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India’s mental health care system better than many developed countries: Dr. Sandeep Govil
With over 25 years of experience, Dr. Govil, a prominent Delhi NCR psychiatrist and four-times-MBBS gold medalist, discusses the evolving landscape of mental health in India, improvements in psychiatric care, and why he believes India offers unique strengths in mental health treatment.
- By Pooja Chaturvedi Sah
- New Delhi
- Oct 03, 2024
As Dr. Sandeep Govil sat with a young inmate at Tihar Jail, where he has served as the psychiatrist-in-charge for four years, the girl shared a profound thought. “If I had access to community activities, sports, or any form of recreation, I might not have taken the wrong path,” she said. This moment highlights Dr. Govil’s core belief: mental health is shaped not just by medicine but by societal and community support.
With over 25 years of experience, Dr. Govil, a prominent Delhi NCR psychiatrist and MBBS gold medalist, emphasizes holistic care, often recommending yoga, meditation, and spiritual texts like the Bhagavad Gita. His goal is clear: to foster a mentally and spiritually healthier India by reconnecting people with their cultural roots.
India, like the rest of the world, faces a mental health crisis. Nearly 15% of the population is affected by mental disorders, straining both individuals and society. The 2023-24 Economic Survey highlighted the need for reform in mental health care.
Dr. Govil’s approach is to bridge modern science and medical practices with traditional wisdom. An expert in schizophrenia and bipolar disorder, he has served as the psychiatrist-in-charge of Tihar Jail’s Mental Health Unit and Drug De-addiction Unit, working with some of the most vulnerable and stigmatized individuals in society. He also works with the underprivileged and homeless kids from Sanskaar Ashram, East Delhi and has headed the responsibilities of many drug research trials in the Institute Of Human Behavior and Allied Sciences. With 15 National and International Publications on his name, Dr Govil has authored the Book Psychiatry Made Easy.
In this interview, Dr. Govil discusses the evolving landscape of mental health in India, improvements in psychiatric care, and why he believes India offers unique strengths in mental health treatment.
Is depression becoming a major health crisis in India? What is driving this trend?
Yes, depression is indeed becoming a significant health crisis in India. One of the main contributors is the rapidly changing lifestyle of urban India. People are facing increased pressures from work, personal life, and the need to meet societal expectations. Urbanization, job-related stress, fragmented family structures, and the increasing reliance on technology all contribute to this.
These changes are leading to higher levels of stress, anxiety, and depression, particularly among young people. The stigma and lack of awareness surrounding mental health only make it worse, as people are hesitant to seek help in a timely manner.
How would you define a “mentally healthy” person in layman’s terms?
A mentally healthy person is able to function well in their personal and social life, manage their emotions effectively, and cope with everyday stressors. Feeling sad or anxious at times is natural, but when these emotions persist and start affecting one’s daily life, work, or relationships, it’s a cause for concern.
A mentally healthy person maintains emotional balance, handles stress, and can have positive interactions without being overwhelmed by life’s challenges.
You’ve been in the field for over 25 years. What are the main challenges of working as a psychiatrist in India?
The biggest challenge is the sheer number of people needing care. In a country as large as India, even a small percentage of the population with mental health issues means millions are struggling. There’s also a shortage of mental health professionals, particularly in rural areas.
Another challenge is the stigma that still surrounds mental health, though this is slowly changing. People often hesitate to seek psychiatric help out of fear of being judged or ostracized. Additionally, there’s a widespread misconception that psychiatric medications are dangerous or lead to lifelong dependence, which deters people from seeking treatment.
Talking about medications, have psychiatric medications and treatments improved recently?
Yes, medications have improved significantly, both in efficacy and in reducing side effects. In the past, people were hesitant to take psychiatric drugs because of side effects like drowsiness, weight gain, or cognitive dulling. But today, newer medications are much more targeted, reducing those side effects considerably. Patients now experience fewer relapses and longer periods of remission, which is a major advancement.
Beyond medications, modern technology has introduced safer, non-invasive techniques like direct magnetic stimulation for the brain. For example, once the neural circuit of depression is identified, it can be modified by applying safe magnetic waves without the need for invasive procedures. Similarly, techniques like transcutaneous vagus nerve stimulation (tVNS) and trans-cranial direct current stimulation (tDCS) are gaining prominence. These methods use safe, controlled waves to stimulate specific brain areas, helping in cases of depression and anxiety without strong physical effects.
Medications are now more refined, much like insulin for diabetes. We can supplement necessary chemicals in the brain to help restore mental balance and improve a person’s quality of life, similar to how physical illnesses are treated. These advancements mark a significant step forward for mental health care in India.
You’ve been in charge of the Drug De-addiction Unit and Mental Health Unit at Tihar Jail for four years. What has been your experience there?
My experience at Tihar Jail has been both challenging and enlightening. Working with inmates who have mental health issues is quite different from traditional practice. Many inmates have had traumatic childhoods and broken family structures, which played a role in their involvement in crime.
Mental health issues such as depression, anxiety, and psychosis are rampant, and addressing these is key to their rehabilitation. Providing structured recreational activities, emotional support, and therapy can help reform individuals. Many inmates have shared that had they received such interventions earlier in life, they might not have turned to crime.
You’ve seen the field evolve over 25 years. How was it when you first entered, and how have government policies helped shape mental health care in India?
When I first entered the field, there was a lot of stigma surrounding mental health, and people were hesitant to seek help. Psychiatric illnesses were often misunderstood, and treatments were limited. However, over the years, this has changed dramatically, with greater awareness, advancements in treatment, and more professionals being trained.
Government initiatives have and are playing a crucial role in shaping mental health care. The National Mental Health Programme (NMHP), launched in 1982, has expanded over the years to provide a range of community-based services. The Mental Healthcare Act of 2017 was a major milestone, ensuring that people have the right to access affordable treatment without discrimination. It also decriminalized suicide, which was a significant step in reducing stigma and making it easier for individuals to seek help.
Prime Minister Narendra Modi’s government has taken additional yet significant steps to address mental health. The National Tele-Mental Health Programme, introduced under the National Health Mission, has made mental health services more accessible, particularly in rural and underserved areas. The Ayushman Bharat scheme, under Universal Health Coverage (UHC), now includes mental health services, making treatment more accessible and affordable.
Moreover, the government’s collaboration with educational institutions and NGOs has helped raise awareness. Campaigns like “Mann Ki Baat,” where the Prime Minister speaks openly about mental health, have also contributed to reducing stigma.
Talking about the encouraging government initiatives, PM Modi also advocates for Yoga and meditation as daily practices. You also believe in adopting a holistic approach towards mental health. India as we know is the birthplace of yoga and meditation. What are your views on their impact on mental health, and do you recommend these practices to your patients?
Absolutely! India has given the world invaluable practices like yoga and meditation, and they are scientifically proven to benefit mental health. For example, Surya Namaskar (Sun Salutation) is a sequence of yoga poses that not only strengthens the body but also calms the mind. Regular practice can help reduce stress, anxiety, and depression by improving blood circulation and releasing tension. Also, meditation can significantly improve emotional regulation and reduce anxiety and depression symptoms.
I often prescribe yoga and meditation to my patients as part of their holistic treatment plan. Studies have shown that combining these traditional methods with modern psychiatric treatments can lead to better overall outcomes. Including yoga in daily routines at schools or workplaces can also serve as a preventive measure, helping to slow down the onset of mental health issues.
When the entire world and countries like the US are embracing these traditional practices and recognizing their benefits; we as Indians should also adopt these practices to build a healthier nation.
Talking about other countries, how does India’s mental health care compare to that of other countries?
India’s mental health care system is actually quite good compared to many developed countries. In countries like Canada or Australia, where health systems are well-developed, people often have to wait for months to see a psychiatrist or get an appointment. Here in India, you can choose your doctor, get an appointment, and meet them—all within the span of a day.
Moreover, mental health care in India is much more affordable. In developed countries, an average consultation with a psychiatrist could cost upwards of $4,000, whereas in India, the same consultation might cost as little as $2. This affordability, combined with the quality of care available, is a huge strength of the Indian system. We should recognize and build on this advantage.
However, India still needs to expand its mental health workforce and reduce the stigma around mental illness. Lessons from countries that have integrated mental health care into their primary health systems can provide valuable guidance for India as we continue to grow and develop our infrastructure.
Finally, what is your prescription for maintaining balanced and healthy mental health?
Maintaining mental health requires a combination of factors. First, strong social connections with family and friends are crucial. Regular physical activity, especially outdoor activities, can boost mental health significantly. Stress management is important, and mindfulness practices like yoga and meditation can help calm the mind and reduce anxiety.
Maintaining a healthy lifestyle with proper sleep, nutrition, and limiting screen time is essential. Finally, seeking help when needed, without fear or judgment, is the most important step in maintaining mental well-being.