India boasts one of the world's largest populations of adolescents, with approximately 253 million individuals aged between 10 and 24. As the country strides towards becoming the fastest-growing economy globally, the foundation of this growth rests upon the shoulders of its youth. However, ensuring the well-being of this demographic is imperative for sustainable progress. (Sivakami, 2023) notes that anxiety and depression afflict 7.3% of the population, yet this likely underestimates the true prevalence due to underreporting driven by awareness gaps and resource shortages.
Today's youth face numerous challenges, including stress from academic and career pressures, body image concerns, and experiences of harassment. Additionally, navigating identity complexities, such as homophobia, and handling familial conflicts and bullying, both online and offline, further compound their daily stressors and emotional well-being (Jaggi, 2021).
The Importance of Accessibility and Equity in Youth Mental Health Care
Youth mental health care faces significant challenges due to structural barriers such as limited services, high costs, and fragmented systems: stigma, discrimination, and the lack of culturally appropriate treatments further compound access issues. Levesque et al.'s framework delineates healthcare access across five dimensions: approachability, availability, affordability, appropriateness, and acceptability, emphasising factors like ease of access, timeliness, cost considerations, service suitability, and sociocultural relevance. This framework addresses socioeconomic disparities and individual needs in accessing mental healthcare (Kourgiantakis et al., 2023).
Existing Policies and Programs Addressing Adolescent Mental Health in India
Numerous policies and programs, spanning from the national to the state level, are in place to address adolescent mental health in India.
- Sarva Siksha Abhiyan (SSA) - 2011: This nationwide program provides primary education to children from diverse socio-economic backgrounds, ensuring a nurturing school environment for their holistic development.
- National Youth Policy (NYP) - 2014: Geared towards empowering young people and acknowledging their vital role in national progress, this policy underwent extensive consultations nationwide. However, specific youth engagement is not delineated in its formulation.
- National Mental Health Policy (NMHP) - 2014: With a core objective of diminishing the treatment gap and disease burden associated with mental illnesses, this policy was crafted through consultations with experts and stakeholders without specified youth participation.
- National Adolescent Health Program (RKSK) - 2014: This initiative aims to deliver comprehensive healthcare services to adolescents, encompassing nutrition, sexual and reproductive health, and substance misuse. Its development involved wide-ranging consultations and collaboration with organisations and experts.
- Youth Empowerment Initiative (YS) - 2015: Tailored for implementing recommendations from the national youth policy in Karnataka, this state-level program engaged in desk reviews and stakeholder consultations, with input sought from youth in schools and colleges to understand their needs.
- Mental Healthcare Act (MHA) - 2017: Enacted at the national level, this legislation is designed to safeguard the rights of individuals with mental illnesses and adhere to international conventions. While various stakeholders were engaged in its development, specific youth involvement in policy formulation was not explicitly outlined.
Accessibility Challenges in Mental Health Care and Policies
Accessibility to quality mental health care in India faces significant challenges, primarily due to the absence of regulations governing the licensing of mental health professionals. This lack of oversight allows unqualified practitioners to offer services without accreditation or supervision, posing patient risks and compromising ethical standards (Mariwala Health Initiative & Sangath, 2022). The absence of regulatory frameworks undermines the accessibility of reliable and competent mental health services, making it difficult for individuals to distinguish between qualified and unqualified providers.
Furthermore, existing mental health programs encounter accessibility hurdles due to insufficient availability of valid indicators and inconsistent data on implementation. This lack of reliable information impedes efforts to monitor and enhance program accessibility, ultimately hindering effective service delivery. Similarly, while the Mental Healthcare Act (MHCA) of 2017 aims to improve accessibility to mental health services, its aspirational nature is critiqued for lacking the necessary infrastructure and resources for implementation. This gap highlights the challenges in translating policy intentions into tangible benefits for individuals seeking mental health support.
Additionally, accessibility barriers are compounded by the top-down approach, administrative complexities, and limited involvement of users and caregivers in mental health policies. Poor coordination and inadequate resources further restrict accessibility to mental health services, particularly in remote or underserved areas. Addressing these challenges requires regulatory reforms, improved data monitoring, and greater community involvement to enhance accessibility to mental health care across India (Hossain & Purohit, 2019).
Recommendations and Strategies
Efforts to rectify the identified disparities in mental health accessibility necessitate prioritising educational outreach and augmenting school health curricula. Despite recent advancements in mental health policies for youth, significant access discrepancies persist, aggravated by shortages of qualified providers and entrenched stigma (Cummings et al., 2013).
To tackle these obstacles, mental health promotion strategies should concentrate on early childhood interventions, youth support programs, and community development initiatives. Simultaneously, initiatives fostering positive youth development should emphasise harnessing strengths and cultivating supportive environments. Prevention tactics should span from universal interventions to tailored treatment approaches, adapting to varying audience needs and intensity levels. These multifaceted endeavours aim to bolster protective factors and healthy behaviours while mitigating risks associated with mental health disorders. Furthermore, there is a pressing need for greater involvement of young individuals in mental health advocacy in India.
Addressing the accessibility gaps in mental health policies is imperative for ensuring equitable access to quality care for youth in India. Efforts must focus on reforms to bridge these disparities and foster holistic well-being among adolescents and young adults.
