One in seven Indians suffered from mental disorders in 2017, finds study

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Prof Rajesh Sagar, Professor, All India Institute of Medical Sciences, New Delhi and the lead author of the paper said, “Mental illnesses contribute significantly to the burden of disease in India as reported by this study. There is an urgent need to strengthen mental health services, integrate these with general healthcare, and remove barriers such as stigma and access to treatment. It is time to act at all levels with all stakeholders to bring mental health at the forefront to reduce the burden. An interesting finding revealed by this study is the slower pace of improvement in the burden of childhood mental disorders such as developmental intellectual disability and conduct disorder in the less developed states of the country which should be examined.”

The prevalence of depression is highest in older adults, which has significant implications for the aging population of India. Depression is associated with suicide deaths in India.

The prevalence of childhood-onset mental disorders such as idiopathic developmental intellectual disability, conduct disorders, and autism is higher in the northern states but is decreasing across India.

Depression contributed to 33.8% of all mental disorder DALYs in India in 2017, followed by anxiety disorders (19.0%), idiopathic developmental intellectual disability (10.8%), and schizophrenia (9.8%). Among the major mental disorders that manifest predominantly during adulthood, the prevalence of depression was 3.3%, anxiety disorders 3.3%, bipolar disorder 0.55%, and schizophrenia 0.25%. Disability-adjusted life years (DALYs) are an international metric of disease burden that estimates the number of life-years lost because of death and disability.

Prof Lalit Dandona, Director of the India State-Level Disease Burden Initiative, Distinguished Scientist and National Chair of Population Health at ICMR, and Distinguished Research Professor Public Health Foundation of India, who is the senior author of this paper said, “This study utilizing all accessible relevant data from India over the past three decades reports that mental disorders are the leading cause of non-fatal disease burden in India and their contribution to the total disease burden is increasing. The high rate of depression among the older adults reported in this study is of concern which needs attention, and the significant association of suicide with depression emphasises the need to identify and deal with depression through wider efforts in the community and in the health system.”

Dr Vinod Paul, Member, NITI Aayog said: “This research paper reports that a large proportion of India’s population is impacted by mental health issues and systematically highlights the variations between the states, which can guide efforts for more specific health services planning for mental health in each state. Policies and initiatives under Ayushman

Bharat including the Health and Wellness Centers and the health insurance coverage are crucial in reducing the adverse impact of mental disorders at the population level across India. Community-level mental health care and integration of mental health services with other aspects of health care should receive high priority from state governments to improve mental health promotion and care.”

The contribution of mental disorders to the total disease burden in India in terms of DALYs increased from 2.5% in 1990 to 4.7% in 2017. Mental disorders were the leading contributor in India to years lived with disability (YLDs), contributing 14.5% of all YLDs in 2017. Prof Christopher J L Murray Director, Institute for Health Metrics and Evaluation said “Before state governments can invest substantially more in mental health services, it is imperative that health officials have an accurate accounting of how depression, anxiety, and other mental disorders are distributed across the country. This study provides a crucial first step in determining state-by-state need.”