Are we prepared for the great Indian depression?

As millions of people stare at unemployment, and a deep economic crisis is on the anvil – will India be able to deal with the mental health crisis that is coming at us?
Migrant workers walking from Telangana
Migrant workers walking from Telangana

Amrit Ramcharan’s body was heating up as he sat in the back of a truck from Surat, hoping to reach home in Uttar Pradesh’s Basti district. His condition caused fear among the other migrant workers, who thought he had COVID-19. The truck dropped Amrit in Shivpuri in Madhya Pradesh, afraid he may infect others – and his friend, Yaqoob Mohammad, decided to get down with him. Friends from the same village, roommates and colleagues in a new city, there was no way Yaqoob could leave Amrit in his condition. You’ve likely seen the photo – of Yaqoob cradling Amrit on the side of a road, waiting for an ambulance. And you probably know that Amrit died soon after.

Yaqoob – like thousands and thousands of migrant workers across the country – will have to live with watching a loved one die...not from the illness that caused the pandemic, but from the incompetence of the state and the indignity forced on the poor. As we look at his photo and theorise about his friendship on Twitter, will Yaqoob – or Jyoti Kumari, or Satvir – at least get acknowledgment of the trauma that they have been put through?

As millions of people stare at unemployment across the country, and a deep economic crisis is surely on the anvil – will India be able to deal with the mental health crisis that is coming at us? Are we ready for The Great Indian Depression – in the economy, and in our minds?

Most likely, we’re far from ready – even if we assume that we’re willing to talk about mental health, beyond some urban bubbles. In fact, we were hardly prepared for the ‘normal’, pre-COVID mental health needs of the country.

The lack of seriousness about mental health is apparent when you find out that the country doesn’t even have a central database of the number of psychiatrists, psychologists and other mental health professionals. The latest government ‘estimate’ was presented in 2018 in the Parliament, although the figures themselves are from January 2015 – and according to these numbers, there are less than 4,000 psychiatrists in the country.

Other estimates suggest there are about 9,000 psychiatrists in India as of early 2019, with another 700 graduates every year. This puts us at an average of 0.77 psychiatrists per 1 lakh population. The US meanwhile has 10.5 psychiatrists per 1 lakh population, Canada has 14.7, Argentina has 21.7, Brazil 3.2, South Africa 1.5, Russia 8.5… Perhaps we can take pride in the fact that there’s no data for Pakistan with WHO, and feel morally superior.

And of course, the concentration of mental health professionals is much more in urban areas – specifically metros – and the teenager who had to cycle thousands of kilometres to take her father home, and the young man who had to watch his best friend die, will hardly be able to access any mental healthcare.

Added to decades of poor attitudes towards mental health, which have resulted in poor mental health infrastructure in most of the country – is our flippant attitude towards some disorders. Take the deaths of people who were addicted to alcohol, for instance. Media reporting around the issue was wanting for sensitivity, and the general discourse in WhatsApp family groups regularly portrayed people struggling with addiction as ‘dumb’, or ‘desperate’, ‘illiterate’ and other terms reserved for anyone we believe doesn’t deserve to make their own choices, or mistakes.

We’re at the brink of a crisis that in 2018 claimed more than 1.3 lakh lives – and this is of course the ‘reported’ number. Further, the suffering of people who attempt to take their own lives, and those who struggle with everyday social interactions and livelihoods is exponentially larger. While states like Kerala and Karnataka were quick to consider the mental health ramifications of the pandemic in its early stages, and started helplines and counselling programmes for those in quarantine, it’s important that we talk about how these measures can be scaled with the available resources.

It’s important to centre the mental health of our people, as we yearn for ‘normal’ – a vaccine isn’t going to fix this.

Views expressed are the author's own.

This piece was first sent as part of Here's The Thing, TNM's weekly newsletter for members. 

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