Expert Article by:
Lata K. McGinn, PhD
Professor of Psychology
Director, Clinical Program
Director, CBT Training Program for Anxiety and Depressive Disorders
Ferkauf Graduate School of Psychology
Albert Einstein College of Medicine
Co-Founder, Cognitive & Behavioral Consultants, LLP www.cognitivebehavioralconsultants.com
Past-President, International Association of Cognitive Psychotherapy
Founding Fellow and Board of Directors, Academy of Cognitive Therapy
The World Health Organization estimates that mental illnesses are extremely common throughout the world. Between 18-36% of people suffer from a mental illness in many parts of the world and most typically suffer from more than one condition at any given time. Many mental illnesses begin in childhood and last throughout a person’s life. Approximately 20% of adults in India suffer from a psychiatric disorder although this is probably an underestimation. Most individuals do not come to the attention of a mental health provider unless they are hospitalized with severe and persistent mental illnesses such as psychotic disorders. Common mental illnesses such as anxiety and depressive disorders are largely hidden in a shroud of shame and secrecy, even though they create deep suffering, lower the quality of a person’s life, and lead to serious consequences such as suicidal attempts, aggression, violence, substance abuse, and family conflict among others.
The burden of mental illness is tremendous, both for the individual and for the society at large. Mental illnesses can lead to poor physical health, higher mortality, increased medical health care costs, poor academic performance, absences at school or work, reduced productivity, and can prevent individuals from living up to their true potential. Individuals with psychological problems also suffer social consequences. They may be unable to form friendships or romantic attachments, or may suffer the loss of such relationships due to their illness.
Despite advances made in understanding and treating mental illnesses, mental illnesses are misunderstood and continue to be stigmatized. This is particularly the case in India where misconceptions about mental illnesses are widespread. Commonly held stereotypes about mentally ill individuals include beliefs that they are incompetent, weak, responsible for their illness, or dangerous and unstable. Not only do these beliefs lead to discrimination against individuals with mental illnesses, they create profound shame within sufferers, and prevent them from seeking and receiving the help they need. Similar to individuals from other Eastern cultures, Indians place a great premium on preserving physical health but tend to misattribute mental health symptoms. Hence, mental health symptoms persist because they are not recognized and appropriately treated.
Of course, other barriers also contribute to the under-treatment of mental illnesses in India, such as a lack of qualified providers, and a lack of financial resources or insurance coverage to effectively treat everyone in need. The rapid increase in problems stemming from untreated mental illnesses underscores the need for a large-scale solution.
Cognitive and behavioral therapies (CBT) have been shown to be effective for the full range of mental illnesses and are widely used with success in the US and other parts of the world. Although CBT is far from gaining a foothold in India, the interest in CBT has grown in recent years. I am fortunate to have helped found the Indian Association of CBT, which has as its mission, the increased dissemination and training of CBT to help the millions of Indians suffering from mental illnesses. However, these measures, by themselves, would be sufficient to fill the huge gap and address the needs of the vast number of sufferers. Recent studies show that electronically guided treatments are effective in treating mental illnesses and may be a key solution to make effective treatment more scalable and economical.