Community models can help solve India’s mental healthcare challenge; philanthropic support and funding to scale required: Report by CAPI



Mumbai (Maharashtra) [India], April 22: The Centre for Asian Philanthropy India (CAPI) launched its landmark report, ‘Mindful Investments: Philanthropy for Mental Health in India’. This in-depth study underscores the critical funding gaps within India’s mental health sector and is based on perspectives from 43 distinguished donors, nonprofit leaders, and mental health experts across 31 organizations. It also suggests recommendations and spotlights opportunities for philanthropy, to make a meaningful contribution towards addressing India’s mental health needs.

India’s mental health crisis is significant and underfunded. The National Mental Health Survey of India, 2015-16 (NMHS) estimated the treatment gap for all mental illnesses at between 70-92%. This massive gap in treatment is due to the acute shortage of mental health professionals, compounded by stigma, limited awareness, and the prohibitive cost of treatment. The WHO estimates losses to the Indian economy at US$1.03 trillion between 2012 and 2030, due to mental illnesses. This underscores the scale of the mental health crisis in India and its adverse implications for developmental goals.

However, public spending in India has stagnated at just around 1%, or so, of the overall health budget over the last five years and is largely allocated toward institutional care. The sheer scale of the challenge means philanthropic and private sector resources have a vital role to play in bridging access gaps.

The silver lining, however, is the increased donor action in the last decade, particularly post-COVID-19. Already, philanthropy’s contribution to the Indian mental health care domain has resulted in the establishment of a range of interventions influenced by the complexity and continuum of care needed.

Jamshyd Godrej, philanthropist and CAPI trustee said, “The evidence is growing around how mental health is not only a health issue and is intertwined with many aspects of development, be it poverty, climate change or gender equality. CAPI’s report comes at the right time and I hope, will guide and encourage many more donors in India to support mental health initiatives in a bigger way.”

The report identifies three approaches presently adopted by Indian donors who fund mental health initiatives:

1) Treatment or care for mental illnesses at the institutional level: Many donors strategically support facilities, such as psychiatric hospitals, clinics, and counselling centers, or telephonic/Whatsapp-based or online helplines. This approach emphasizes treatment through medical professionals at specialized care centers.

2) Mental health care at a community level: Adopted by fewer donors, these programs deliver mental health care in localized settings — at the village/district level — through lay counsellors from within the community.

3) Scientific research, knowledge, and evidence-building : Donors have made significant grants to support studies at reputable institutions, such as the National Institute of Mental Health and Neurosciences. These studies focus on data collection among an Indian sample population to gather contextualized and nuanced insights.

Donor approaches continue to evolve to best suit their goals: prevention and mitigation of stigma; immediate alleviation of suffering; a more high-risk view of backing bets in science and medicine that might pay off in the long term; or a combination of these. Going forward, the report recommends key areas where philanthropic funding is needed.

Philanthropy can support overlooked and underfunded programs, such as those focusing on prevention and rehabilitation through disseminating educational materials, guidance on self-care programs, anti-stigma campaigns, early screening of target populations, etc.

Community models of mental health present as low-cost, effective options for donors to support. These models rely on community volunteers and are often integrated with government’s District Mental Health Programmes, thereby reducing the burden on medical specialists. This model relies on task shifting or task sharing, wherein individuals living with mental health conditions receive care from community-based workers or volunteers. This community-based cadre, often known as ‘lay volunteers’, is trained to deliver certain mental health services, recognizing that not all mental health services require the expertise of a psychiatrist or psychologist — tasks such as basic counselling, raising mental health awareness, and ensuring medication adherence can be carried out by non-specialists. Nonetheless, these non-specialists can and do provide referrals up the value chain to medical specialists, as needed, for more severe conditions.

These models also align with the WHO (2009) recommendation that countries allocate a greater share of resources towards community-based and primary care services, for treating common mental disorders, and fewer for severe mental disorders. The NMHS indicates a 10% prevalence rate for common mental disorders (e.g., anxiety, depression, substance use) and a 0.8% rate for severe mental disorders (e.g., schizophrenia, bipolar disorder), meaning common disorders are 12.5 times more prevalent in the country. Severe mental disorders which need intensive specialist care are required by a smaller subset of the population.

Donors can contribute to mental health capacity-building through programs for professionals in the mental health space as well as non-specialists and volunteers, while facilitating cross-sectoral partnerships to encourage collaboration, resource-sharing, and cross-pollination of ideas across diverse fields.

Dr. Shyam Bhat, Chairperson of the Live Love Foundation, remarks in the Foreword, “The report stresses the need for collaboration with government efforts and the vital role of community mental health services. CAPI’s work inspires a united vision among the public, private, and nonprofit sectors, to make mental well-being a key development focus.”

Download a full copy of the report here:

About CAPI

Established in 2020 as a Section 8 nonprofit company, the Centre for Asian Philanthropy India’s mission is to enhance the quantity and quality of philanthropic giving and other forms of social investment in India. CAPI aims to contribute to the development of the social investment sector in India by conducting and propagating research, insights, models, and strategies that create positive societal change.

CAPI’s trustees are Jamshyd N. Godrej, Chairman of Godrej & Boyce Manufacturing Limited, and S. Ramadorai, former Vice Chairman of Tata Consultancy Services Limited.

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Follow CAPI on LinkedIn: Centre-for-Asian-Philanthropy-India


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First Published: Apr 22 2024 | 3:15 PM IST


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