The World Health Organization (WHO) (1950) defines “Mental Health” as a “state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn, work well and contribute to their community”.
Despite growing awareness, the discourse around mental health and particularly mental illness is shrouded by stigma (negative stereotypes about the mentally ill, discrimination of mentally ill persons etc.). This stigma is also often internalized by the person suffering from mental illness (self stigma; fear of being judged) and this acts as one of the most significant barriers to seeking help for persons with mental illness; which in turn intensifies the detrimental impact of mental illness on the person and the society.
But the mind and body function in unison and just like physical illnesses, mental health conditions are universal and affect people irrespective of gender, age, culture and socio-economic background. According to WHO, one in eight people globally live with a mental health condition, ranging from anxiety and depression to more severe psychiatric disorders (WHO, 2022). The National Mental Health Survey (NMHS) 2015-16 by NIMHANS found that 10.6% of adults in India suffer from mental disorders.
However, it is important to remember that absence of a mental illness is not analogous to mental health / well-being. Psycho-social stressors such as significant life transitions (new job, getting married, having a child, moving to a new city, academic/workplace stress, relationship disturbances, chronic physical illness, trauma and social pressures) can all impact mental well-being. This is because an individual’s mental health exists at the juncture of a balanced interaction between biological disposition (genes), psychological processes (thoughts, emotions, behaviour) and socio-cultural factors (environmental and cultural factors; poverty, violence, neglect, harsh parenting, abuse, bullying etc.), (Biopsychosocial Model; Engel, 1977).
For some people, adverse life experiences may make them more vulnerable to develop symptoms of mental illness. The risk factors for mental illness may be present at any stage of life. But, if they emerge during sensitive developmental periods such as childhood or adolescence, their impact is stronger. Similarly, protective factors also exert a favorable influence throughout our life and they include positive inter-personal interaction, social support, access to education, health-care, safety etc.
Research reveals lower incidents of depression and anxiety in the presence of a strong social support network (Thoits, 2011). Interestingly, at present, mental health conditions are amenable to low cost treatment and evidence based research confirms that early intervention and presence of adequate support helps boost quality of life (Patel et al., 2018).
But, in India, mental health resources are relatively under-utilized because of stigma and lack of awareness. Thus, it is pertinent to recognize and acknowledge that mental health concerns arise from a complex interface of biological, psychological and social factors. Further, decline in mental health, not only creates problem in the individual level but, also has a negative impact on the society/ community, as mental health concerns are manifested in terms of compromised socio-occupational functioning; poor parenting, non-congenial conjugal life, poor performance at work, increased absenteeism, cognitive challenges, disturbed biological functioning and decreased desire to carry out activities of daily life (Ling Na et al, 2017).
It is noteworthy that family members caring for individuals with mental illness are also not free from stressors and / or stigma (affiliate stigma) and Zarit et al (1980), has defined “caregiver burden” as “the emotional, physical, financial demands and responsibilities of an individual’s illness that are placed on the family members, friends, or other individuals involved with the individual outside the health-care system”.
Caregiver burden is also influenced by factors such as age and gender of the caregiver as well as the severity of the diagnosis of mental illness (Tesfaye & Demelash, 2025).
Mental health concerns can be addressed by a team of trained professionals such as psychiatrists and clinical psychologists who vary in terms of their professional training and the nomenclature of the professionals occasionally vary in terms of the country in which they work. In India Psychiatrists are physicians with an MBBS degree recognized by the Medical Council of India (MCI) along with a specialization in Psychiatry (MD, Doctor of Medicine). They help individuals with mental illness by prescribing medicines. Clinical Psychologists, on the other hand, have a degree of M.Phil in Clinical Psychology, recognized by the Rehabilitation Council of India (RCI). They do not prescribe medicines but are proficient in psychological evaluation and psychotherapeutic intervention.
In their endeavour to help individuals suffering from mental illness, mental health professionals provide a safe, confidential and non-judgmental space where individuals can express their thoughts and emotions freely and are on the road to recovery based on scientific, evidence based treatment procedures. Medicine and psychotherapy, in conjunction with each other, help individuals to identify, acknowledge and challenge unhelpful / erroneous thinking patterns, develop healthy coping skills, improve emotional regulation, strengthen problem solving abilities, build resilience and self-confidence. When appropriately prescribed and monitored, psychiatric medications can significantly reduce symptoms and improve functioning (American Psychiatric Association, 2023).
Professional help gains positive momentum with the assistance of a safety net consisting of a secure and reassuring support group of friends and family. Human connection plays a critical role in emotional healing. Sharing one’s feelings with a trusted loved one can reduce loneliness, provide comfort and foster a sense of belonging. This can bring about self-help seeking behaviour, encourage a secure base for emotional validation, reinforce hope and motivation.
Stigmatisation and Caregiver burden are the cardinal factors for negligence of mental illness in India. The Indian Government has taken measures to minimize this gap through the introduction of the National Mental Health Program (2024): establishing awareness programmes, opening of multiple DMHP centres and issuing of metal health care insurance policies.
The journey toward better mental health is not always linear. There may be setbacks, periods of uncertainty and moments of doubt. However, the role of consistent and continuous social support and treatment plan help result in substantial recovery rates.
(The writer is a Clinical Psychologist)