According to Pooler (2009), depression is a form of disorder which is characterized by persistent feelings of worthlessness and sadness which makes someone lack the desire to engage in any formerly activity that is pleasurable. All mood disorders are characterized by a syndrome that include psychological like decreased concentration or somatic symptoms like insomnia. Anhedonia (depressed mood) is a prominent feature of this illness. Nevid (2009), adds that depression involves moods, body and thoughts hence cause pain for individual with the disorder and those who care about him or her. Mood disorders are classified into unipolar depressive disorders and bipolar disorders. The disorders are in different forms which include Major Depression disorder, dysthymic disorder and several others with different characteristics like postpartum depression, psychotic depression and seasonal affective disorder. Individuals suffering this illness have such symptoms like agitation, loss of interest; sleep disturbance, lack of concentration, low self-esteem, and a very low mood. Individuals under depression may ruminate over feelings of worthlessness, helplessness or self-hatred (Tsuang, Tohen, & Jone, 2011). They have poor concentration and memory and hence they might report multiple physical symptoms. Individual behavior is usually lethargic or agitated hence affecting family and friends. In most children, irritable mood is highly displayed unlike depressed mood. Due to lack of treatment or early recognition the illness is missed and delayed hence making it much worse. This is in low and middle income countries where access to healthcare is a major problem (Herrman, Maj, & Sartorius, 2009).
The point of prevalence in India is serious with mental disorders reaching 10-20 per 1000 of population. The provisions of health services are severely lacking where only about 20% of districts have implemented District Mental Health Program plan. Around 10% of individuals affected by mental disorders in India are receiving the right treatment facilitated by the huge disparity to access to health care facilities that are largely concentrated in urban areas (Goldberg, 2012). By 1999 the prevalence of India was 26.3% and 14,582 thousand DALY’s from depression. The current prevalence rate is estimated to be 15.1%. This is 3.66% of DALY’s due to all causes. In 2006 the suicide mortality rate was 10.5 per 100,000. The prevalence level is even higher on individuals who are most vulnerable and this constitutes those with extremely low income (Sadock & Sadock, 2007). Worse is that 2 psychiatrist are estimated to attend to 1 million Indians and this is in the urban area: a worse scenario for local areas. The lifetime incidents of the Major Depressive Episodes in India are around 35.9%. The prevalence remains high in rural areas 36% while urban being 27% while those in low social-economic group 34% (Spicer, Sarche, & Farrell, 2011).
India has an estimated population of around 1.27 billion as by 2013. Mental health continues to be treated as an afterthought. The World Health Organization estimates that 16.6 million cases involving major depression every year while an estimate of 10.3 million cases any time. This is therefore a big number in any given country especially if it is also affected by low income and high rates of unemployment. Currently, depression in India accounts for between 60-70% 0f all the suicide records while a majority of these cases around 15-19% are cases of major depression (Bostic & Bagnell, 2012). The number of patient’s suffering mental illness in India is as many as 20 million. The country has about 3,500 psychiatrists and around 1,500 psychiatric nurses.
The government is implementing policies to help improve mental health facilities. This is under the National Mental Health Program launched back in 1982. It has been able to allocate Rs.1, 000 crore to support the program and creation of more psychiatry departments. India spends 0.83% of its health budget to mental health (Patel, Minas, Prince, Cohen, & Prince, 2013). The government through this program aims to generate 60 psychiatrists, 600 psychiatric nurses and 240 clinical psychologists per year. The current existing 3500 are poorly distributed while a majority remaining in urban centers. The government has been in the process of making the health care system better including the PHC-level psychiatric treatment and the Bellary project (Goodwin & Jamison, 2007). The District Mental health Program was aimed at covering a total of 600 districts but has still failed. India approved the mental health bill in 2012 after amending the disability laws. Both human and financial resources have been starved in mental health in India. However, with the help of WHO, the government is considering making advances in correcting the existing mental health care system. The bill considers the element of the right to mental health care regardless of their economic status. The government also hopes to provide a range of treatment options including half-way homes, community service and outpatient. The government is also creating awareness on depression disorders and the need to differentiate the disease from initial perceptions brought in by cultures. The legislation only allows psychiatrists to prescribe psychotropic drugs. However, the government is considering integrating primary care so that primary health care professions can prescribe these drugs to the patients (Herrman, Maj, & Sartorius, 2009).