Depressed state

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The state is the biggest consumer of drugs that treat mental illness. It is a whopping 30 per cent of Malayalees who buy anti-depressant and anti-anxiety drugs used to treat common mental illnesses.

The Kerala Sastra Sahitya Parishad (KSSP), which is now undertaking a health survey in all villages and towns in the state, has revealed that their secondary data indicates that the sale of anti-depressants and anti-anxiety drugs is very high, constituting one-third of the sale in the country.

“Several study reports, including that of the department of health services, Kerala, have shown that mental illness is rife in the state. The sale of drugs for common mental illnesses like depression, stress, anxiety, alcoholism and behavioural disorders is very high.

The state is the market for one-third of the anti-depressant and anti-anxiety drugs manufactured in the country,” said KSSP state committee member K.G. Radhakrishnan.

Last year, the Comptroller and Auditor General (CAG) report on the utilisation of health funds in the state indicated that the total population of Kerala that was suffering from mental illness was 5.8 per cent against a national average of two per cent.

“One in every five families in the state has a member with an emotional imbalance. This indicates the poor mental health of Keralites which is a by-product of the changed social setup, increased stress levels, alcoholism, consumerism and a troubled family atmosphere.

However, the high incidences of mental illness is also due to the better reportage of cases, increased awareness of people about mental health and easy access to mental hospitals and psychiatrists,” added Dr. Radhakrishnan.

Meanwhile, another survey on mental health ‘Gender and Mental Health in Kerala’ conducted by the Institute of Social Studies Trust indicates that women in Kerala experience higher degrees of mental stress and lower mental wellbeing as compared to men.

The survey covered 2,740 males and 2,710 females in 1,000 households in the state. The findings of the survey also indicate that the level of psychological wellbeing declines as people of both sexes grow older.

‘Depression is often ignored by family’

The focus of this year’s World Mental Health Day is on depression, which is now being seen as a global crisis.

Psychiatrists say that depression will emerge as the second leading cause of disability, overtaking many major disorders by 2020 and Keralites are as vulnerable to it as anyone else.

In fact, they could be more prone to depression as it is related to alcohol abuse in many cases, according to them. “The habit not only pushes the individual, but also the spouse into depression.

Alcohol-related psychiatric disorders are likely to be a great challenge in Kerala in coming years,” warns Dr C.J. John, consultant psychiatrist with the Medical Trust Hospital, Kochi.

Dr Kuruvila Mathew, professor of psychiatry, MOSC Medical College, Kolenchery, says women are now increasingly becoming vulnerable to depression owing to their new stressful lives.

“They have more responsibility these days both on the family and professional fronts. The expectation levels of an average woman too have gone up and when they are not satisfied it can lead to depression,” he says, adding that alcoholism and drug abuse too contribute greatly to mental disorders.

Psychiatrists, however, find that depression is generally ignored as it doesn’t cause relatives any distress, unlike some other ailments that have embarrassing symptoms.

But with 15 per cent of the depressed committing suicide, the condition needs to be taken seriously, they stress.

Dr C.J. John believes there is a need to train general physicians in identifying depressive disorders and in skills of basic counselling and medical management to treat them.

“The greatest challenge mental health practitioners in Kerala face is the reluctance of the community to seek help for mental disorders due to the stigma.”

Plans on anvil for mental health

With 10 per cent of the state’s population, which comes to about 33.30 lakh, suffering from some psychological or psychiatric problems, the mental healthcare authorities have devised a comprehensive plan to deal with the challenges coming up in the mental healthcare sector.

The multi-pronged strategy includes an epidemiological survey, redrafting of the state mental health policy, psychiatric care at the doorstep, plan for the rehabilitation of mentally challenged destitutes and raising an army of trained doctors at the local level.

Amongst the daunting tasks the mental health sector faces is the lack of rehabilitation facilities for mentally challenged destitutes.

The state has just two rehabilitation centres for them in Thiruvananthapuram district. The government now plans to open rehabilitation homes in the remaining 13 districts.

Considering the high incidences of psychiatric ailments in the state, experts say the number of persons with mental disorders is sure to increase significantly from the existing 10 per cent.

The state mental health authority is also raising a trained army of doctors working in the community and primary health centres to provide psychiatric care at the local level.

300 people are seen on an average at a primary or community health centre across all districts and at least 10 per cent of these patients have some psychiatric problem.

Once the training programme is completed, there won’t be any need to refer such patients to mental health centres which are already bursting at the seams.