India and China, the two most populous nations on earth, could continue to lose millions of years of healthy life to mental disorders. This is an observation based on the Global Burden of Disease study of 2013, following a report in Lancet which revealed that suicide is a significant cause of death in India in the age bracket of 10-24. That was a startling revelation, for depression and suicide were not expected to afflict the best years of our lives. However, Lancet’s observation that nine of 10 cases of mental disorder in India and China are not treated in a rational, clinical manner does not come as a surprise. This serious public health problem, which was known anecdotally, has only entered the formal literature.
It appears that China and India account for almost one-third of the world’s mental, neurological and substance abuse disorders. This, too, is not unexpected, since the Asian giants account for 38 per cent of the world’s population. However, enumerating the problem does clarify it. The fact that there are less then seven psychiatrists per lakh of population in China, and less than three in India, illustrates its gravity. Lack of access to qualified help is exacerbating the problem.
However, in India, the reluctance to acknowledge mental disease is the defining criterion. The fear of social opprobrium and loss of opportunity are great equalisers, urging families across demographics and economic strata to conceal illness. The totally dysfunctional make news when they are found in captivity and neglect. But the burden of less obvious conditions like anxiety remains hidden. The only danger signal is the readiness with which anxiolytic drugs are prescribed. The Lancet paper, marking the launch of the China-India Mental Health Alliance, would highlight an acknowledged but unaddressed problem yet again.