Introduction
Mental health disorders affect people of all age groups, geographical regions, and socioeconomic backgrounds. The consequences of these conditions extend beyond personal suffering, often disrupting daily functioning and imposing significant societal costs. Addressing mental health issues is crucial for the well-being of individuals and the overall progress of society. This white paper explores various segments of mental health disorders and provides a detailed classification of these disorders.
Mental Health Disorders in India
India has seen a rise in mental health disorders, with approximately 15% of the population grappling with issues such as anxiety, depression, bipolar disorder, schizophrenia, substance use, and neurodevelopmental disorders. Rapid urbanization and changing social dynamics have contributed to these growing mental health concerns, particularly among vulnerable sections like children, adolescents, and women. Poverty and mental health share a complex relationship, further intensifying the public health challenge.
Impact of Urbanization on Mental Health
Urbanisation has brought several changes, such as increased transportation and communication speeds, but it has also led to challenges for mental health. Issues like psychosis, depression, sociopathy, alcoholism, vandalism, and substance abuse have become more prevalent in urban settings. The rapid pace of urbanization has resulted in the breakdown of traditional social support systems, making mental health care an urgent need.
Mental Health Category Segments
Mental health disorders can be divided into several categories based on the nature of the disorder, its impact on individuals, and the type of treatment required. Below is a detailed breakdown of key mental health segments:
- Mood Disorders
- Description: Mood disorders are characterised by disturbances in a person’s emotional state.
Examples:
- Depression (Major Depressive Disorder)
- Bipolar Disorder
- Cyclothymic Disorder
- Symptoms: Persistent sadness, mood swings, loss of interest in activities, manic or depressive episodes.
- Anxiety Disorders
- Description: Disorders involving excessive worry or fear that impairs daily functioning.
- Examples:
- Generalised Anxiety Disorder (GAD)
- Panic Disorder
- Social Anxiety Disorder (SAD)
- Phobias
- Symptoms: Overwhelming fear, panic attacks, restlessness, difficulty concentrating.
- Psychotic Disorders
- Description: Disorders affecting an individual’s perception of reality.
- Examples:
- Schizophrenia
- Schizoaffective Disorder
- Brief Psychotic Disorder
- Symptoms: Hallucinations, delusions, disorganised thinking, impaired functioning.
- Personality Disorders
- Description: Enduring patterns of behaviour and cognition that deviate from cultural expectations.
- Examples:
- Borderline Personality Disorder (BPD)
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Obsessive-Compulsive Personality Disorder
- Symptoms: Emotional instability, difficulty maintaining relationships, impulsivity.
- Neuro developmental Disorders
- Description: Disorders that affect cognitive, social, and emotional development, typically diagnosed in childhood.
- Examples:
- Autism Spectrum Disorder (ASD)
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Intellectual Disabilities
- Learning Disorders
- Symptoms: Delayed language or cognitive development, hyperactivity, repetitive behaviors.
- Obsessive-Compulsive and Related Disorders
- Description: Disorders involving obsessions and compulsions that interfere with daily life.
- Examples:
- Obsessive-Compulsive Disorder (OCD)
- Body Dysmorphic Disorder (BDD)
- Hoarding Disorder
- Symptoms: Repetitive behaviours, intrusive thoughts, body image issues.
- Trauma- and Stressor-Related Disorders
- Description: Conditions related to exposure to traumatic or stressful events.
- Examples:
- Post-Traumatic Stress Disorder (PTSD)
- Acute Stress Disorder
- Adjustment Disorder
- Symptoms: Flashbacks, nightmares, emotional numbness, difficulty adjusting to change.
- Eating Disorders
- Description: Disorders involving severe disturbances in eating behavior and body image.
- Examples:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
- Symptoms: Preoccupation with food, distorted body image, excessive exercise.
- Substance-Related and Addictive Disorders
- Description: Disorders related to the misuse of substances like alcohol and drugs.
- Examples:
- Alcohol Use Disorder
- Opioid Use Disorder
- Gambling Disorder
- Symptoms: Cravings, withdrawal symptoms, inability to control substance use, social impairment.
- Somatic Symptom and Related Disorders
- Description: Conditions where a person experiences physical symptoms without a clear medical cause.
- Examples:
- Somatic Symptom Disorder
- Illness Anxiety Disorder
- Conversion Disorder
- Symptoms: Physical pain with no medical explanation, excessive worry about health.
- Sleep-Wake Disorders
- Description: Disorders involving disturbances in sleep patterns.
- Examples:
- Insomnia
- Narcolepsy
- Sleep Apnea
- Restless Legs Syndrome
- Symptoms: Difficulty falling asleep, excessive daytime sleepiness, abnormal sleep behaviours.
- Dissociative Disorders
- Description: Disorders characterised by a disconnection between thoughts, identity, consciousness, and memory.
- Examples:
- Dissociative Identity Disorder
- Dissociative Amnesia
- Depersonalisation/Derealisation Disorder
- Symptoms: Memory loss, fragmented identity, feelings of detachment.
- Neurocognitive Disorders
- Description: Conditions that involve a decline in cognitive functioning due to aging, brain injury, or illness.
- Examples:
- Alzheimer’s Disease
- Dementia
- Traumatic Brain Injury
- Symptoms: Memory loss, confusion, impaired judgment.
- Gender Dysphoria
- Description: A condition where individuals experience discomfort due to a mismatch between their gender identity and biological sex.
- Symptoms: Discomfort with assigned gender, emotional distress, desire for gender transition.
- Impulse-Control and Conduct Disorders
- Description: Disorders that affect emotional and behavioural self-control.
- Examples:
- Oppositional Defiant Disorder
- Conduct Disorder
- Intermittent Explosive Disorder
- Symptoms: Aggressive behaviour, defiance, temper outbursts.
- Other Mental Health Disorders
- Description: Conditions that do not fit neatly into other categories but affect mental and emotional well-being.
- Examples:
- Factitious Disorder
- Pica
- Depressive Disorder due to another medical condition.
- Developmental and Behavioural Disorders
- Description: Disorders typically diagnosed in childhood, affecting social interaction and behavior.
- Examples
- Autism Spectrum Disorder (ASD)
- ADHD
- Oppositional Defiant Disorder (ODD)
Mental Health Statistics and Awareness in Children in India
Mental health disorders among children and adolescents are on the rise, making it a growing concern in India. Here are some key statistics and insights regarding mental health in this age group:
- Prevalence of Mental Health Issues
- National Mental Health Survey (2015-2016): Around 7.3% of children aged 13-17 years suffer from mental health disorders.
- Lancet Report (2020): 50 million children in India affected by mental health disorders, projecting a rise if unaddressed.
- UNICEF (2021): 1 in 7 children aged 15-24 reported depression symptoms, while 14% of adolescents aged 13-15 experienced similar issues.
- COVID-19 Impact: The pandemic exacerbated mental health challenges, with increased cases of anxiety, stress, and depression in children due to isolation and disrupted schooling.
- Common Mental Health Disorders in Indian Children
- Anxiety Disorders: Commonly seen among school-going children, exacerbated by social and academic pressures.
- Depression: More common in adolescents due to academic stress, bullying, and family issues.
- Attention-Deficit/Hyperactivity Disorder (ADHD): Underdiagnosed in rural areas despite growing awareness.
- Developmental Disorders (including Autism): Lack of early diagnosis, especially in underprivileged and rural areas, adds to the burden.
- Awareness and Access to Mental Health Services
- Stigma and Underreporting: Stigma around mental illness leads to underreporting and late diagnoses, with parents and schools lacking the knowledge to identify early signs.
- National Initiatives:
- National Mental Health Programme (NMHP) and District Mental Health Programme (DMHP) have expanded mental health services but still lack specific services for children.
- Manodarpan (2020): Launched by the Government of India to provide psychosocial support to students and teachers during and post-pandemic.
- School-Based Programs: Some schools have started integrating mental health education, but it is inconsistent across the country.
- Challenges in Mental Health Awareness for Children
- Limited Resources and Professionals: Severe shortage of child psychologists and psychiatrists in India. There is less than 1 child psychiatrist per 1 million children.
- Urban-Rural Divide: Mental health services are concentrated in urban areas, with limited access in rural regions.
- Parental Awareness: A significant gap in parental awareness leads to a lack of early interventions.
- Increase in Awareness
- Social Media Campaigns: Awareness around children’s mental health is slowly growing through social media and celebrity endorsements.
- NGO Efforts: Organisations like The Live Love Laugh Foundation work towards raising awareness about child and adolescent mental health.
- Tele-Mental Health: With the rise of Telehealth during the pandemic, more families can access mental health services, though mostly in urban settings.
- Looking Forward: The National Institute of Mental Health and Neurosciences (NIMHANS) (2021) recommended a national strategy for child and adolescent mental health. This strategy includes integrating mental health services in schools, improving teacher training, and launching public health campaigns to reduce stigma.
Mental Health Startups in India
Several Indian startups are working in collaboration with mental health institutions to develop technology-driven solutions that bridge the treatment gap. These startups leverage partnerships with academic and medical institutions to provide evidence-based, accessible mental healthcare.
1.Wysa
- Connection: National Institute of Mental Health and Neurosciences (NIMHANS)
- Overview: Wysa is an AI-powered chatbot offering cognitive behavioral therapy (CBT) techniques for managing stress, anxiety, and depression. In collaboration with NIMHANS, it ensures that its therapeutic methods are clinically validated.
2. YourDOST
- Connection: Indian Institute of Technology (IIT) and NIMHANS
- Overview: YourDOST is an online platform providing emotional and psychological support through professional counseling. It has partnerships with IITs and NIMHANS to offer a combination of professional guidance and research-backed solutions.
3. ePsyClinic
- Connection: All India Institute of Medical Sciences (AIIMS)
- Overview: ePsyClinic provides virtual consultations with psychologists and psychiatrists and is backed by mental health professionals from AIIMS.
4. InnerHour
- Connection: Prominent psychiatric institutions in Mumbai
- Overview: InnerHour offers digital mental health services including self-help tools and licensed therapist support, developed in partnership with clinical psychologists and psychiatrists from key Indian institutions.
5. MediBuddy (DocsApp)
- Connection: NIMHANS
- Overview: MediBuddy offers telemedicine services, including mental health consultations. Through its partnership with NIMHANS, MediBuddy ensures that its mental health services are rooted in clinical expertise.
Top Mental Health Institutes in India
- All India Institute of Medical Sciences (AIIMS), New Delhi
A premier medical institute providing extensive mental healthcare and psychiatric research.
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh
A top institution known for its mental health services and psychiatric research.
- Christian Medical College (CMC), Vellore
Renowned for its psychiatric department and comprehensive mental health programs.
- Banaras Hindu University (BHU), Varanasi
Offers well-established programs in psychology and psychiatry.
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry
A leading institution known for its psychiatric care and mental health education.
- Armed Forces Medical College (AFMC), Pune
Recognised for its psychiatric training and services provided to military personnel and civilians.
Gen Z More Stressed About Mental Health
A study has revealed that 77% of Indians exhibited at least one symptom of stress, with one in three Indians struggling with stress and anxiety. However, Generation Z (those born between 1997-2012), particularly, has been more affected by mental health challenges, including stress, anxiety, and chronic illnesses.
The workplace well-being of Gen Z has particularly deteriorated post-pandemic, as younger workers face heightened pressures to conform to hustle culture. According to clinical psychologist Pratishtha Trivedi Mirza, many young people feel constant anxiety about not achieving enough. Social comparison with peers and influencers also fuels a decline in self-esteem, further compounding stress.
Despite increasing awareness about mental health—reflected in a 2021 survey by the Live Love Laugh Foundation, which showed that 92% of respondents were willing to seek mental health treatment, up from 54% in 2018—there remains a gap between awareness and actionable solutions for Gen Z.
Access to credible resources and timely help is also hindered by social stigma and self-stigma, and Gen Z continues to face broader societal, cultural, and economic challenges beyond their control. While mental health awareness has improved post-COVID, according to experts like Mirza, there is still “a long way to go.”
Strengthening Mental Health Systems in India: Challenges and Opportunities
India’s mental health system faces a large treatment gap, particularly in rural areas. According to the 2016 National Mental Health Survey, the prevalence of common mental disorders stands at 5.1%, but the treatment gap is as high as 80.4%.
Key Challenges:
- Resource Shortage: A lack of trained professionals and uneven distribution of mental health services.
- Urban-Rural Divide: Access to care remains unequal, with rural areas receiving less focus.
- Stigma: Societal stigma around mental illness continues to delay treatment.
Opportunities:
The National Mental Health Policy (2014) and Mental Healthcare Act (2017) represent key steps toward reform, while programs such as the National Mental Health Programme (NMHP) and District Mental Health Programme (DMHP) continue to expand coverage. Initiatives like Ayushmann Bharat and PM-JAY aim to integrate mental health into broader healthcare systems. Moreover, community involvement and digital health innovations are critical to future success in expanding access and reducing stigma.
References
https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(23)00160-9/fulltext
https://collegedunia.com/medical/psychiatry-colleges?sort=rating_desc
https://pubmed.ncbi.nlm.nih.gov/15327811/
https://www.cdc.gov/childrensmentalhealth/depression.html
https://startup.siliconindia.com/ranking/10-best-mental-health-startups-2024-rid-2158.html
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1751-7893.2008.00066.x
– Anshu (Author)
