India’s path towards better mental health in a pandemic

Abstract

COVID-19 has wide-ranging effects on population health including mental health, particularly in low-and-middle-income countries (LMICs). Outbreak and interventions such as quarantine and isolation against it have contributed to psychosocial adversities. We aimed to review the state of India’s mental healthcare planning, identify the gaps in the health systems and policies, and present cost-effective and scalable solutions. Necessary background information was triangulated through an iterative literature review of the policy, preprint, and peer-reviewed research literature. We focused on the following themes-a) health system capacity, policy, and law for India, b) psychological impact of COVID-19 outbreak in India, c) psychological impact of interventions against COVID-19, and d) best practices across countries for mental health management during the pandemic. We used qualitative synthesis to identify health systems and policy gaps to generate short- and long-term solutions supported by high-grade evidence for effectiveness, cost-effectiveness, and adaptation feasibility in India. The Indian health system has several shortcomings in its mental health care that became pronounced during the current COVID-19 pandemic. To overcome these, long-term goals should include increased public financing, increased human resources production, integration of health emergency and mental health policies and legislation. Immediate needs could be met by scale-up of task-shifting initiatives and telepsychiatry services in rural regions. In the ongoing pandemic, employing school-based psychosocial interventions, public awareness campaigning, subverting misinformation through broadcast legislations, and stigma reduction for general mental illnesses are pertinent. These solutions can help bridge the gaps in mental health care in India.