Cost of Covid on mental health

A good mental health refers to cognitive, behavioral, and emotional well-being. It is all about how a person thinks, understands and behaves in a situation. Since March 2020, when India went into lockdown due to Covid-19, there has been a significant increase in the number of consultations a mental health professionals (MHPs) is doing. Majority of MHPs had very few to no slots for consultations. The purpose of consultations vary from anxiety, depression, work stress to marital discords among couples arising from spending excessive time (quality) together vis-à-vis qualitative time they used to spend. We can relate that one of the main reasons for this is that, Covid-19 pandemic has increased the imbalance in all components of mental health especially behavioral and emotional wellbeing to be simple, the work life balance. This is reflected in the UN World Happiness Report 2021 where India stood at 139 out of 149 countries.

The World Health Organisation (WHO) estimated that the burden of mental health problems in India is 2443 disability-adjusted life years (DALYs) per 10,000 population. In simple words, there is a loss of 2443 years of full health for every 10,000 populations. 2443 work years!!! And with Covid – 19 this has increased significantly. Before Covid-19, the World Health Organization estimated that India would lose $1.03 trillion between 2012 and 2030 due to poor mental health; the pandemic is likely to have increased this cost.

The Covid-19 pandemic isn't just a threat to the economy or human life but also has led to a mental health catastrophe with significant personal and economic consequences. Fear of falling ill, getting admitted to hospital, uncertainty about lockdowns, poor social life, schooling concern about children, thoughts of becoming unemployed and collapsing economic structure are playing on the minds of people across all age groups, be it a fresher or a pensioner. An indirect proof for this is that people are reaching out for help for a mental health problem; with reduced income due to various reasons, they don't follow up for a second time as most apps or helplines charge from second consultation onwards. Majority feel that instead of spending for mental health help, it is better to invest in something else or they look for another place for a free consultation which restarts the process and doesn't give a solution at one go.

A poor mental health leads to poor concentration, reduced effort on work and this might lead to expulsion from job due to poor or non-performance. This increases the chances of a person to cross the line for a mental illness and vice versa. In addition to work, family crises in the background are exhausting the working population, further depreciating the mental health and driving a person to a burnout. It is a vicious cycle in which the majority of Indians are currently trapped and are finding it very difficult to get out of it. Rubbing salt into the wounds is the stigma attached to both mental illness and medicines used to treat them. Many clients I have seen in the past year are either postponing getting married or planning a child or investing somewhere as they are highly uncertain about what will happen next week and are literally scared to even think how their bank balance will look next month. Many people who used to be happy with some savings are now anxious as they are living paycheck to paycheck.

A study in the US proved that for every Dollar invested on mental health, the person gets back 4$. Though we do not have enough data to support this in India for this, many of them who took help from a MHP would concur with that. It's the right time for us to invest in mental health. The International Labor Organization (ILO) has already said that if we don't take timely action to stem the mental health crisis, India's youth may suffer severe and long-term effects that will affect their productivity, and in turn the national economy in the current decade. Be it a rupee or crores, the returns will always being very high, both instantly and long term. And for those who cannot spend out of pocket, Mental Health Act 2017 makes it compulsory for insurance companies to provide mental health cover including Outpatient Consultations, Therapy or counselling, to which Supreme court has seconded in its ruling in June 2020.

(The author is consultant psychiatrist at Aster Prime Hospitals and alumni of Harvard University)