Impetus to Mental Health | Dr. Soumitra Pathare | TEDxGSMC

Impetus to Mental Health | Dr. Soumitra Pathare | TEDxGSMC

[Music] as he said I I trained here in gs Medical College and this is my first visit back here after 25 years so it feels good to be back it’s also good to know some things don’t change you know the psychiatry Ward is still next to the mortuary as it used to be and in those days we always thought is a very unusual why were we next to the mortuary why were we not in a different part of the hospital and as I have traveled and worked over the last 25 years I’ve realized that psychiatry wards and many hospitals across the country are next to the mortuary and that is not by accident that is by design we try to exclude people whom we are afraid of whom we don’t understand and about whom we hold certain stereotypes and that is what our hospitals try to do they try to exclude people with mental health problems discrimination and exclusion is everywhere in our society two days ago there was a news item which said that the Miss India contest will not allow you to apply for the Miss India contest if you suffered from mental illness or I had a history of mental illness what mental illness has to do with beauty is something I have not yet understood and it also means that Deepika Padukone can say goodbye to ever becoming Miss India because Deepika Padukone has publicly talked about her depression about a year ago I can give you lots of examples of such discrimination that happens in our society but since we are in a healthcare setting since we are in a hospital let me tell you about the kind of effect that it has on people’s lives when we discriminate in our health sector what happens when the health sector people like you and me discriminate against people with mental illness there is now very strong evidence that people with mental health problems died around 10 to 20 years younger than their peers okay 10 to 20 years of low life expectancy this has been repeatedly shown across countries and in different settings so it’s not just an accidental finding and if I say this is discrimination I’m sure you will say oh but that could be lots of reasons it could be the illness it could be the medicines it could be all sorts of things let me give you one piece of evidence which proves my point on discrimination if you look at people who had a heart attack and look at people who had a heart attack and have had a mental illness they have 40% less chance of being offered either an angioplasty or a cardiac bypass surgery how do you explain that other than discrimination why should somebody who has a mental illness have 40% less chance of getting a bypass surgery after a heart attack when everybody else is likely to get that I’ll give you another bit of evidence tuberculosis which is a really big important issue for our country kills about 500,000 people in this country and that’s a revised figure until two years ago the government claimed they’d only killed 250,000 people and our government very rightly spends about a hundred million dollars on tuberculosis programs every year suicides kill about 250,000 people every year about half the number of what tuberculosis does how much does our government spend on suicide prevention nada zilch zero this to my mind is discrimination if tuberculosis is important suicide is equally important why don’t we treat tuberculosis we treat tuberculosis why don’t we do something about suicides why suicide is important because I don’t know if you know but suicides are now the number one cause of death among young women in this country ahead of the maternal mortality rate we are losing young women to suicide not to maternal mortality suicides are the number two cause of death for young men after road traffic accidents India needs to understand that it’s demographic dividend you actually killing itself you know there’s going to be no demographic dividend if this continues for a long time 13% of the health burden if you add up the entire health burden 13% of it is made up by mental health problems and our government devotes 1% of the health budget to mental health in fact less than one person is that a fair distribution is that equity is there is that not evidence of some kind of discrimination happening what it results in is a 90 percent treatment gap what I mean by treatment gap is that people who need treatment versus people who get it 9 out of 10 people who need mental health treatment do not get it again to my mind if this was happening with some other health condition people would be out on the streets there would be lots of articles written about it it doesn’t happen when it comes to mental illness and I think we should ask ourselves why that is so and it’s not actually difficult to treat mental health problems you know this is an estimate from Lancet which says that if you spend $2 per head $2 per head will reduce the treatment gap by 50% it’s not a lot of money $2 per capita per year will reduce 50% of the mental health need and you just heard from the deputy governor of the RBI that economics are an important part of our life and so what does what am I going to give you now is an economic argument every $1 invested in treating mental health gives you a $4 return in terms of social benefits you know in terms of increased productivity in terms of economic growth that’s good value for money $1 invested $4 of return and yet we don’t invest that $1 I want you to go home and think why do we do that and why do we allow our society to do that when there are paybacks which are good for our society which are good for the individual and which are good for our economic and before I end I’m just going to remind you that many of you will end up working in a casualty or seeing people in the casualty just remember that the next time somebody turns up in the casualty with chest pain and has a history of mental illness don’t call the psychiatrist call the cardiologist thank you [Applause]

Our most neglected require valiant leaders to help cross the obstacles life has put in their path. Dr Pathare is perhaps one such saviour, for the mentally ill.

Dr. Soumitra Pathare, is a consultant Psychiatrist and Director at the Centre for Mental Health Law and Policy at the Indian Law Society, Pune. He has provided assistance in the making of the Mental Health Care Act, 2017. He is also involved in spreading the Atmiyata Movement, which helps improve access to mental health services in the rural areas.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx