Mental health problems and suicide are the leading cause of mortality in young people globally. India is home to the largest number of adolescents in the world. This study was undertaken to assess the policy environment for addressing adolescent mental health in India.
We conducted a review of 6 policies and programs and 11 in-depth interviews with key stakeholders. The findings were analyzed using the policy triangle analysis framework (i.e., context, content, actors and process).
There is no conformity of the age ranges addressed by these documents nor are vulnerable groups explicitly recognized. Stress, anxiety and depression were commonly identified as mental health concerns and diverse platforms such as community, family, school, digital and health facility were recommended to deliver preventive and treatment interventions. Some interventions specifically targeted some social determinants (like safe and supportive schools) but many others (like social norms) were not addressed. Preventive interventions were recommended for delivery through peers and other non-specialist providers while treatment interventions were recommended for delivery in healthcare facilities by specialist health professionals. There was very little engagement of young people in the development of these policies or in their implementation, except for peer educators mentioned in one policy. Stakeholders identified several major challenges in implementing these policies, notably the lack of inter-sectoral coordination and fragmentation of governance; budgetary constraints; and scanty human resources.
Although there are now several policy instruments testifying to a comprehensive approach on adolescent mental health, there are gaps in the extent of engagement of young people and how these will be operationalized that may limit their impact on addressing the burden of mental health problems in young people in India.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE. Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ. Vos T (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382:1575–1586 CrossRef
Belfer M (2008) Child and adolescent mental disorders: the magnitude of the problems across the globe. J Child Psychol Psychiatry 49:226–236 CrossRef
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, Mcgovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F, Viner RM (2016) Our future: a lancet commission on adolescent health and wellbeing. Lancet 387:2423–2478 CrossRef
Patel V, Ramasundarahettige C, Vijayakumar L, Thakur JS, Gajalakshmi V, Gururaj G, Suraweera W, Jha P (2012) Suicide mortality in india: a nationally representative survey. Lancet 379:2343–2351 CrossRef
Malhotra S, Patra B (2014) Prevalence of child and adolescent psychiatric disorders in India: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 8:22–30 CrossRef
Mental health policy, plans and programmes—updated version 2 (2005) Mental health policy and service guidance package. World Health Organization, Geneva
Brugha R, Varvasovszky Z (2000) Stakeholder analysis: a review. Health Policy Plan 15:239–246 CrossRef
Collins T (2005) Health policy analysis: a simple tool for policy makers. Public Health 119:192–196. https://doi.org/10.1016/j.puhe.2004.03.006 CrossRef
Walt G, Shiffman J, Schneider H, Murray SF, Brugha R, Gilson L (2008) Doing health policy analysis: methodological and conceptual reflections and challenges. Health Policy Plan 23:308–317 CrossRef
Evans MS (2014) A computational approach to qualitative analysis in large textual datasets. Plos One 9:E87908 CrossRef
Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B (2018) Saturation in qualitative research: exploring its conceptualisation and operationalization. Qual Quant 52:1893–1907 CrossRef
Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC (2018) The age of adolescence. Lancet Child Adolesc Health 2:223–228 CrossRef
Gururaj G, Varghese M, Benegal V, Rao G, Pathak K, Singh L (2016) National Mental Health Survey of India, 2015–2016: prevalence, patterns and outcomes. National Institute of Mental Health and Neuro Sciences, Bengaluru
Berman P, Ahuja R, Tandon A, Sparkes S, Gottret P (2010) Government health financing in india: challenges in achieving ambitious goals. Health, nutrition and population discussion paper. World Bank
Petersen I, Marais D, Abdulmalik J, Ahuja S, Alem A, Chisholm D, Egbe C, Gureje O, Hanlon C, Lund C, Shidhaye R, Jordans M, Kigozi F, Mugisha J, Upadhaya N, Thornicroft G (2017) Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies. Health Policy Plan 32:699–709 CrossRef
- India’s response to adolescent mental health: a policy review and stakeholder analysis
Bidyut K. Sarkar
- Springer Berlin Heidelberg
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