The burden of mental disorders across the states of India: the Global Burden of Disease Study 1990–2017

In 2017, mental disorders affected 197.3 million people in India, making it a major public health challenge. This figure represents approximately 14.3 per cent of the total population, or nearly one in seven Indians.

Among those affected, an estimated 45.7 million individuals were living with depressive disorders, and around 44.9 million had anxiety disorders. These were the two most prevalent categories of mental illness in the country.

Mental health conditions were a primary driver of non-fatal health loss in India in 2017, accounting for 14.5 per cent of all years lived with disability (YLDs). YLDs made up almost the entirety of disability-adjusted life-years (DALYs) attributable to mental disorders.

The largest shares of mental health related DALYs were attributed to depressive disorders (33.8 per cent) and anxiety disorders (19 per cent), followed by intellectual developmental disabilities (10.8 per cent), schizophrenia (9.8 per cent), bipolar disorder (6.9 per cent), and conduct disorder (5.9 per cent).

Gender plays a significant role in the distribution of mental disorders in India. Women experience substantially higher prevalence of depression, anxiety, and eating disorders, which could be linked to the gender discrimination, exposure to violence and sexual abuse, antenatal and postnatal stress, and adverse socio-cultural norms they experience. In contrast, men are more frequently diagnosed with autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), and conduct disorders, with genetic and hormonal factors suggested as contributors.

The report highlights a worrying link between mental health and suicide, particularly among women. There is a positive correlation between the prevalence of depression and suicide death rates at the state level, and the suicide death rate among Indian women is double the global suicide death rate.

Depression among the elderly is an emerging concern as India’s population ages. The prevalence of depressive disorders was found to be high among older adults, which researchers link to chronic physical illness, social isolation and elder abuse. The report adds that this pattern of increasing prevalence with increasing age has not been reported in high-income countries.

Environmental and social factors contribute substantially to the burden of certain mental disorders. Notably, 62.8 per cent of the burden of idiopathic developmental intellectual disability (IDID) was attributable to lead exposure. Other major risk factors for depression and anxiety include childhood sexual abuse, bullying, and domestic violence.

Despite the large number of people requiring care, India faces a severe shortage of mental health professionals. The country has only two mental health workers and 0.3 psychiatrists per 100,000 population, far below the global average.

Social stigma remains a major barrier to treatment in India. Many individuals do not seek care due to lack of awareness about mental disorders or fear of discriminatory attitudes from health workers and communities.

To address the treatment gap, the researchers recommend leveraging modern technology. They suggest that telemedicine, telephone helplines, and mental health mobile applications could help provide support in remote and underserved areas where trained professionals are scarce.

Focus and Factoids by Harsh Choudhary.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.