ADDRESS BY THE PRESIDENT OF INDIA, SHRI RAM NATH KOVIND AT THE 22ND CONVOCATION OF NIMHANS
Bengaluru : 30.12.2017
1. I am happy to be here at the 22nd convocation of the National Institute of Mental Health and Neurosciences. NIMHANS is a national asset. It has integrated education and research in medical sciences with clinical services and treatment. Each year it treats about 700,000 patients – including many from abroad. Two of every three patients belong to the poorer sections. They obtain free or highly subsidised care. This is a very commendable and I congratulate the NIMHANS community for it.
2. I also congratulate the graduating students of today. They are inheritors of a remarkable legacy. They have worked hard for their success, and for this they must thank their professors as well as their supportive families. They must thank society as well, for having helped create this institution and this opportunity for them.
3. Yet, for those who are getting their degrees at this convocation, the real challenge has just begun. They go into a world where their skills are acutely needed – more than ever before. India does not simply have a mental health challenge. As I have said on an earlier occasion, it is facing a possible mental health epidemic.
4. There are several reasons for this. As a country, we are experiencing technological, economic and demographic changes that are transforming the nature of our disease burden. Non-Communicable Diseases such as heart ailments and diabetes are emerging as a big risk. These are often related to lifestyle and stress. And mental illness or mental health concerns are rarely very far away.
5. I understand NIMHANS has conducted the National Mental Health Survey and estimated the burden of mental disorders across the country. The findings are alarming. More than 10 per cent of Indians have one or more mental health problem. In a nation of 1.3 billion people, that is a staggering figure. To put it in context, the number of Indians suffering from a mental health problem is larger than the entire population of Japan.
6. This results in what is called the triple burden of mental disorders:
I.Common mental health problems
II.Severe mental illnesses; and
III.Substance use and abuse
7. India also has a triple burden of another kind. Mental health is particularly a problem among the young, in the prime of their life; among the elderly; and among those in urban areas. In India, all three segments are growing. Sixty-five per cent of our population is below the age of 35. The absolute number of elderly and senior people in our country is among the largest in the world. And we are urbanising at a pace not seen in our history.
8. The biggest obstacle that patients of mental and neurological problems face is stigma and denial. This leads to the issue being ignored or simply not discussed. In some cases it leads to self-diagnosis that could worsen the situation. As I have said before, our society has to fight this culture of stigma. We need to talk about mental health issues and treat ailments such as depression and stress as diseases that can be cured – not as guilty secrets to be pushed under the carpet.
9. That is why I am glad that advocacy and awareness are important components of the Government of India’s National Mental Health Programme. This Programme is building 23 centres of excellence in the field of mental health. In parallel, the District Mental Health Programme has already covered 517 of the approximately 650 districts in India. I commend Union Minister for Health and Family Welfare Shri J.P. Nadda for making such efforts. I must add that the Bellary model for community-based mental health, which was designed by NIMHANS, is a template for other districts in the country.
10. Another major gap we have to address is that of mental health professionals. I am told there are just about 5,000 psychiatrists and less than 2,000 clinical psychologists in our country. These numbers are very small. Especially for the purpose of diagnosis of mental illnesses, it would be advisable to use physicians, psychologists who teach in colleges and educational institutions as well as Auxiliary Nurses and Midwives – who are at the front line of the public health system across the country.
Ladies and Gentlemen
11. The National Mental Health Survey is a wake-up call. It has focused attention on the more chronic and disabling mental health problems. With the National Mental Health Policy and the Mental Health Care Act now in place, the stage is set for an earnest and broad-based effort. It is important to set ambitious but achievable targets – and make sure we reach them within a tight deadline.
12. In 2022, India will be celebrating the 75thanniversary of Independence. We need to ensure that by then at least those who are suffering from severe mental disorders have been diagnosed and have access to treatment facilities. Let us take this up as a national mission.
13. The government and the non-government sector – and all related public and private institutions – will need to contribute to this effort. It is for NIMHANS, as India’s premier mental health institute, to draw a road map and to be the navigator. Other than conventional treatment, the role of counselling services and of practices such as yoga and vipassana meditation in helping those with mental health problems should also be explored with greater vigour.
14. NIMHANS has been at the forefront in supporting development of policies and programmes for mental, neurological, substance use, and behaviour problems and injuries – both at the state and national levels. I urge you to challenge yourselves and to raise the bar. Your country needs you – and our fellow citizens who suffer mental illnesses need you to succeed.
15. Continuous capacity building at NIMHANS will go a long way in helping all of you serve patients. Today, we are inaugurating a 125-bed sub-specialty block of neurosciences. This facility will strengthen in-patient services and manage disorders in neurology and neurosurgery. The foundation stone has also been laid for a super-specialty psychiatry block. And of course I am optimistic about the prospect of a new campus for NIMHANS in north Bengaluru.
16. But do note that as your infrastructural capacities expand, so must your hearts. The troubled minds of your patients need a cold, clinical diagnosis – and a doctor’s warm and sympathetic heart. As those of you who are graduating leave this function, please remember that. I wish all of you, and I wish NIMHANS, all the best for the future. And I wish everybody a very happy and fulfilling 2018.
Thank you
Jai Hind!