The Founder and Chairperson of Aditya Birla Education Trust, says India’s performance on the mental health index reveals substantial challenges.
The Sunday Guardian talked with Dr Neerja Birla, Founder and Chairperson of Aditya Birla Education Trust, regarding her mental health venture M Power and how it is bringing changes in the lives of individuals.
Excerpts:
Q: What is MPower and what has been its journey so far? What is the reason behind your foray into mental health?
A: MPower is a mental health care social enterprise that I founded to create a stigma-free world where individuals with mental health concerns can lead a meaningful and productive life with respect and dignity. It was during a late-night conversation with my daughter Ananya that I realized it was time to pursue my dream of making a difference in the mental health sector. Ananya nudged me to establish MPower, which aims to raise awareness about mental health, combat social stigma, and provide accessible and affordable mental health services.
Since its inception, MPower has had a remarkable journey, working with various groups like Indian paramilitary forces, government institutions, law enforcement officials, frontline health workers, farmers, LGBTQIA+ individuals, doctors, community health workers, teachers, and students. We have positively impacted over 20 million lives through clinical interventions, counselling, and other initiatives.
Our greatest achievements lie in the testimonials of gratitude from people and families whose lives have been transformed by our mental health interventions. Living our vision of creating awareness, fighting stigma, and providing holistic mental health care has been a source of immense pride. We are committed to promoting mental health as a priority and building a stigma-free society.
MPower has become a symbol of hope and a driving force for change in the mental health landscape. We take great pride in our accomplishments and will continue to work relentlessly toward a world where mental health is a top priority for everyone.
Q: What are the challenges in the mental health space in India across urban and rural communities?
A: In the picturesque rural landscapes, an unseen challenge lurks beneath the surface–limited access to essential services, particularly mental health care. With awareness levels low and stigma soaring high, even the determined help-seekers often face insurmountable barriers. A dearth of mental health professionals and basic medical facilities further exacerbates the issue.
To conquer the dragons of distance and cost, we partnered with the Government of Maharashtra in a groundbreaking public-private initiative called Mpower Samvedna. This project decentralized mental health care, extending its reach from bustling city centres to tranquil rural hospitals. No longer do individuals have to embark on long, costly journeys to access mental healthcare–it›s now available right around the corner—much closer to the primary district health care centres. With medications and mental health professionals stationed at all rural hospitals, the primary healthcare centre has become the first port of call for those in need.
Our efforts have been able to cumulatively get the beneficiaries 60 lakh rupees in just one year, a testament to the incredible impact of increased accessibility and affordability.
Mpower Foundation strives to bridge this gap by offering affordable services to the underprivileged. We›ve established cells in high-risk urban areas, providing subsidized services to those who need them most. Simultaneously, our outreach program combats stigma and raises awareness through workshops held in schools, colleges, and communities.
Our mission is to enhance access to mental health services, improve affordability, spread awareness, and eradicate stigma in urban areas. By tackling these challenges head-on, we aim to empower everyone with the support they need to lead fulfilling, healthy lives.
Q: How is India faring on the mental health index? Why are Indian employees facing increased stress, anxiety, and burnout? Are we equipped to handle the growing pressure and anxiety?
A: India’s performance on the mental health index reveals substantial challenges, with the country shouldering 15% of the global mental health burden and accounting for 36.6% of worldwide suicides. Economic loss due to mental health conditions between 2012 and 2030 is projected to reach USD 1.03 trillion, and Indian employers face annual costs of around USD 14 billion due to poor mental health among employees.
Multiple factors contribute to the increasing stress, anxiety, and burnout among Indian employees, including socio-economic disparities, gender-based issues, and inadequate healthcare funding. The Indian government spends only 2.1% of GDP on healthcare, compared to the 9.7% average among OECD countries. Consequently, 55% of healthcare expenditures are out-of-pocket costs for citizens.
India has taken steps to address these challenges, including launching the National Mental Health Program (NMHP) in 1982 and decentralizing it in 1996. Recent initiatives like Ayushman Bharat, the Mental Health Care Act of 2017, and the National Mental Health Policy (2014) are prioritizing mental healthcare and fostering well-being. The government has also allocated approximately USD 81 million for mental health and well-being, launching the first National Tele-Mental Health Program in collaboration with NIMHANS and MPower.
Despite these efforts, stigma remains a significant barrier, with nearly 80% of individuals not seeking treatment due to stigma. The government is working on mass campaigns to address this issue, but further investment in mental health across various sectors, promoting good mental health, integrating interventions across health, education, and social protection sectors, and breaking the silence surrounding mental illness are all essential steps in improving India’s mental health landscape.
Q: As per your understanding, which is the age group most prone to suffer from mental health issues?
A: Identifying a specific age group most susceptible to mental health issues is challenging, as these concerns do not differentiate based on age or economic status, impacting individuals in both rural and urban settings. Rural areas face difficulties accessing mental health services due to limited availability and high costs, while urban areas grapple with stigma, preventing many from seeking help. Consequently, mental health problems persist in both rural and urban communities, each confronting their own unique obstacles.
The ongoing pandemic has not only exacerbated the pre-existing mental health crisis but has also underscored the importance of mental health in all aspects of our lives. It is highly likely that each person has a family member currently wrestling with a mental health issue, emphasizing the need to address this vital component of our well-being. Mental health challenges can significantly affect daily life and can emerge at any stage of our lives, whether during youth, adolescence, adulthood, or old age.
Q: Can you suggest policies/measures that can democratize mental healthcare across the nation.
A: To democratize mental healthcare across the nation, these are the policies and measures I would suggest: Combat social stigma by identifying barriers, promoting understanding through mass media campaigns, and encouraging supportive public behaviour. Urgently invest in mental health across sectors, promoting good mental health and preventing violence. Integrate interventions across health, education, and social protection sectors, such as parenting programmes and school-based mental health support.
Accelerate the integration of mental health facilities with existing government primary healthcare infrastructure and promote public-private partnerships to expand mental healthcare services.
Make generic psychotropic medicines widely available through the Pradhan Mantri Bharatiya JanaAushadhi Pariyojana (PMBJP) and consider raising long-term ESG/Thematic bonds for mental healthcare sector transformation. Address the human resource gap in mental healthcare by establishing new psychiatry and mental health nursing colleges and updating curriculums.
Incentivize private sector participation in mental healthcare, consider GST exemption on mental health counselling services and generic medicines, and develop a specific subsidy scheme for vulnerable and underprivileged populations. These policy enhancements aim to create a more inclusive mental healthcare system that serves the entire population, ensuring access to quality care and support for all.
Q: How does MPower intend to support these policies?
A: MPower is committed to supporting policies that improve mental healthcare access and affordability through public-private partnerships (PPPs). One outstanding example is the Mpower Samvedna project, which worked with the Government of Maharashtra to decentralize mental health services to rural hospitals. This initiative has provided over 6,500 mental health screenings, 500 psychiatry consultations, and 150 counseling sessions, positively impacting more than 10,000 lives and saving over 60 lakhs rupees in just one year.
Another successful collaboration is Project Mpower Saksham, a partnership with Mumbai police that places counsellors in local police stations to provide mental health support for both victims and perpetrators of crimes involving women and children. With over 800 sessions held and 450 clients reached, this project has led to positive changes in people’s lives and is set to be replicated in other districts.
The Oorja Empowered project, in partnership with the Department of Education and Ramanu Mahanagar Palika, focuses on empowering students in 1,100 schools across Brahmanagar Palika, Maharashtra. By training teachers to identify early signs of mental health issues in children, this initiative has increased help-seeking behavior and reduced school dropouts.
MPower has also collaborated with the Central Industrial Security Force (CISF) to provide mental health services for their personnel, leading to increased help-seeking behaviour and early diagnosis and treatment of those at risk.
Future plans include partnering with the Department of Women and Child Development to support women and, children in their shelter homes who have experienced trauma, helping them lead healthy and productive lives.
Through these combined efforts, MPower aims to increase access to mental health services, raise awareness, and reduce stigma in both urban and rural areas, ultimately ensuring that everyone has the support they need to lead happy, healthy lives.