Mental Illness Chapter Summary

The purpose of this chapter is to highlight the importance of doing research on mental illness particularly one that measures the quality of life (QOL) of patients with such illnesses. It is also to demonstrate that there are practical and policy applications of undertaking such a study.

There are five sections to this chapter. The first section (1.1) brings to the fore the burden of mental illness and morbidity patterns around the world, in India and Kerala. This has dictated which mental disorders policies are required to focus on and in turn the answers, the study has chosen to pursue. In the next section (1.2), the previously addressed and as yet unaddressed issues pertaining to mental illness research are highlighted. Emphasis is given

In lower- middle-income countries (LMICs) like India, depressive disorders are second in terms of YLDs (WHO, 2016d). In LMICs in general, 7.1% of total YLDs are due to depressive disorders (WHO, 2016d). Anxiety disorders, schizophrenia, and BPAD contribute to 2.8%, 1.6%, and 1.17% respectively (WHO, 2016d). Despite the disability burden these disorders present, research output that has a bearing on mental health policy is poor, especially in LMICs (Yasamy et al., 2011). The Lancet 2007 mental health priority setting exercises and WHO Mental Health GAP Action Programme (WHO mhGAP) in 2009, identified the need for research in epidemiology, burden of disease, health system delivery, social justice and equity, and social and community interventions and gave less priority to developing new drug interventions (Razzouk et al., 2010; Sharan et al., 2009; Tomlinson et al., 2009; Yasamy et al., 2011). Thus in LMICs, the burden of mental illness is slightly lower than UMICs and HICs but the resource and infrastructure of mental health research as well as practice and policy are

The next most prevalent disorder was depressive disorders with approximately 12% lifetime prevalence and approximately 6% 12-month prevalence (Kessler et al., 2009). In 2011, the lifetime prevalence and 12-month prevalence of bipolar spectrum disorders were 2.4 % and 1.5% respectively (Merikangas et al., 2011). The only mental disorder that has been found to have a consistent prevalence across cultures is schizophrenia (Avasthi & Singh, 2004; Ganguli, 2000; Kulhara & Chakrabarti, 2001). Studies across the world, in India and even Kerala (Shaji, Verghese, Promodu, George, & Shibu, 1995) has shown that it has a life time prevalence of close to 4/1000 population and a period prevalence between 2-3/1000 per population(Bhugra, 2005; Ganguli, 2000; Kulhara & Chakrabarti, 2001; Shaji et al., 1995). The prevalence of other disorders vary among and within countries, including India (Math & Srinivasaraju, 2010) and so do the reasons for it being so (Bhugra, 2005; Kessler et al., 2009; Math & Srinivasaraju, 2010; Merikangas et al., 2011; Ormel et al., 1994). However, the correlation of disability with psychopathology rather than disorders is the only other consistent finding in cross-cultural and international studies (Ormel et al., 1994). This leads to the conclusion that personal and socioeconomic factors have an