Cost estimation for the implementation of the Mental Healthcare Act 2017

Math, Suresh Bada; Gowda, Guru S; Basavaraju, Vinay; Manjunatha, Narayana; Kumar, Channaveerachari Naveen; Enara, Arun; Gowda, Mahesh; Thirthalli, Jagadisha

doi:10.4103/psychiatry.indianjpsychiatry_188_19

Cited by 96 publications

(45 citation statements)

References 28 publications

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“…This could be due to two reasons. First, individuals may conceal their diagnosis due to the stigma associated with mental disorders [20,21], and second, India's health system is highly underfunded and fragmented at the system level, which hampers access to mental health services [22][23][24]. However, self-reporting of mental disorders was higher in the upper socioeconomic population compared to the lower socioeconomic population.…”

Section: Discussionmentioning

confidence: 99%

“…Often, individuals with a mental health disorder from lower socioeconomic groups and rural areas may either forgo their treatment or turn to traditional healers or informal providers that are not legally approved in the country [38]. This could be due to the unavailability of mental health facilities at the primary healthcare facilities (health sub-centre, primary health centre, and community health centre), which are closest to the community [20,22]. Moreover, the private sector does not typically invest in setting up mental health facilities in remote and rural areas of India.…”

Section: Discussionmentioning

confidence: 99%

“…According to one conservative estimate, the annual estimated cost on the government to meet the mental health needs of the country would be Rs. 94,073 crore [22].…”

Section: Discussionmentioning

confidence: 99%

“…While tax-funded government health facilities provide selective care related to immunization, maternal and child health, leprosy, etc., there are limited resources for mental health disorders [26,27]. For India's population of 1.39 billion, there are 9,000 psychiatrists, 2,000 psychiatric nurses, 1,000 psychiatric social workers, 1,000 clinical psychologists, and 60,000 psychiatric beds [22,28]. In other words, India has 0.3 psychiatrists per 100,000 population compared to the global median of 3 per 100,000 population.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare utilization and financial protection among those with mental disorders in India: Insights from the 75th round of the National Sample Survey

Ranjan

Crasta

2022

Preprint

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Background: Mental disorders pose a significant public health issue in India, with a prevalence rate of one in seven individuals diagnosed with varying severities of mental disorders in 2017. This study examined the patterns of socio-demographic factors associated with diseases burden, healthcare utilization, and financial protection among individuals reported to have a mental disorder across India.Methods: Data from the recently released (November 2019) 75th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used. Data collected from 555,115 individuals (rural: 325,232; urban: 229,232) included 283 outpatient and 374 hospitalization cases due to mental disorders in India. Logistic regression models were used for analyses.Results: Self-reporting of mental health disorders was significantly higher in the general category compared to scheduled tribe, and among the richest income quintile compared to the poorest income quintile in India. The private sector was a major service provider for mental health services with a larger share for outpatient (66.1%) than inpatient care (59.2%). Over 63.5% of individuals with a mental disorder and who went to the private sector for hospitalization reported unavailability or poor service quality at public facilities. Out of total hospitalization cases, 23.5% had insurance coverage. Average out of pocket expenditure during hospitalization [public: Rs.7947 (107 USD); private: Rs. 37152 (502 USD)] and outpatient care [ public: Rs.544 (7 USD); private: Rs. 2358 (32 USD)] was higher under the private sector than the public sector. This led to high catastrophic health expenditure (CHE-10: public- 30.8%; private- 82.5%).Conclusions: Stigma associated with mental disorders may have decreased the self-reporting of mental disorders in this survey. India urgently needs greater investment in mental health resources to improve access and financial protection. To achieve universal health coverage under sustainable development goals, the country needs to strengthen its healthcare system, providing comprehensive primary care, along with robust tertiary and rehabilitative care referral linkages.Trial Registration: Not applicable

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…According to one conservative estimate, the annual estimated cost on the government to meet the mental health needs of the country would be Rs. 94,073 crore [22].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Healthcare utilization and financial protection among those with mental disorders in India: Insights from the 75th round of the National Sample Survey

Ranjan

Crasta

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…2017; Campion and Knapp, 2018; Math et al ., 2019; Campion, 2019). [ 9 16 17 18 19 ] All PMH interventions require more targeted approaches for groups at higher risk of mental disorder and poor mental well-being in order to prevent widening of inequalities.…”

Section: Public Mental Health Interventionsmentioning

confidence: 99%