At any given time, one in ten adults in India experiences one or more mental health conditions. Despite this significant burden, the self-reported treatment gap as per the National Mental Health Survey 2016 remains alarmingly high at 84.5%. The treatment gap is highest for substance use disorders (91%, excluding tobacco use disorder) and lowest for bipolar affective disorder (70%). Among common mental disorders, major depressive disorder and anxiety disorders exhibit treatment gaps of 85.2% and 84.0%, respectively, both exceeding the treatment gap for severe mental disorders, which stands at 73.6%.
This means that a large proportion of individuals with mental illness either never access care or reach services only after years of suffering. The reasons most often cited are: shortage of trained professionals, limited infrastructure, low mental health literacy, and stigma in society. The treatment gap is not merely individuals not accessing services; it is also individuals not having access to services. It can be argued that the treatment gap is also a product of professional culture where psychiatry is discriminated against within the profession itself.
It usually manifests as reduced academic emphasis in the form of being seen as a minor subject, dismissive attitudes towards psychiatry as being a less preferred career choice, and a perception of the speciality as being less scientific. When the discipline responsible for mental health care is undervalued within the profession, the consequences inevitably extend beyond institutional walls and into patient outcomes.
Addressing this problem requires more than increasing the number of psychiatrists. Meaningful changes must begin within medical colleges. Psychiatry teaching must be integrated across disciplines, like medicine, surgery, paediatrics, and obstetrics and gynaecology. Medical colleges shape how future doctors think about illness, patients, and professional responsibility. Until psychiatry is taken seriously, where doctors are created, the mental health treatment gap will continue to widen.
As we step into this new year, one resolution for us as healthcare professionals could be to actively fight stigma and discrimination against psychiatry within our own community. Narrowing the treatment gap must begin at home.
Warm Regards,
Dr. Priyash Jain
Editor, Minds Newsletter
