No Money for Mental Health: the Government Negligence Continues

In her budget speech, Finance Minister Nirmala Sitharaman mentioned vehicle scrapping policy under 'health and well being' but not mental health!

As soon as I downloaded the Budget 2020-21 documents, I looked for allocations under the Ministry of Health and Welfare. When I saw the budgetary support for National Mental Health Programme (NMHP), my instant reaction was laughter as it was no laughing matter. Millions of Indians spent the year 2020 dealing with mental health issues during theCOVID-19 pandemic. But instead of enhancing the funding for NMHP, the government reduced it during financial year 2020-21 from the already measly amount of Rs 40 crore to Rs 27.36 crore. Moreover, for the year 2021-22, the allocation has been kept flat at Rs 40 crore. In an article before the presentation of the Budget, I had stated “If a pandemic — which woke up millions of people each day to realities of mental health crises within their four walls — cannot force a government to pay attention and allocate significant resources to mental health sector, then nothing ever can.” Now, I could only look at the allocation figures and imagine that ‘meri taraf mat dekhiye, main aapki koi sahayta nahi kar paunga’ — please don’t look at me, I can’t help you — meme. 

Even though I had no hope from the government as far as mental health is concerned, I am disappointed. In her budget address, Finance Minister Nirmala Sitharaman spoke about nutrition, water supply, Swachh Bharat, clean air and even vehicle scrapping policy under ‘health and wellbeing’ but did not mention mental health at all. Vehicle scrapping policy but not mental health? In a year of millions of mental health conversations? The neglect is just amazing.

The allocations for other mental health related schemes are down too. The National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation [why do we still have this phrase?] and Multiple Disabilities has seen its proposed expenditure reduced from Rs 39.50 crore (Budget Estimates 2020-21) to Rs 30 crore (Budget Estimates 2021-22). For the Scheme for Implementation of Persons with Disability Act, the budget is down to Rs 209.77 crore from Rs 251.50 crore. For the second consecutive year, the National Institute of Mental Health Rehabilitation has been given no money. Only National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru and Lokpriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur have seen some marginal enhancements in their budgets.

Another point I had mentioned in my article was the mental health data. The Finance Minister’s speech made no mention of it, but the real surprise came today. A Rajya Sabha member Elamaram Kareem had asked the government the number of registered mental health professionals including clinical psychologists in the country. He also asked the number of additional seats created in clinical psychology and psychiatry since the implementation of the Mental Healthcare Act, 2017 (MHCA 2017). The Health and Family Welfare State Minister Ashwini Kumar Choubey replied that the requested data is “not maintained centrally.” This is surprising since MHCA 2017 mandates Central Mental Health Authority to maintain and publish a register of all mental health establishments and certain mental health professionals including clinical psychologists. 

It is not that after decades of neglect, one expects the government to transform mental health landscape overnight. It is that the budget did not even take baby steps. Much was made about the fact that it is this decade’s first budget. Well, if we expect great results in the mental health sector by 2030, it would have been better if the Finance Minister had begun yesterday by announcing some initiatives. For instance, I had written that even an allocation of just Rs 10,000 crore (against a necessity of at least Rs 100,000 crore) for mental health would be a good start. In fact, even if the Finance Minister had budgeted only Rs 100 crore for NMHP (instead of keeping it at Rs 40 crore) and mentioned it in the speech (saying, for example, that the allocation had been increased by 150%), it would have been reasonable. 

Sometimes, you just need an intent and the evidence that it is backed by action. But in Budget 2021, our mental health got nothing.

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