productivity and motivation.
According to government statistics, India has only 0.75 psychiatrists per 100,000, way lower than the recommended number of three psychiatrists per 100,000 by the WHO. In a country of India’s population, it is simply not sustainable to depend entirely on conventional urban psychiatry.
There is no doubt that the future belongs to a stepped-care model of healthcare service delivery where technology is harnessed to provide early diagnosis, monitoring and continuous support. Technology, if used judiciously, will help make mental health care services scalable, affordable and accessible without compromising on empathy.
India is currently facing a critical juncture. The sustainability of healthcare services should not just depend on infrastructural efficiency and lower emissions when millions of people are silently suffering from mental health problems without proper treatment. A sustainable health care system is the one that considers protecting the emotional well-being of people, supporting their families, and equal access to health care facilities.
Mental well-being is no longer seen as a marginal problem; it is a matter of economy, workforce, and society. To create a sustainable future, India needs to make mental well-being the central theme of its health care policy.
(The views expressed are personal)
This article is authored by Dr Jothi Neeraja, founder, chairwoman & MD of People Tree Hospitals and Maarga Mind Care.