Stigma a 'silent epidemic', hindering access to care for mental health: Experts

New Delhi, Sep 16 (PTI) Stigma and lack of awareness are among the major roadblocks towards making care for mental health conditions accessible to people who require help, experts have said, while underlining that early diagnosis is key to better treatment.

"People hesitate to even acknowledge mental illness," said Dr Neerja Agarwal, a psychologist and the founder of Emoneeds, which provides care to people struggling with mental health problems.

She said it is important to recognise mental illness as a health condition and should be treated as such, not as a personality flaw. "Just as diabetes and blood pressure need lifelong treatment, so too do conditions like schizophrenia or bipolar disorder," Dr Agarwal said.

Dr Deepika Dahima, a scientist at AIIMS, Delhi, also pointed out that stigma remains one of the greatest silent epidemics surrounding mental health in India.

"It is not the illness alone that debilitates individuals, but the shame, secrecy and silence that accompany it. In many households, a psychiatric diagnosis is still perceived as a threat to family honour, marriage prospects, or social standing. This cultural weight deepens suffering, isolates people, and deters them from seeking timely care," she said.

Dr Agarwal emphasised the need for consistency in following medical advice for treating mental health issues. "Only then can patients live a normal life." Her Emoneeds colleague, Dr Prerna Chaudhary, spoke of a marriage on the brink of collapse because the woman's parents stopped medication in the days leading up to her marriage. "She suffers from schizophrenia. Her husband left her soon after the wedding, citing her mental illness," the psychologist said.

"While on regular medication and treatment for one-and-a-half years, the woman's condition had been improving. But when her marriage was fixed, her family members discontinued her medicines," said Dr Chaudhary.

Soon after the wedding, her illness resurfaced with symptoms becoming visible, and she was eventually sent back to her parents. "Schizophrenia requires lifelong treatment. She has now resumed treatment with us," the doctor said.

Dr Agarwal explained that schizophrenia can cause excessive anger, delusions, slow functioning, and poor social skills. It can be trauma-induced or hereditary.

Highlighting the importance of early diagnosis, Dr Jitender Jakhar, a consultant psychiatrist at the Sitaram Bhartia Hospital, said when it comes to mental health, psychiatrists often use the phrase "duration of untreated illness." "It means the longer someone lives with an untreated mental health condition, the harder it becomes to recover. Just like untreated diabetes can damage organs over time, untreated depression, anxiety, or psychosis can affect the brain, emotions, and daily life," he said.

According to experts, when mental health conditions are identified early, treatment works better. People respond faster, have fewer relapses, and regain their confidence more quickly.

But if the illness goes untreated for years, the consequences are more serious, Dr Jakhar pointed out.

"Symptoms become harder to manage, and the illness turns out to be more resistant to treatment. People may lose productivity and struggle at their jobs. Also, long-standing illness often leads to social withdrawal, poor social skills, or social anxiety, making it difficult to build relationships and support networks," he explained.

Dr Dahima is of the opinion that sustained community sensitisation can dismantle the stigma.

She highlighted that at the policy level, integration of mental health services into primary healthcare through initiatives like the District Mental Health Programme is essential to close India's 70 per cent to 80 per cent treatment gap.

On making mental health care accessible, Dr Jakhar said India now has more resources for mental health care than ever before. "What we truly need is acceptance -- both from society and from individuals who may hesitate to seek help." He said that mental health treatment is becoming more accessible through telepsychiatry and video consultations. Now, people can speak to mental health professionals from the privacy of their homes, he said, adding that many small towns now have trained psychologists and psychiatrists.

"India's National Mental Health Programme is working to reach the grassroots, ensuring mental health services are not just urban privileges but rural rights too," Dr Jakhar stated.

"Alongside these, we need to build mental health literacy. Just like people know the signs of a heart attack or stroke, we must teach communities to recognise early signs of depression, anxiety, or psychosis," he said.

Dr Jakhar also said, "Schools and workplaces should include mental health awareness in their programs. Insurance companies must cover psychiatric illnesses fully, not partially, so cost is never a barrier. And, most importantly, families should encourage help-seeking rather than hiding the problem." Ultimately, making treatment accessible is not only about geography or economics, it is about creating environments where people feel safe to seek help without judgment, Dr Dahima said. PTI PLB ARI