Of healthcare system and mental disorders

Dr. Gyan Pathak
In the largest global review by WHO so far, nearly one in eight people have been found suffering with mental disorders while this ratio is one in seven for teenagers. The common conditions, such as depression and anxiety have even gone up by over 25 per cent during the first year of the COVID-19 crisis in 2020. The most vulnerable age group is 15-19, which suffers all sorts of mental disorders, which is a matter of great concern. The frightening data has triggered even WHO warning that has urged countries to get to grips with worsening condition in a backdrop in which a majority of the patients do not have access to any help or treatment.
The World Mental Health report data shows that 13 per cent of the global population suffers from mental disorders. Females with 13.5 per cent suffer more than males with 12.5 per cent. Anxiety disorders are most common (4 per cent) followed by depressive disorders (3.8 per cent), developmental disorder (idiopathic) (1.5 per cent) and attention-deficity/ hyper-activity disorder 1.1 per cent. All other mental disorders are below one per cent.
Females need more attention than males. While 3 per cent males suffer from depressive disorders it is 50 per cent higher for females at 4.5 per cent. Anxiety disorder is even worse for female at 5 per cent compared to 3 per cent in males.
Mental disorders are found even among 3 per cent of children less than five years of age. Anxiety disorders are found in 0.1 per cent of them, autism spectrum disorders in 0.5, attention-deficit hyper-activity disorder 0.2, and developmental disorder (idiopathic) among 2.2 per cent. Not other mental disorders were reported among this group of children.
During 5-9 years of age, depressive disorders begin though at very low level of 0.1 per cent. All other mental disorders found in earlier age group aggravates and overall percentage of patients more than doubles at 7.6 per cent. Anxiety disorder sharply rises from 0.1 to 1.5 per cent and attention-deficit/ hyper-activity disorder from 0.2 to 2.4 per cent. Conduct disorders is noticed in a big way at 1.1 per cent for the first time which was absent in early phase of life.
Mental disorders get even worse in the next age group of 10-14 and exceed the average prevalence of 13 per cent to increased level of 13.5 per cent. It also remains above the average in all age groups later. Bipolar disorder and eating disorders, which are absent in earlier age, is found for the first time in this age group. Anxiety disorders even more than doubles to 3.6 per cent compared to the earlier age group while conduct disorders become most aggravated from 1.1 to 3.6 per cent.
In the next age group of 15-19, all sorts of mental disorders are found which increases from 13.5 in previous age group to 14.7 per cent. Most alarming is the entry of Schizophrenia in the age group, and anxiety disorder rises sharply from 3.6 to 4.6 per cent, and depressive disorders from 1.1 to 2.8 per cent. However, attention-deficit/ hyper-activity disorder recedes from 3.1 to 2.4 per cent and conduct disorder from 3.6 to 2.1 per cent. Schizophrenia gets introduced in this age group increases with higher age groups until the age of 49, and then remains stagnate at 0.5 per cent until the age of 69 only to retreat to 0.2 per cent beyond 70 years of age.
The age group of 20-24 are little less turbulent as far as mental disorders are concerned which recede to 14.1 per cent, but sharply rises again to 14.9 per cent during 25-49 age group, and remain elevated at little lower level at 14.7 during 50-69 years of age. In 70 plus people mental disorders substantially decreased to 13.1 per cent yet above the average 13 per cent for entire population. Conduct disorder entirely vanishes after 20 years of age and then never reappears in life. Depressive disorders increases sharply during 20-24 years of age to 4 per cent from 2.8 in the previous age group while attention-deficit/ hyper-activity disorder decreases for 2.4 to 1.7 per cent.
Most sufferings from mental disorders are the people of 25-49 age group in which its prevalence is 14.9 per cent. Sharp increase in depressive disorders is witnessed in this age group to 4.8 per cent from 4 in the earlier. It increases further to 5.8 per cent until the age of 69, and retreats a little to 5.4 per cent beyond 70 years of age. A little reduction is found in this age group in eating disorders, attention-deficit/ hyper-activity disorder, and developmental disorder (idiopathic).
Eating disorders, which were not found in the persons below 10 years of age, now totally disappears in the people beyond 50. Schizophrenia remains elevated at 0.5 per cent during 50-69 age group, depressive disorders increases to 5.8 per cent from the previous 4.8 in the earlier group, and anxiety reduces a little.
Attention-deficit/hyper-activity disorder entirely vanishes in people above 70 years of age. All other conditions of mental disorder witnesses decline, but overall per cent remains a little above at 13.1 per cent from 13 per cent. Depressive disorders, though remain higher at 5.4 per cent from average 3.8 per cent for all age groups.
In this backdrop we need to transform our attitudes, actions, and approaches to tackle the situation, as WHO Director General Tedros Adhanom Ghebreyesus has rightly said. There is a compelling case of change since everyone’s life touches someone with a mental health condition. Government needs to substantially increase investment and come out with comprehensive plans. (IPA)