The burden of mental health illnesses in Kerala: a secondary analysis of reported data from 2002 to 2018

Abstract

Background The burden of mental health in India, as in other Low- and Middle-Income Countries (LMICs), is substantial. Secondary Analysis of survey data provides insight into trends in mental health morbidity over time, while administrative data can indicate corresponding trends in availability of infrastructure and services. We compared data from three national level surveys conducted in India to analyse trends in mental health morbidity and available institutional mechanisms to address mental health needs in Kerala, a south Indian state. Methods We compiled data from national and state level population surveys which reported mental health morbidity from 2002 to 2018. We compared the prevalence of mental health illness and disability reported in Kerala with national estimates. We also mapped the most recently available health human resource and infrastructure available in Kerala for mental health care. Basic descriptive statistics were computed for both sets of indicators using Microsoft Excel. Results In 2002, Kerala had 194 persons per hundred thousand population with mental retardation and intellectual disability which increased to 300 persons per hundred thousand population in 2018. The number of individuals with mental health illness in the state increased from 272 person per hundred thousand to 400 persons per hundred thousand in the time period of 2002 to 2018. There were 5.53 beds available per ten thousand persons for treatment in Kerala in 2018. Conclusion Kerala experienced a rapid rise in mental health morbidity between 2002 and 2018. The most recently reported health human resource and infrastructure availability in the state appears to be inadequate to cater to the requirements of mental health care, even as improvements and upgradations are underway. Service and system design changes will have to be mapped and evaluated over time.

Open Science, Mental Health, and Sustainable Development: A Proposed Model for a Low-Resource Setting

“…This has been called the 'Kerala Model' of development, characterised by a Human Development Index (HDI) comparable to developed nations, high literacy, quality primary health care services, and low maternal mortality (Parayil 2000). In spite of past achievements, the state has recently reported increased mental morbidity, along with inadequate infrastructure and human resources to address this issue (Joseph, Hari Sankar, and Nambiar 2021;Shibukumar and Thavody 2017). The state has responded with projects aimed at addressing specific issues such as maternal mental health and adolescent mental health.…”

Reliability and validity of Malayalam version of 12-item Community Attitude Towards Mental Illness (CAMI-12) questionnaire

“…27 A study regarding the burden of MI in Kerala has found that the number of individuals with mental illness in Kerala increased from 272 persons per lakh to 400 persons per lakh in the time period of 2002 to 2018. 28 Even though studies have been done among the caregivers and college students to evaluate the knowledge, attitude and behaviors towards patients with MI, the tools for assessing the community attitude towards MI are not available in the local language, Malayalam. A validated and reliable Malayalam tool is an essential prerequisite for assessing the level of stigma towards MI.…”

An integrated care model for primary prevention in a wellbeing-oriented, community mental health care service - new understandings for LMIC settings

“…Kerala is also lagging behind other nations in terms of the availability, scope, and calibre of mental health care providers. According to a study by Joseph, Sankar, and Nambiar (2021), Kerala saw a sharp increase in mental health morbidity between 2002 and 2018. This increase is likely the result of a variety of social trends, including more nuclear families, loneliness, and divorce, as well as unemployment, gender inequality, economic migration, pressure on students, addiction, and other factors.…”

“…This increase is likely the result of a variety of social trends, including more nuclear families, loneliness, and divorce, as well as unemployment, gender inequality, economic migration, pressure on students, addiction, and other factors. Infrastructure and human resources appear to be getting better, although they are still judged inadequate at this time (Joseph et al, 2021).…”