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1.Introduction
The Sustainable Development Goals (SDGs) refer to 17 interrelated objectives established by the United Nations in 2015 with the aim of accomplishing sustainable development globally. They are considered as a roadmap for creating a bright and more secure future for all the people on earth, by pinpointing global problems such as poverty, unequal opportunity, climate change, environmental damage, war, and social injustice.
The idea for the SDGs comes from the realizations that global challenges are intricate and have interconnected factors that the world needs several solutions to address them. The conventional form of development used to be the one which gave priority to the economy and lacked adequate social and environmental concerns, which eventually resulted in inappropriate behavior and unfair results. The SDGs offer an inclusive, integrated and equitable approach that views economic, social and environmental dimensions of development as interdependent, thus ensuring that progress is sustainable and brings positive and meaningful change. SDGs timeline starts in 2015 and ends in 2030, and thus having indicators and targets would help in better monitoring of progress towards each goal. The goals range from eradicating poverty and hunger to delivering on good health and well-being, from ensuring quality education to achieving gender equality, and from combating climate change to taking other necessary actions. Each target is associated with particular indicators and expertise, enabling governments, businesses, civil society, and other partners to work along a shared path.
Expectations for SDGs are quite high since leaving nobody behind is the role of the SDGs to accomplish. By 2030 the SDGs target the elimination of poverty in its all forms, ensuring that everybody has access to good education and medical aid, achieve gender equality, foster sustainable development and safeguards of nature at the same time. Policy support and financial mobilization at the global level, which is crucial for the success of the sustainable development goals, needs to be accompanied by strong partnerships and innovative solutions at national and local levels. Despite the fact that the SDGs were adopted, the problem still exists nowadays, like an increasing level of inequality, environmental degradation, poverty, and the problems caused by climate change. On the other hand, the SDGs represent a mutual aim and an agreed framework of action, bringing up the hope that we may achieve the desired development model that takes into account both environmental and social aspects.
There is an influx of concern for mental health issues in the current world due to a confluence of factors ranging from pandemic to socio-economic challenges combined with the wider understanding of mental health problems. Identification of the mental health issue and action for it is of utmost importance as it affects people, communities and economy at a very core level.
Fundamentally, mental health must be one of the top priorities put on human rights and social justice issues. Mental health disorders impact a huge amount of people globally, they range from very severe to mild and include disabilities and stigmas. The civil society can keep dignity, equity and inclusion for all inhabitants through mental health issues, acceptance and dealing with them. In addition, mental health bears a direct relationship to overall health and efficiency. The impaired cognitive activity, the inadequate decision- making, and disrupted interpersonal relationships result in the inability of individuals to excel and take part in a productive community. However, mental health promotion can help people to build resilience, enhance creativity and productivity and improve the overall health status of workers, thus developing the workforce.
The Sustainable Development Goals (SDGs) therefore put mental health among the various goals with the aim of ensuring sustainable development. Mental health though is not an explicit goal in this framework, but it is a factor to be considered in other goals like SDG3 (Good health and well-being), SDG4 (Quality education), SDG5 (Gender equality), SDG8 (decent work and economic growth), SDG10 (Reduced inequalities), and SDG 16 (peace, justice, and strong institutions). The targets, in turn, deal not only with the issue of mental health services, but also with psychosocial support, as well as with ensuring the good mental condition for people at different ages.
To make advancement in mind health we need government involvement, civil society, private sector and international organizations as a combined force. Governments are responsible for the creation and implementation of programs to establish mechanisms for resource distribution and the strengthening of mental health systems that ensure equal treatment. Besides that, governments should attach mental health to the general public healthcare agenda, thereby promoting mental health prevention and screening which could be delivered in primary health care and community-based initiatives.
The private sector like the other stakeholders can contribute substantially to mental health in the workplace and community at large. By putting in place workplace policies and programs which boosts a stigma-free atmosphere and offers access to mental health resources and services and further promotes work-life balance and stress management, an employer can play a role in reducing stigma and improving mental health. The exact way to raise employee efficiency is through enterprise employee well-being. This is achieved through the reduction of the absenteeism rate, decreasing the rate of turnover, and raising the organizational success level.
Why Goal 3 is resonating with the current scenario of India?
ndia shares one of the largest populations in the globe that makes a perfect example of
wonderful diversity that characterizes the country with languages, cultures, and socio-
economic disparities. Even though the scope of the problem is huge, mental health issues
attract much less attention and resources from the society, though it should be one of the
top priority health issues. The public stigma and discrimination surrounding mental illness
are widespread thereby encouraging people to hide their mental wellness issues, refusing
to seek help and facing social exclusion. The mental health disorder in India is a huge
burden, as approximately around a hundred thousands of people are affected by conditions
such as depression, anxiety, schizophrenia, substance use disorders etc. These factors can
include high levels of urbanization, socio-economic disparities, family and work related
stressors, exposure to violence or witnessing trauma, etc.
According to the National Mental Health Survey (NMHS) conducted in 2015-16, it was
estimated that nearly 150 million people in India were in need of active mental health
interventions. The survey found that common mental disorders such as depression, anxiety,
and substance use disorders were highly prevalent, affecting approximately 10% of the
population. Furthermore, severe mental disorders such as schizophrenia and bipolar
disorder were estimated to affect around 1-2% of the population. The NMHS also
highlighted the significant treatment gap in mental healthcare, with a large proportion of
individuals with mental disorders not receiving adequate care or support.
The solution of the mental health crisis in India is based on multidimensional support,
provided by the government, private companies and communities, and on the increase of
the investments in the mental health foundation. Strategy is to address the stigma, include
mental health in primary healthcare, expand expert mental health workforce, and
implement tested methods for all life stages.
Furthermore, by embracing technology and thinking outside the box, solutions can be
found for the issues of access to care via telemedicine, mobile applications and community-
based projects. Together with the government, civil society, healthcare providers, academic
institutions, and private sector, the community should mobilize around the emerging
mental health crisis and then build a more responsive and conducive society that embraces
and accommodates all who are living with mental illness in India.
In this white paper we provide an insight on how all the Sustainable Development Goal-
3.4 mental health being is connected to other goals and why a joint effort is required to address it.
2. Choosing the focal point for the white paper in terms of different mental disorders
Classification of Mental Disorders
The classification of mental disorders is a critical framework for the diagnosis, treatment, and
research of psychiatric conditions. The most widely utilized system is the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric
Association. This comprehensive taxonomy delineates mental disorders into distinct categories
based on a constellation of symptoms, etiology, and clinical characteristics.
A prominent category is Neurodevelopmental Disorders, encompassing conditions such as autism, spectrum disorder, attention-deficit/hyperactivity disorder, and intellectual disabilities, which typically manifest during the developmental period. The Schizophrenia Spectrum and Other Psychotic Disorders category encompasses disorders characterized by psychotic symptoms, including delusions, hallucinations, and disorganized thought processes, with schizophrenia being the most well-known exemplar.
The Bipolar and Related Disorders category encompasses mood disorders marked by distinct manic and depressive episodes, such as bipolar I disorder and bipolar II disorder. Depressive Disorders, on the other hand, are characterized by persistent depressed mood, anhedonia,and associated symptoms, exemplified by major depressive disorder and persistent depressive disorder.
Anxiety Disorders constitute a diverse group of conditions defined by excessive anxiety, fear, and related behavioral disturbances, including generalized anxiety disorder, panic disorder, and specific phobias. The Obsessive-Compulsive and Related Disorders category is characterized by intrusive thoughts, compulsions, or preoccupations, such as obsessive-compulsive disorder and body dysmorphic disorder.
Other categories include Trauma- and Stressor-Related Disorders, Dissociative Disorders, Somatic Symptom and Related Disorders, Feeding and Eating Disorders, Sleep-Wake Disorders, Sexual Dysfunctions, Gender Dysphoria, Disruptive, Impulse-Control, and Conduct Disorders, Substance-Related and Addictive Disorders, and Neurocognitive Disorders.
Selection of Major Depressive Disorder as a Priority Mental Disorder :
Among the array of mental disorders with substantial public health implications, major depressive disorder emerges as a critical priority based on its high prevalence and significant burden across the globe, including in India.
Global Scenario: According to the World Health Organization, over 264 million people worldwide are affected by depression, making it a leading cause of disability.
Indian Scenario: The nationwide prevalence of depressive disorders in India is estimated to be around 4.5% (Gururaj et al., 2016). However, regional studies have reported higher prevalence rates in certain areas.
The high prevalence underscores the urgency to address this issue through resource allocation and interventions. While major depressive disorder is a global concern, it warrants special attention in the Indian context due to its significant public health implications.
Prevalence and Burden:
● The nationwide prevalence of depressive disorders in India is around 4.5% (Gururaj et al., 2016).
● Depressive disorders are a leading cause of disability in India, accounting for 11.5% of the total disability-adjusted life years (DALYs) (Indian State-Level Disease Burden Initiative, 2017).
Functional Impairment and Health Consequences:
● Individuals with major depressive disorder experience significant impairments in daily functioning, social relationships, and overall quality of life.
● Major depression is a risk factor for various chronic medical conditions, further exacerbating the disease burden and healthcare utilization.
Economic Impact:
● The estimated cost of depressive disorders in India is $3.08 billion annually (Choudhry et al., 2016).
● Lost productivity costs were estimated at $1.03 billion per year (Choudhry et al., 2016).
The high prevalence, substantial burden, and economic costs highlight the urgent need to prioritize efforts to address major depressive disorder in India.
While effective treatments exist, many individuals lack access to adequate care due to barriers such as stigma and limited mental health resources. By prioritizing major depressive disorder, concerted efforts can be directed towards early identification, evidence-based treatments, and addressing the significant treatment gap.
Functional Impairment and Health Consequences:
● Individuals with major depressive disorder experience significant impairments in daily functioning, social relationships, and overall quality of life.
● Major depression is a risk factor for various chronic medical conditions, including cardiovascular disease, diabetes, and chronic pain disorders, further exacerbating the disease burden and healthcare utilization (Penninx, 2017).
● Alarmingly, major depressive disorder is a significant risk factor for suicide, which accounts for over 800,000 deaths annually worldwide (WHO, 2021).
Economic and Societal Impact: Global:
● The economic toll of major depressive disorder is staggering. In the United States alone, the direct and indirect costs associated with major depression are estimated to exceed $210 billion annually, encompassing healthcare expenditures, lost productivity, and disability claims (Greenberg et al., 2015).
● were estimated at $1.03 billion per year (Choudhry et al., 2016).
Treatment Challenges and Opportunities:
●While effective treatments for major depressive disorder exist, including pharmacotherapy, psychotherapy, and emerging interventions such as transcranial magnetic stimulation (TMS), many individuals do not receive adequate care due to various barriers.
● These barriers include stigma, limited access to mental health services, treatment non- adherence, and suboptimal treatment responses (Ionescu et al., 2015).
● Addressing major depressive disorder requires a multifaceted approach encompassing early identification, evidence-based treatments, and the development of novel, personalized interventions.
Given the staggering global prevalence, profound functional impairment, substantial economic burden across nations including India, and severe health consequences, major depressive disorder emerges as a critical public health priority warranting concerted efforts and resource allocation worldwide. By prioritizing this condition, collaborative efforts can be undertaken to alleviate immense suffering and mitigate the far-reaching societal impacts of this debilitating mental disorder.
3.Current Mental Health Infrastructure Conditions in India
India has made strides in addressing mental health, with initiatives dating back to the 1980s, including the establishment of a National Mental Health Programme (NMHP) and the passing of the National Mental Health Act in 1987. Despite these efforts, the burden of mental illness has increased significantly over the years. In 2017, an estimated 197 million Indians had some form of mental illness, representing approximately one in seven individuals. However, the treatment gap remains high, with studies indicating a gap of 83% for all mental disorders.
The financial burden of mental health care is substantial, with both direct and indirect costs posing challenges for individuals and families. Direct costs include expenses related to pharmacological and non-pharmacological treatments, while indirect costs encompass travel expenses, lost wages, and decreased productivity. These financial strains often prevent individuals, particularly those from low-income households, from accessing necessary care. Additionally, high expenditures on mental health care contribute to impoverishment, further exacerbating the treatment gap.
Government expenditure on mental health remains inadequate, with less than 1% of the total health budget allocated to mental health initiatives. Most of this funding is directed towards tertiary care facilities, neglecting the need for decentralized and community-oriented services. While programs like the District Mental Health Programme (DMHP) aim to address these gaps, challenges such as limited funding and administrative issues have hindered their effectiveness. Moreover, the integration of mental health into broader health initiatives, such as the National Health Mission, has yet to realize its full potential due to funding constraints and implementation failures.
Despite legislative efforts, including the enactment of the Mental Health Care Act in 2017, access to mental health services remains limited, particularly in rural and underserved areas. The shortage of mental health professionals further compounds this issue, with India facing a significant deficit in psychiatrists, psychologists, social workers, and nurses. As a result, individuals with mental disorders often go untreated, highlighting the urgent need for improved infrastructure, resources, and policies to address mental health challenges in India.
Gap for Mental Health Treatment and Its Reasons in India
The treatment gap for mental health disorders in India is substantial, with studies indicating rates as high as 95% for common mental disorders. Several factors contribute to this treatment gap, including low perceived need for mental health services, financial barriers, stigma, and inadequate resources. Despite efforts to increase access to care through programs like the NationalMental Health Programme and the District Mental Health Programme, challenges such as limited funding, administrative issues, and workforce shortages have hindered their effectiveness.
Financial barriers pose a significant challenge to accessing mental health care in India, with both direct and indirect costs placing strains on individuals and families. High expenditures on treatment often result in foregone care, particularly for those from low-income households. Moreover, the concentration of mental health funding in tertiary care facilities neglects the need for decentralized and community-oriented services, further widening the treatment gap.
Stigma surrounding mental illness also deters individuals from seeking help, perpetuating the treatment gap and exacerbating the burden of mental illness. Additionally, the shortage of mental health professionals, including psychiatrists, psychologists, and social workers, limits access to care, particularly in rural and underserved areas. As a result, individuals with mental disorders often face significant barriers to receiving timely and appropriate treatment, highlighting the need for comprehensive strategies to address the root causes of the treatment gap in India.
4.SDG Goals and Actions Taken Globally by Private Sectors
Major companies in the healthcare and life sciences industry are playing a significant role in addressing mental health issues and aligning with Sustainable Development Goal 3 (SDG 3) on good health and well-being. These companies are leveraging their resources, expertise, and influence to improve mental health outcomes globally through various innovative and comprehensive strategies.
1.Workplace Mental Health Programs and Policies
● Unilever: Implemented comprehensive mental health strategies, including employee assistance programs (EAPs) that provide confidential counseling, legal and financial advice, and referrals to mental health professionals. Mental health awareness training for managers and partnerships with mental health organizations are also part of their approach.
● Deloitte: Features a "Mental Health Champions" program, where selected employees receive specialized training to support colleagues. Offers flexible work arrangements, mental health days off, and integrates mental health into diversity and inclusion initiatives.
● American Express: Provides a dedicated mental health fund for financial assistance to employees seeking treatment, on-site counseling services, and free subscriptions to mental health apps like Calm and Headspace.
2.Mental Health Days and Well-being Initiatives
● Hootsuite: Introduced an unlimited mental health day policy, allowing employees to take time off as needed for their mental well-being. They also provide access to a wellness coach and host regular mindfulness sessions.
● Nike: Offers a "Mental Health Guidance" program, including mental health days off, on- site counseling, and mental health first aid training for managers. Additionally, they have a "Mindful Month" initiative with various activities to promote well-being.
● Goldman Sachs: Provides resilience training, mindfulness sessions, and on-site mental health counseling. They also support a "Mental Health & Wellness" employee resource group to foster a supportive community.
3.Leadership and Culture Change
● Starbucks: Prioritizes mental health with training for store managers and various well- being resources for employees. The company's leadership openly discusses mental health, helping to reduce stigma.
● Target: Promotes mental health awareness and destigmatization efforts through its Chief Health Officer. They have launched mental health ally programs and encourage employees to share their stories.
● Levi Strauss & Co.: Integrates mental health into diversity and inclusion initiatives and offers resources to employees. Leadership actively discusses the importance of mental well-being.
4.Technology and Innovative Solutions
● Talkspace: Partners with companies to provide employees with virtual counseling services through video, voice, or text-based therapy sessions, offering accessible mental health support.
● Ginger.io: Uses artificial intelligence and machine learning to provide personalized mental health support, offering on-demand coaching, video therapy sessions, and resources through a mobile app.
● Calm: Adopted by numerous companies as part of their well-being initiatives, providing employees with free access to guided meditations, sleep stories, and mindfulness resources.
5.Partnerships and Collaborative Initiatives
● Morgan Stanley Alliance for Children's Mental Health: A philanthropic initiative funding research and supporting organizations addressing mental health issues in children and families.
● Citymill Initiative: A collective effort by real estate companies to address mental health challenges within the industry, organizing events, workshops, and providing resources to promote mental well-being.
● Mental Health at Work Initiative: A collaborative effort by companies like Starbucks, Cisco, and Bank of America to share best practices, resources, and drive systemic changes in workplace mental health policies.
These best practices demonstrate the private sector's recognition of the importance of mental health and the various strategies employed to support employees, create a supportive culture, and drive positive change. These efforts align with SDG 3's objective of ensuring access to quality essential healthcare services for all and contribute to promoting good health and well-being globally. Continuous evaluation, adaptation, and scaling of effective practices are crucial to comprehensively addressing mental health challenges in the workplace and society.
5.Initiative India's Private Sector including Pharmaceutical Giants Should Take for Improving Mental Health Well-being
To address mental health challenges in India, the private sector and pharmaceutical giants should take comprehensive and collaborative action. This includes:
● Investing in mental health infrastructure: Private companies can invest in expanding mental health infrastructure, including the establishment of community-based clinics and telemedicine services to improve access to care, particularly in rural and underserved areas.
● Raising awareness and reducing stigma: Companies can launch public awareness campaigns to reduce stigma surrounding mental illness and promote help-seeking behavior among individuals and families.
● Providing financial support: Pharmaceutical companies can offer financial support for mental health initiatives, including funding for research, training programs for mental health professionals, and subsidies for mental health medications to make them more affordable.
● Collaborating with government and NGOs: Private companies can collaborate with government agencies and non-governmental organizations (NGOs) to implement comprehensive mental health programs and initiatives, leveraging their resources and expertise to reach more individuals in need.
● Implementing employee wellness programs: Private companies can prioritize employee mental health by implementing workplace wellness programs, providing access to counseling services, and promoting a healthy work-life balance to support the well-being of their workforce.
Meet The Thought Leader
Karan Patel (he/him) is a mentor at GGI an undergraduate from IIT Madras. He is correctly employed with Teachmint, an ed-tech start-up in their strategy team. Prior to Teachmint, he worked at Dalberg Advisors as an analyst where he worked with multi-laterals and international foundations on gender, education and energy sectors. He has also interned in MIT Sloan, Qualcomm and IIM Ahmedabad giving him a plethora of experience in the corporate and academic world. He also started his own venture in hyperlocal air-quality monitoring. Karan is an avid sport-person and masala chai fanatic.
Meet The Authors (GGI Fellows)
Abhijeet Saxena is a skilled professional with a robust educational background. He is currently pursuing MBA from IIM Kozhikode and holds a Master of Public Health degree from IIPH Gandhinagar, PHFI. His diverse experience in impact consulting spans in national programs such as National TB Elimination Program, POSHAN Abhiyaan, and National Health Program where he has impacted thousands of lives. Abhijeet excels in government liaison, implementation research, and team management. He has successfully published research in international journals and is dedicated to enhancing healthcare systems.
Asim is an accomplished Electrical Engineering graduate from KIIT University, currently leading the Marketing Science team at Lifesight. With over six years in Consulting and Advanced Analytics, he has honed expertise in Market Mix Modeling, Data Analytics, Strategic Consulting, and Product Management. Asim's portfolio showcases successful projects that enhance budget efficiency, drive growth, and boost brand awareness across various sectors. Notably, he excels in solving complex problems, from global strategic roadmaps for omnichannel pharma engagement to ML-based orchestrators for better targeting, and optimizing budgets to save millions and generate increased revenue through precise allocation strategies.
Well, my name is Akansha !!! As my name surmises, I am very aspirational. Given my personality traits, I am very optimistic, ambitious and enthusiastic person. I belong to Nagpur - the Orange city of India which is a major commercial and political center in the Vidarbha region of Maharashtra.
I am a graduate in Computer Science Engineering from Pune University and also an MBA graduate from IIM Calcutta. I have worked in companies like Tech Mahindra, British Telecom, RPG Enterprises (Zensar Technologies), Pepe Jeans London, Reliance Retail (AJIO) etc. My work experience spans cross-functional roles which extend to various facets of Business such as Strategic Planning, Lead Generation, B2B Sales, Market research, Product launch, Branding, Digital marketing, Customer relationship and Analytics, P&L management, Partner performance etc. Before my MBA, I was majorly into software development roles and post my MBA, I have worked into Strategy and growth roles.
A changemaker at heart, Kavita aims to transform lives through sustainable livelihoods. Armed with a Master's in Social Work from Tata Institute of Social Sciences and diverse grassroots experience, she currently drives impactful projects as a Project Manager for the Grant for Agroecology Program Fund at Access Development Services. Her expertise spans over community mobilization, entrepreneurship development, training, and implementing innovative projects across education and livelihood sectors. A go-getter with a knack for stakeholder management, Kavita has catalyzed change by establishing over 500 community institutions and nurturing 1000+ rural women entrepreneurs.
If you are interested in applying to GGI's Impact Fellowship program, you can access our application link here.
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