Depression is a major mental health disorder affecting numerous people around the world. In India, 56 million, i.e., 4.5% of Indians, suffer from depression. However, despite its significant impact on public health, several people suffering from it never receive adequate treatment. The treatment gap is interwoven in economic, cultural, societal, and individual factors.
Depression goes beyond typical sadness, and it significantly affects the individual’s ability to function, work, or sustain relationships. Evidence-based treatments and medications are available, but the need far exceeds healthcare systems’ capacity. The treatment gap is not a statistical oversight, but a failure of public health systems and social structures. Understanding these barriers is crucial in developing effective strategies to increase access and care for those living with depression.
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8 Reasons Why Depression Goes Untreated in Mumbai
The major reasons for the low rate of depression treatment in Mumbai stem from multiple reasons. These include:
Social Stigma
The stigma associated with mental illness is a formidable barrier to the treatment of depression. Despite the growing awareness about mental illness, the prejudice against it persists. In fact, many traditional households misunderstand depression as a sign of weakness, a character flaw, or even some form of supernatural cause. People in Mumbai usually hide this feeling of shame, guilt, or embarrassment. Additionally, people are worried about being judged, which can jeopardize their social standing and career opportunities. Overall, the fear of being labeled mad or unstable makes most people hide their symptoms.
Financial Barriers
Financial barrier is a major reason for depression to remain untreated. The cost of living in the metropolitan city is high, and accessing quality mental healthcare adds more financial burden. Insurance coverage for mental health disorders is not present or developed in India. This means individuals have to bear the full cost of diagnosis, medication, and therapy from their own pocket. This financial strain from treatment and loss of income due to it may deter them from getting treatment.
Systematic Issues within Healthcare Systems
Mumbai’s healthcare system is quite robust in some areas, but struggles when treating mental health illnesses. The city has seen a severe shortage in trained mental health professionals, counselors, psychologists, and psychiatrists. Most professionals in this space are concentrated on private practices in affluent areas, limiting access.
Public hospitals offer affordable care but have longer wait times and limited privacy. It is also difficult to add mental health services in primary care as general practitioners are not adequately trained. If a person comes forward with their problems, they might not get effective treatment.
Lack of Awareness
There have been increased conversations around mental health, but a major part of the population in Mumbai is still unaware of depression. They lack knowledge about its symptoms, causes, and available treatment. Individuals suffering from depression may attribute it to sadness, stress, or a bad mood rather than an indicator of a clinical disorder. This lack of mental health literacy means individuals may not know that they need help.
There may be public health campaigns on depression and mental health, but they are less impactful. In fact, many may be unaware that depression is a treatable mental condition. Additionally, the lack of awareness means that individuals don’t know who to approach if they manage to diagnose the illness.
Fear of Treatment and Medical Misinformation
Numerous misconceptions about depression treatment deter people from engaging with treatment. Cases of dependency and severe side effects in some individuals have led to the widespread fear of medication. There is also a belief that antidepressants will change the personality of the individual. Some individuals think therapy is unnecessary, ineffective, leading them to resist or drop out of treatment. Denial is another powerful defense mechanism, which may make individuals resist the idea of seeking professional help.
Logistical and Infrastructural Stress
The daily grind of commuting in overcrowded trains and navigating dense traffic takes a major toll on mental well-being. The logistical stress of taking time off work to travel across the city to a clinic and waiting for an appointment is another major hurdle. The fast-paced culture makes taking a break for mental health a luxury and a dent in career progression. This infrastructural and logistical stress can make it difficult to get help and sustain a healthy lifestyle.
Lack of Continuity and Support Systems
Effective treatment for depression requires continued care and support. In Mumbai, where people frequently relocate for work, getting help from the same psychiatrist is difficult. Individuals may also discontinue treatment due to financial constraints, and without consistent follow-ups, there are high chances of relapse.
The absence of a strong family or community support is also crucial to maintaining emotional well-being. Individuals in Mumbai usually live alone or in a nuclear family, which may make some people adhere to their treatment plans. This leads to relapses and prolonged suffering.
What Happens if Depression Goes Untreated
If depression is left untreated, it can have a profound and far-reaching impact on the lives of the individual and their families. Some effects include:
- Worsening Symptoms: Untreated depression can worsen persistent symptoms, which will make recovery harder.
- Substance Abuse: Individuals may turn to drugs or alcohol to cope with the sadness of depression. However, this will lead to addiction and complicate health problems.
- Impaired Functioning: It will significantly affect the individual’s ability to perform at school, work, and engage in daily activities. This can lead to job loss, social isolation, and academic failure.
- Physical Health Complications: Depression can cause severe physical symptoms, such as chronic pain, weakened immunity, and digestive problems. It can also aggravate existing conditions like diabetes and heart disease.
- Relationship Breakdown: Depression and mental illness can take a toll on relationships.
- Increased Risk of Self-Harm or Suicide: Untreated depression is a leading factor for suicide or self-harm, so timely intervention is crucial.
Frequently Asked Questions
Depression is a mental health illness wherein the chemical balances in the brain are affected. It is characterized by low energy and hopelessness, which is why it needs to be treated early.
Yes, as per the Mental Healthcare Act (MHCA), 2017, health insurance covers mental illness. However, it is limited to inpatient treatment, with outpatient programs being excluded.
Yes, evidence-based treatment and medication are very effective in treating depression. Using both these components together can lead to significant improvement for the majority of patients.
