Goa needs to push for early intervention, breaking of stigma and community outreach
We have come a long way from when the number of psychiatrists practising here could be counted on the fingers of one hand, and the apex treatment institution at Altinho was callously called the ‘Mental Hospital,’ with foreboding walls and a tiny circular peep-hole through which one could glimpse at our world of mental illness. But while things have indeed changed, have we conquered all challenges? Hardly so.
World Mental Health Day is celebrated on October 10 every year to promote mental health awareness and action. The day is highly relevant to Goa, given the state’s unique socio-economic, cultural and public health context. Goa faces challenges such as high rates of “substance use,” particularly alcohol, and rising stress levels among youth and working-age adults. There is also the mental health impact of tourism-driven economic fluctuations. Stigma persists around seeking psychological help, and the mental health infrastructure – though improving – is still limited and insufficient to meet all current and unfulfilled needs.
Goa has few specialised facilities and limited professionals per capita. Our policymakers need to be pushed to strengthen services, education and outreach programmes. Other realities exist too. Goa has one of the highest suicide rates in India, consistently ranking above the national average.
Causes are complex, deeply intertwined with Goa’s social and economic fabric. This reality is linked to unemployment and underemployment, alcoholism, relationship breakdowns, debt, academic stress and loneliness among the elderly. The problem is compounded by the continuing social stigma around seeking mental health support. Mental health conditions are medical issues, not moral failings. Experts like Goa’s Dr Vikram Patel imply that medical disorders are health conditions like any other, affecting many and needing attention, respect and innovative health approaches. This World Health Organisation-supported commemoration, marked since 1992, is an opportunity for professionals to discuss and shed light on their work too. Australia celebrates a Mental Health Week; the UK and Japan have a minister for loneliness.
In recent times, Goa has seen headlines emerge over inhuman treatment of those suffering from mental illness. One case saw a woman being kept confined to a dark room for years together, in conditions described as inhumane. Many patients declared cured remain at the Institute of Psychiatry and Human Behaviour, as their relatives fail to reclaim them; some stay there until death. On Wednesday, Chief Minister Pramod Sawant also said that some families don’t even visit their own members in hospitals such as IPHB. He said ten in 100 people in Goa need help for mental illness. In August, Goa’s Human Rights Commission issued a notice about poor infrastructure and financial support to mental health care homes. Mental health services need to be affordable and accessible.
World Mental Health Day reminds us of how mental illness, substance dependence and social change connect and intersect in rapidly modernising (albeit small) societies like Goa. Mental health centres are doing a good job.
Post-pandemic has seen an increase in mental health issues in the state. Sometimes, domestic crimes are linked to mental illness. The media had reported of a case in which a man who was going through depression killed his children and himself too. The community is also partly responsible for such avoidable cases. There is a strong need for mental health awareness, right from school level. If a citizen knows how to detect a person experiencing depression, lives can be saved.
