Context:

• To address the rising frequency of student suicides in higher education institutions, particularly IITs, the Supreme Court of India has lately created a National Task Force.
• This response to many suicides at IIT Delhi in 2023. It denotes a more general concern about institutional shortcomings addressing mental health problems, prejudice, and campus support networks.

Institutional Response and Mental Health Challenges in Higher Education

1. Superficial Institutional Response: Though growing worries about student mental health, institutional responses are mostly limited to increasing the number of psychologists without addressing deeper socio-structural determinants such discrimination, marginalisation, and institutional exclusion.
2. Reductionist Approach: The emphasis stays mostly on individual-level treatments while neglecting more general institutional elements causing mental health crises and suicides in educational institutions.
3. Institutional Bias and Non-Inclusive Practices: Many counselling centres overlook the need of critically interact with biassed institutional regulations, thereby sustaining conditions that negatively impact underprivileged groups, including queer and transgender students.
4. Lack of Language Inclusivity: The language used in official documents and on institutional websites often lacks gender-neutral pronouns and queer-affirmative expressions, which is indicative of a larger institutional disregard for sexual and gender diversity.
5. Legal Non-Compliance: The persistent use of gender-exclusionary language violates legal standards established by the 2014 NALSA judgment by the Supreme Court, which recognized the rights and equal representation of gender non-binary individuals.
6. Power of Language: Language is a tool for communication, but it also builds institutional culture, shapes ideas, either supports or undermines power systems.
7. Need for Structural Reform: Structural changes, inclusive practices, and legal compliance must all be part of a comprehensive mental health strategy to guarantee psychological support is both fair and sensitive to cultural backgrounds.

Mental Health in India: An Analytical Overview

Prevalence of Mental Disorders:

The World Health Organisation (WHO) estimates that roughly 7.5% of Indians are currently afflicted by a mental condition.  These statistics indicate a considerable strain on India's healthcare system, especially for non-communicable diseases.

Specific Disorders:

India boasts a startlingly high prevalence of particular mental illnesses: 56 million people deal with depression alone.

• Anxiety problems impact an extra 38 million people.
• The mental illness of the nation can be mostly attributed to these two categories by themselves.

Shortage of Mental Health Professionals:

• A significant issue in addressing the mental health epidemic is the acute deficiency of qualified experts. According to WHO assessments, there is a significant shortage of psychiatrists, clinical psychologists, and psychiatric social workers in India.
• This treatment gap substantially impacts the diagnosis, management, and rehabilitation of patients with mental disorders.

Suicide Statistics:

With 36.6% of all suicides worldwide attributable to India, the magnitude of the mental health epidemic is highlighted. Notwithstanding India's population share, this disproportionately high rate points to a lack of preventative mental healthcare systems, great mental suffering, and societal stigma.

Adolescent Mental Health – National Mental Health Survey 2015–16 (NIMHANS):

The National Mental Health Survey, conducted by NIMHANS, Bengaluru, reveals that approximately 9.8 million adolescents (aged 13–17 years) suffer from depression and other mental health disorders. These adolescents are identified as needing active intervention, indicating the necessity for school-based mental health programs, early screening, and counselling services.

Policy Implications and Way Forward:

• It is imperative to improve the mental health workforce using more training, recruiting, and deployment.
• Increasing the reach of District Mental Health Programmes (DMHP) and include mental health into main medical treatments.
• Tackling mental illness's stigma using awareness initiatives and community involvement.
• Guaranting improved mental health spending allocation under the National Health Mission.
• Promoting public-private partnerships and leveraging digital mental health platforms to bridge the accessibility gap.

Best Practice: Integration of Mental Health Services in Thiruvananthapuram, Kerala Thiruvananthapuram District has pioneered integrating mental health services into primary health care since 1999, making mental health care more accessible and community-based.Medical officers at the primary care level are trained to diagnose and treat mental disorders, incorporating these responsibilities into their general duties, thus mainstreaming mental health care delivery.A multidisciplinary District Mental Health Team (DMHT) plays a central role by offering outreach clinical services, managing complex psychiatric cases, and providing in-service training and supervision to primary care providers.From 2002 onwards, there has been a progressive decentralization of mental health services, with primary health centres (PHCs) assuming operational responsibility for mental health clinics with minimal support from the central DMHT.As of now, 22 mental health clinics are functional across the district, providing a range of services including:Diagnosis and treatment planning for newly diagnosed individualsFollow-up and review consultations for ongoing casesCounselling by qualified clinical psychologists or psychiatristsPsychoeducation for patients and caregiversReferral services to higher centres when necessary

Mental Health: Global and National Initiatives with a Focus on Institutional Reform

WHO’s Role in Mental Health Promotion

• The World Health Organization (WHO) plays significant role in supporting governments to strengthen and promote mental health.
• It assesses evidence-based strategies and aids in their integration into national policies and programs.
• The Comprehensive Mental Health Action Plan 2013–2020, approved by the World Health Assembly, aims to:

1. Promote mental well-being and prevent disorders.
2. Enhance recovery, and safeguard human rights.
3. Reduce mortality, morbidity, and disability associated with mental disorders.

• Focus on four key objectives:

1. Strengthen leadership and governance in mental health.
2. Ensure community-based, integrated care services.
3. Implement preventive and promotional strategies.
4. Improve data systems, research, and evidence-based practices.

Government of India Initiatives

National Mental Health Programme (NMHP), 1982:

Works to provide easily available mental health treatment, particularly for impoverished and vulnerable groups.

Mental Healthcare Act, 2017:

• Replaced the Mental Health Act of 1987 and came into effect in 2018.
• Decriminalized suicide, aligning with global mental health frameworks.
• Adopted WHO’s guidelines in defining mental illnesses.
• Introduced advance directives, allowing individuals to determine their treatment and nominate representatives.
• Restricted Electroconvulsive Therapy (ECT) and banned its use on minors.
• Addressed social stigma through legal provisions.

Rights of Persons with Disabilities Act, 2017:

Recognize mental illness as a form of disability, promoting empowerment and societal inclusion.

• Manodarpan Initiative:
• It is a part of the Atmanirbhar Bharat Abhiyan, it offers psycho-social support to students.
• Kiran Helpline:
• A national helpline for suicide prevention and crisis management, offers early screening and psychological support.

Way Forward: Institutional and Structural Reforms

Unbiased Language in Education:

• The 2023 Supreme Court Handbook stresses objective, gender-neutral language to increase social and legal inclusiveness.

Inclusive Classrooms and Pronoun Use:

• Student well-being—trans and non-binary especially depends on gender-inclusive terminology.
• Developing trans-affirming pedagogy means gathering pronouns and correcting usage.

1. Anti-Discrimination Policies:
• Gender-inclusive anti-discrimination rules have to be followed by institutions to guarantee mental health and fairness.
2. Reassessing Educational Focus:
• Current emphasis on grades undermines the ethic of care.
• Teachers must recognize human value beyond academic performance.
3. Building Compassionate Communities:
• Along with intellectual growth, classrooms should promote empathy, and compassion.
4. Attendance Policies and Cultural Safety:
• Arbitrary attendance rules negatively impact student mental health.
• Emphasis on cultural safety and teacher-student interactions is vital.
5. Addressing Structural Challenges:
• The emphasis now on clinical therapies is insufficient.
• Institutions have to take structural elements causing mental discomfort under consideration.
6. Counseling and Ethics of Care:
• Counseling centres should prioritize care-centric values.
• A mobilization of resources is necessary to counter institutional policies that may be counter-therapeutic.
• Embedding an ethics of care in educational and health institutions is imperative.

Conclusion

Creating safe environments for students of many identities depends on inclusive practices in language and policies. Helping mental health, building compassionate, sympathetic, nonjudging societies, and helping student well-being depend on teachers.

Practice Questions Suggest some best ways to promote mental health.

FAQs

• What is Naya Daur?

Naya Daur in West Bengal collaborates with local networks and volunteers to assist homeless individuals through its outreach program.  This facilitates access to sustenance, apparel, guidance, accommodation, and housing.