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The Magnitude of Mental Health Problems in India: Insights from census and
large–scale surveys

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Paper presented at the National Seminar on ‘Suicide and Self-harm: Issues and
Challenges’, held at Centre for the Culture and Development, Vadodara, 7-8
December, 2018.

The Magnitude of Mental Health

Problems in India: Insights from census
and large–scale surveys
Tanusree Dutta* & R. B. Bhagat**

Abstract
India’s rising population and its possibilities of reaping a demographic dividend in near future are faced
with challenges of public health, as the current scenario of health and healthcare implies. There are
widespread research and interventions on public health, on increasing morbidities, especially those
related to lifestyle changes. However, data and research are lagging much behind in the case of mental
health issues. It has been recognized that a wide gap exists in mental health research in India, collecting
data and its utilization in formulating policies and designing interventions at the national level,
especially compared to other health issues. Often other health issues overshadow the domain of mental
health, rendering it as an unimportant and sidelined public health issue. However, to ensure a healthy
population and overall human development, mental health issues need as much attention and resources
as other public health issues. The aim of this study therefore, is to bring out key findings related to
mental health problems in India, its distribution among gender, age groups, marital status, caste religion,
etc and try to understand its evolving nature in the Indian context. The present study focuses only on
youth population, aged 15-24, with specific mental health problems which are reported, based on the
Youth in India Survey, conducted in 2006-07.

Introduction
Health is defined as a state of overall well-being which includes physical, mental, and social aspects of a
human being. Therefore, health itself incorporates the dimension of mental well-being in its definition. The
World Health Organization defines mental health as “a state of well-being in which every individual realizes
his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and
is able to make a contribution to her or his community”. Without mental and psychological well-being
individuals cannot attain a healthy status. The mental well-being is not an isolated state but an outcome of
physical and social determinants of well-being. It includes subjective well-being, perceived self-efficacy,
autonomy, competence, intergenerational dependence and recognition of the ability to realize one’s
intellectual and emotional potential (WHO, 2003).

The Sustainable Development Goals (SDGs) focuses on mental health and development stating in its targets
3.4 “By 2030, reduce by one third premature mortality from Non communicable diseases through
prevention and treatment and promote mental health and well-being.” and target 3.5 requests that countries:
“Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
use of alcohol.” (Izutsu et al., 2015). The National Mental Health Policy of India was drafted in October
2014, which states about promoting mental health, preventing and enabling recovery from mental illnesses,
promotes de-stigmatisation and desegregation, promote social inclusiveness, and providing accessible,
affordable and quality health care to all in their life-span, with a rights based approach (MoHFW, 2014).
The National Mental Health Survey of India, conducted by NIMHANS, Bengaluru in 2015-16 on the
prevalence, patterns and outcomes of mental health problems in India also established the fact that India is
faced with a huge burden of mental health issues, nearly 11% of Indians above 18 years are suffering from
mental disorders and most of them do not receive care for a variety of reasons deserves the urgent attention
of our policy makers and professionals (Gururaj et al., 2016; WHO, 2005). The problem of mental health
has been well-recognised in developed countries, but in developing countries, there exists a wide gap in
understanding of the problems, in the genesis of such problems, how to address them and in research (WHO,
2014). There is a need for mainstreaming mental health problems within the general framework of health
care system of our country (Murthy, 2014).

Studies on mental health came to the fore in the latter part of the 20th century, when mental health was also
recognized as a component of health and well-being. In India, data on mental health is limited and studies
usually rely on very small datasets on a limited number of indicators (Khandelwal et al., 2004). Till date it
is a challenge for social researchers to present much grounded evidence on mental health and its correlates.
Studies have found that there is a close association of mental health with the level of urbanization (Helson
& Srivastava, 2001; Chandra Prabha et al., 2018). The study of mental health also becomes interesting in
the context of rapid urbanization which is taking place globally. Urbanization impacts mental health
significantly through various driving forces and stimulators like overcrowding and congestion, pollution,
joblessness, poverty and ill-health. Although rural population is more and the prevalence of reported mental
health problems is found to be higher in people living in rural areas, some specific mental disorders are
direct outcomes of urban life. Dependence on cash based economy, higher cost of living and inequality,
increased levels of violence and reduced social support are few important among the major urban drivers
of mental health problems. Stigmatization and ignorance towards mental disorders often lead to untreated
problems and may increase the problem further and may also hinder access to help and health care services.
The aim of the present study is to look at the differentials of mental health problems in rural and urban
settings, how urbanization influences mental health, and which specific mental disorders are more common
in urban areas? Urban areas provide a complex setting in which different types of mental health disorders
may arise. Urbanization has a direct relationship with human well-being. Similar to chronic diseases, mental
illness, which is a broader term compared to mental health problems, implying various kinds of psychiatric,
bipolar and behavioral disorders pose several threats to the health and functionality of people. Unlike other
health problems, mental health problems are much more difficult to identify and diagnose. Mental health
problems demand attention across the world, because not only it has been witnessed in high-income
countries, but is also seen to be rising in middle and low-income countries. In India, mental health problems
require very special attention because not only India is still a growing economy, and a society with rising
income inequality, but also, the Indian society is dissected by many forms of inequalities, such as caste,
religion, and gender. The combination of these inequalities creates a complex and intertwined system,
where people suffer from a range of mental health issues, which affect their daily life knowingly or
unknowingly.

The public healthcare system has very low response towards mental health, especially in India (Shidhaye,
2016). According to the Mental Health Atlas, WHO, 2018, levels of public expenditure on mental health
are very meagre in low and middle-income countries and more than 80% of these funds go to mental
hospitals. It also states that globally, the median number of mental health workers is 9 per 100 000
population, but there is extreme variation (from below 1 in low-income countries to 72 in high-income
countries). This creates a lot of burden on the family of the persons affected by mental health. Therefore,
research in mental health and its different aspects such as the degree of severity of the problems, the
patterns, the health care facilities to address mental illnesses, public expenditure scenario and the social

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
costs associated with mental illnesses need to be researched to ensure effective mental health care and
mental well-being of the citizens of this country. This paper highlights the magnitude and correlates of
mental health problem in India based on census and large scale surveys.

Concepts and Definitions

This study uses three indicators of mental health problems – mental retardation, mental illness and mental
health disorders. Although some mental health problems may be overlapping in all these three indicators,
still there are significant differences, especially in the genesis of the mental health problems.

Mental Retardation – Mental retardation is a condition of arrested or incomplete development of the mind,
which is especially characterized by impairment of skills manifested during the developmental period,
which contribute to the overall level of intelligence, i.e. cognitive, language, motor, and social abilities.
Retardation can occur with or without any other mental or physical disorder. However, mentally retarded
individuals can experience the full range of mental disorders, and the prevalence of other mental disorders
is at least three to four times greater in this population than in the general population. In addition, mentally
retarded individuals are at greater risk of exploitation and physical/sexual abuse. Adaptive behaviour is
always impaired, but in protected social environments where support is available this impairment may not
be at all obvious in subjects with mild mental retardation.

Mental Illness – A mental illness is a health problem that significantly affects how a person feels, thinks,
behaves, and interacts with other people. It is diagnosed according to standardised criteria. Mental illnesses
are of different types and degrees of severity. Some of the major types are depression, anxiety,
schizophrenia, bipolar mood disorder, personality disorders, and eating disorders. A mental health problem
also interferes with how a person thinks, feels, and behaves, but to a lesser extent than a mental illness.
Mental health problems are more common and include the mental ill health that can be experienced
temporarily as a reaction to the stresses of life.

Mental Health Disorders – Often mental illness and mental disorders are used synonymously. However,
there are differences among them. Mental disorders can be different forms of mental illnesses such as
anxiety, depression, schizophrenia, bipolar disorders, alcoholism and substance addiction, but these can be
categorised according to the severity of illness. Generally, anxiety and depression, and in many cases
substance abuse are referred to as common mental disorders which result from stressful situations, while
mental illnesses such as schizophrenia or bipolar disorders are more severe forms of mental disorders which
needs more specialised attention. These conditions of mental health are resultant of a complex system
produced by the social, environmental, physical and biological conditions.

The current study uses all the three indicators discussed above. Census provides data on mental retardation
and mental illness; however it does not specify the forms of mental illnesses it collects data on. Specific
forms of mental disorders, or more commonly termed as common mental disorder or common mental health
problems and some symptoms of mental health conditions are given by Youth in India survey, conducted
in 2006-2007.

Data and Methodology

The study uses both Census and Survey data. Census 2011 for the first time has published data on disability
which also gives data on mental disability in the form of mental retardation and mental illness,
disaggregated by sex and age. The study also uses the secondary data, “Youth in India: Situation and Needs
2006-2007” conducted during 2006-07. It is the first ever sub-nationally representative study conducted to

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
identify key transitions experienced by married and unmarried young women and men aged 15–24 years
and married men aged 15–29 years. The data is collected from rural and urban settings of six states viz.,
Andhra Pradesh, Bihar, Jharkhand, Maharashtra, Rajasthan, and Tamil Nadu representing 39 per cent of
the country’s population. The selected states represent the different geographic and socio-cultural regions
of the country.

The Youth in India survey was conducted in 2006-07, in six states of India, which were Bihar, Jharkhand,
Maharashtra, Rajasthan, Andhra Pradesh and Tamil Nadu. The Youth in India: Situation and Needs study
is a sub-nationally representative study, undertaken for the first time in India, of key transitions experienced
by young people. The study was an attempt to bring out multiple issues related to youth in our country,
ranging from education, working life, marriage, physical, sexual and mental health and also reproductive
behaviors. The study was carried out in these six states as each of them provided a unique but comparative
geographical and cultural setting. The present study utilized the data on mental health from the youth
survey. The section on mental health consists of a set of 12 item questionnaire, which is based on General
Health Questionnaire (GHQ) – 12. It asks a set of questions to the respondent related to their daily lives
and feelings which have a serious impact on their mental health. Responses are coded in either yes or no.

2.2 Methodology:
The outcome variable for looking at mental health is ‘mental health disorder’ which is assessed using
General Health Questionnaire-12 (GHQ-12). GHQ- 12 is a 12-item inventory, originally developed in the
United Kingdom (Goldberg, 1978; Sriram et al., 1989). It is a well-established screening questionnaire for
measuring psychological distress and has demonstrated validity in developing countries including India
(Goldberg et al., 1998; Shamma Sundar et al., 1986). Designed to identify psychiatric morbidity, the
questionnaire asks respondents whether in the past month they had experienced a range of emotions
including losing sleep because of worry, worry about playing a useful role, feeling capable of making
decisions, feeling constantly under strain etc. Items are coded as ‘1’ for ‘negative emotions’ and ‘0’
otherwise, and then summed to produce a score from 0-12. A similar method of scoring has been used in
another study from India (Shidhaye and Patel, 2010).A composite score is constructed using the 12 items
on mental health, which is basically a count score ranging from 0 to 12, with cut off value at 3, which
implies that persons scoring above three have significant self-reported mental health problems. Mental
Health Disorders (MHD) – Count score computed by summing the values on a 12-item scale with cut-off
point 4. Those with 4 or more reported problems are considered to be having significant mental health
disorders. The values are in percentage (%). This composite score is an established measure of mental
health based on the GHQ-12 questionnaire.

The analysis uses some bivariate and multivariate techniques to understand the correlation between mental
health disorders and various socio-economic, demographic and geographical characteristics. Multinomial
logistic regression is also done to understand the determinants of absence or presence of mental health
problems according to various social and cultural factors.

Results and Findings

Findings from Census Data, 2011

Prevalence of mental health problems (Tables 1 & 2) shows that number of people with mental retardation
is around 15.05 lakhs as shown by Census data 2011, which is more than double the number of people with
mental illness (7.22 lakhs). The same is true even for males and females, with females having lower number
of cases than males in case of both mental retardation and illness. Sex ratio, i.e. number of females per 1000
males is 729 calculated for mental retardation is 729, and that for mental illness is 738. It gives a relative
figure of the male-female differential in mental health problems and shows that females constitute a slightly
higher proportion of mental illness cases compared to mental retardation.

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Similar case is also seen in rural and urban areas in the proportion of the two types of mental health
problems. Proportion of mental retardation cases in rural areas is 10.25 lakhs, while in urban areas it is 4.8
lakhs. In case of mental illness, the difference is slightly less with 4.95 lakhs in rural areas, and 2.27 lakhs
in urban areas. Among these, maximum number in both cases is found in households, followed by
institutional and homeless.

Prevalence of mental health problems is found to be same in urban areas for mental illness, which is around
60 per 10 lakh population, while for mental retardation it is found to be higher in urban areas (127 per 10
lakh population) than rural areas (123 per 10 lakh population).

Fig. 2 shows the age composition graph of mental health problems from Census data 2011 shows that the
occurrence of mental retardation cases is highest in the age group 10-19, while for mental illness it is in the
age group 30-39. In both the cases, the age graph is seen to be rapidly rising as age increases, forming a
peak in the adolescence and youth and declining gradually as old age approaches.

Findings from Large scale sample surveys: Youth in India Survey, 2006-07
The Youth in India: Situation and Needs Survey, conducted in 2006-07 gives somewhat detailed figures on
mental health problems not reported by Census. The definition also varies as has been already discussed
earlier. It gives data on mental disorder problems which are collected in the form of twelve symptoms of
mental health, adapted from the GHQ-12 questionnaire.

Prevalence of Common Mental Disorders (CMDs): Percentage of mental health disorders (based on three
or more symptoms during last one month) is more in rural areas with 156 rural males per 1000 population
and 155 rural females per 1000 population, and 95 urban males and 93 urban females per 1000 population.

Table 6 gives an interesting pattern of the individual mental health problems in urban and rural areas. The
most common problems are feeling unhappy and depressed, feeling constantly under strain and losing much
sleep over worry in both rural and urban areas, followed by incapability of taking decisions and feeling of
not playing a useful role in life.

Age-pattern of Common Mental Disorders:

Tables 3, 4 and 5 show that mental health problems occur more or less uniformly across the youth age
group, which varies from 15 to 22-24 years. Highest prevalence of CMDs is found at the start of adulthood,
18-19 years, and also at around 22, when one is about to enter the working life. Therefore, it forms a two-
humped curve on the graph with age in the x-axis and prevalence of CMDs in the y-axis. Among the specific
reported health problems, decision-making is the most common problems during the early phase of
adulthood (18-20 years), and strain at the start of working life (22-24 years). Sleeplessness and depression
are also seen to be increasing with age, due to rising stress in life. In urban areas, CMDs occur mostly in
the working age, the time when a youth seeks for employment opportunity, whereas, not much variation is
found across different ages in rural areas. Gender differentials in age-pattern of CMDs show that females
suffer from CMDs more after their twenties, while it is found be in and around 17-18 years for males.

Prevalence of CMDs among various socio-economic groups in India: Figures 6 to 10 show that among
the socio-economic and cultural factors, this study has considered religion, caste, wealth quintile,
employment status and marital status of individuals to find out the differentials in CMDs. Among the
religious groups, CMDs are found to be less prevalent in the Christians, Jains, Hindus and Muslims. Highest
is found among people who do not follow any religion, and Sarana religion (tribal religion), followed by
Buddhists and Sikhs. Separated/divorced and widowed persons are more prone to having CMDs. Among
caste categories, it is found that prevalence is highest among people belonging to Scheduled Castes,
Scheduled Tribes and people who do not identify themselves with any caste/category. Prevalence is least

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
among general category and Other Backward Categories (OBC). Educational status is also found to be
significantly associated with mental health status, with non-literates having maximum prevalence.
Therefore, it is clear that there exists socio-economic and cultural difference in the presence of mental
health disorders.

Prevalence of mental health problems in states of India: The Youth in India data, 2006-07 conducted the
survey in six states of India, namely, Bihar, Jharkhand, Rajasthan, Maharashtra, Andhra Pradesh and Tamil
Nadu. Highest prevalence of common mental disorders (CMDs) is found in Jharkhand (22.24 per cent),
followed by Rajasthan (17.93 per cent) and Maharashtra (15.94 per cent). Table 7 & 8 show the prevalence
of mental health problems is found to be below national average of 13.77 per cent in states of Bihar, Andhra
Pradesh and Tamil Nadu. Analysis of state-wise rural-urban differentials in CMDs show that prevalence is
high in both urban and rural areas of Jharkhand and Rajasthan. Urban-rural differentials are maximum in
Maharashtra, followed by Tamil Nadu and Andhra Pradesh. Bihar shows no significant differential in rural
and urban areas. Compared to rural-urban differentials, gender differentials in states present a much more
interesting picture. National average shows no gender differentials, while mental health prevalence is found
to be very high among women in Rajasthan and Maharashtra. Prevalence is found to be high in males of
Jharkhand and Bihar. South Indian states like Andhra Pradesh and Tamil Nadu show negligible difference.
Among all the twelve reported mental health problems, as stated in the GHQ-12 questionnaire,
sleeplessness, strain, depression, playing useful role in one’s life, decision-making capability and
overcoming difficulties in life are found to be highly prevalent in almost all six states, among which
sleeplessness is highest in Jharkhand, along with strain and depression, role playing in life and decision-
making. Jharkhand is thus suffering from a high burden of mental health disorders among the states in India,
specifically common mental health disorders. Decision-making problem is found to be highest in Bihar
after Jharkhand, while sleeplessness and strain is high in Tamil Nadu and Rajasthan. Decision-making and
overcoming difficulties are also found high in Maharashtra and Rajasthan. Among all the states Andhra and
Tamil Nadu are better-off in terms of reported mental health problems, with sleeplessness, strain and
depression level high in Tamil Nadu. Therefore, the results suggest that in Northern and Eastern India
(Bihar and Jharkhand), playing a useful role in life and decision-making abilities are the most common
problems, while in Southern India (Andhra Pradesh and Tamil Nadu), sleeplessness and depression are the
most common. In Western India (Rajasthan and Maharashtra), all the above stated problems are found to
be highly prevalent.

Correlates of mental health problems: Table 9 gives the correlation matrix shows high correlation between
worthlessness and confidence (correlation coefficient value 0.72), facing own problems and overcoming
difficulties (0.71), followed by enjoying daily activities and facing own problems (0.70), strain and
depression (0.70), enjoying daily activities and happiness (0.67) and depression and sleep (0.65). These
correlation coefficient values are in the moderately high range. It implies that the individual problems of
mental health faced by a person is not isolated in nature, but is an outcome of and may occur from a set of
related symptoms of mental health disorders. For example, facing own problems, enjoying daily activities
and depression are some very common disorders which lead to other related conditions as well. Multivariate
regression analysis (Table 10) shows that the presence of common mental disorders depend on an
individual’s place of residence, age, sex, economic class, family type, employment status and cultural
background. These variables show significant relationship with the presence of mental disorders. Among
these, rural areas and age have positive relationship, with rural areas more likely to have mental health
problems (Odds ratio 1.255), age 20-24 i.e. young adults have more likelihood of having mental health
disorders (Odds ratio 1.11), general and OBC category people having lesser likelihood (Odds ratio 0.884
and 0.894 respectively), middle and upper wealth quintiles having less likelihood (Odds ratio 0.869, 0.784
and 0.63 respectively), non-nuclear family having slightly greater likelihood (Odds ratio 1.106), employed
people having less likelihood (Odds ratio 0.909), individuals belonging to states of Rajasthan and Jharkhand
(Odds ratio 1.252 and 1.526) have higher likelihood.

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Discussion
The analysis done using Census and Survey data reveals a number of issues regarding the occurrence of
mental health problems in India. It segregates the nature of problem, i.e., whether the problem is common
or severe, the characteristics associated with mental health problems, i.e. vulnerability among rural-urban
youths, males and females, different religious and socio-economic groups and also their causal factors.

The results suggest that the nature and causes of occurrence of common mental health disorders is much
different from that of severe forms of mental health problems like retardation or illness. Common mental
health disorders are on the rise in today’s world due to rapid urbanization, change in lifestyles, substance
abuse, social and economic stresses, isolation, etc (Patel et al., 2008). Although severe mental health
problems like bipolar disorders or schizophrenia demand urgent attention, but they affect a smaller section
of the population, whereas anybody is vulnerable to CMDs. Therefore, CMDs demand special attention of
the civil society, health planners and the government. While discussing about how to prevent mental health
problems in our country, it must also be kept in mind that addressing mental disorders alone would not be
sufficient, it needs an overall societal and behavioral change. Unipolar disorders like depression or stress
or sleeplessness, may lead to dangerous outcomes such as self-harm or suicide. They may work as
symptoms, which if go unnoticed may lead to bigger psychological distress.

Fig1: A Schematic Representation of Socio-economic Context, urbanisation and mental Health

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Regarding the socio-economic and urbanisation related factors affecting mental health; one can say that
there are a number of stressors that work in combination in an individual’s and also community life
(Srivastava, 2009). These stressors vary in rural and urban areas and among males and females. With the
change in economic conditions, society is also changing, there is rising inequality and poverty, and change
in lifestyles as well. Rising inequality is arising from a situation of economic growth which is growing in
terms of GDP only, but not leading to the redistribution of wealth. This growth can be called ‘jobless
growth’, as has been termed by various experts. The situation of unemployment that prevails in the country
today is appalling. Educated youth not getting employment opportunities is leading to mental stress and
depression. Our findings also show the same thing, that employment status of youth has a direct and
significant relationship with their mental health status. Similar to rising unemployment among educated
youth in urban areas, rural population is also facing severe distress in livelihood opportunities in rural areas.
Agricultural distress is increasing, lack of farm-based employment, rising casual labour, rising seasonal and
disguised employment. Rising aspiration also arising from urban lifestyle and cultural change as an effect
of globalization is also leading to various kinds of mental health problems.

Merton theorizes that anomie (normative breakdown) and some forms of deviant behavior derive largely
from a disjunction between “culturally prescribed aspirations” of a society and “socially structured avenues
for realizing those aspirations.” (Merton, 1968:188). In other words, the gap that arises from people’s
aspirations or social expectations and the means to achieve them, there arises such a situation where
breakdown of societal and personal values and norms takes place. Anomie also implies personal alienation
and isolation, associated with lack of confidence and uncertainty. Experts also stated that certain types of
societies and social norms help in the development of deviant behavior (Etzioni et al., 1964). Existence of
social divisions in society is a major determinant of mental health status and mental well-being in India.
Discrimination exists along many lines, such as class, caste, gender, religion, education and employment
status. Studies have found that in many cultural and socio-economic settings, gender plays an important
role in making females vulnerable to depression and lack of decision-making (Malhotra & Patra, 2014).
Experts have found that more women suffer from mental illness compared to males in some cases. Women
not only have different physical characteristics, but also different psychological attributes (Hare-Musteen
& Marecek, 1988), which make them more sensitive than men in their emotional make up, and also more
vulnerable. Women also face more violence in all forms, be it physical, verbal, mental or sexual (Chandra
et al., 2003). Though there is much evidence to support the fact that women are more vulnerable to mental
problems in specific cultural settings, gender roles are also changing in societies. The responsibility of care
for the mentally ill women is often left to her own family than to husband or his family. In a study, of
women with schizophrenia and broken marriages, Thara et al., (2003) found that the stigma of being
separated/divorced is often felt more acutely by families and patients than the stigma of having a mental
illness.

Conclusion
From this study one can conclude that mental health in India is now a burning issue and calls for urgent
attention. It has been observed that the increasing gap between rising aspiration and its non-fulfilment is

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
leading to higher stress in various segments of Indian society. Also, stress in rural areas is higher than urban
stress in personal and social life. Health policy response to mental health problems is very poor. There is
lack of data about the magnitude of the problem and disaggregated by age, sex, social and economic groups.
Also, there is very limited data availability on health care seeking behaviour of mental health, disability
due to mental illness, stigma related and impact on families and individuals. From a policy perspective one
can say that there should exist a systems approach towards the addressal of mental health problems, i.e.
incorporating mental health care within the existing framework of healthcare in the country (Jain, 2012).
Often mental health problems, both common and severe are not reported due to lack of knowledge,
awareness or social stigma associated to it. The civil society and government should work together in
reducing the stigma associated to mental health issues and encourage healthcare seeking behaviour among
people.

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** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Patel, V., Araya, R., Chowdhary, N., King, M., Kirkwood, B., Nayak, S., ... & Weiss, H. A. (2008).
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Tables and Figures

Table 1: Disability Type by Sex

Type of Disability Persons Males Females
Mental Retardation 1,505,624 870,708 634,916
Mental Illness 722,826 415,732 307,094
Source: C-Series, Table C-20, Census of India 2011

Table 2: Number of People with Mental Health Problems in Rural and Urban Areas by Household
Types, India, 2011

Mental Retardation Mental Illness

Rural 1025900 495880
Household 1011340 485805
Institutional 12998 8517

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Houseless 1562 1558
Urban 480064 227000
Household 462217 210887
Institutional 15171 13732
Houseless 2676 2381
Source: C-Series, Table C-20, Census of India 2011

Table 3: Age Pattern of Mental Health

Disorders among Youth in India

Age in completed Mental Health

years Disorders (%)

15 12.58
16 13.13
17 14.2
18 14.33
19 13.93
20 13.43
21 13.77
22 14.07
23 14.39
24 14.18
Source: Youth in India: Situation and Needs 2006-2007, International
Institute for Population Sceinces, Mumbai

Table 4: Age Pattern of Mental Health Disorders in Urban and Rural

Areas
MHD in Urban MHD in Rural
Age in completed years areas areas
15 9.14 13.71
16 9.48 14.49
17 9.41 16.17
18 9.34 16.25
19 7.88 16.44
20 9.18 15.28
21 9.93 15.58
22 8.68 16.69
23 11.27 15.9
24 10.04 16.26
Total 9.44 15.6

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Source: Same as in Table 1

Table 5: Age Pattern of Mental Health Disorders among

Males and Females
Age in completed MHD in MHD in
years Males Females
15 13.94 12.06
16 13.15 13.11
17 14.07 14.27
18 14.24 14.38
19 13.99 13.9
20 13.38 13.45
21 13.25 14
22 14.05 14.08
23 13.94 14.58
24 13.55 14.48
Total 13.76 13.77

Source: Same as in Table 1

Table 6: Specific Mental Health Disorders according to Place of

Residence
Types of Mental Disoders Total Rural Urban
Sleep 11.52 12.56 9.06
Strain 12.28 12.57 11.59
Depression 10.86 11.48 9.4
Confidence 5.96 6.87 3.79
Worthlessness 4.89 5.8 2.74
Concentration 4.19 4.7 2.97
Role play 8.3 9.32 5.32
Decision making 14.92 16.63 10.88
Overcoming difficulties 10.2 11.92 6.13
Daily activities 4.86 5.96 3.47
Facing problems 9.37 10.47 6.78
Happiness 5.13 5.65 3.89
Source: Same as in Table 1

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Table 7: Mental Health Disorders across selected states of India
State Mental Health Disorders (%)
Rajasthan 17.93
Bihar 11.17
Jharkhand 22.24
Maharasthra 15.79
Andhra Pradesh 10.31
Tamil Nadu 10.76
Total 13.77
Source: Same as in Table 1

Table 8: Mental Health Disorders across selected states of India

State Mental Health Disorders (%)
Rajasthan 17.93
Bihar 11.17
Jharkhand 22.24
Maharasthra 15.79
Andhra Pradesh 10.31
Tamil Nadu 10.76
Total 13.77
Source: Same as in Table 1

Table 9: Correlation Matrix showing the interrelationship between the different symptoms of
mental health disorder

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Sleep Strain Depres~n Confid~e Worthl~s Concen~n Role_p~y Decisi~g Overco~s Daily_~s Facing~s Happin~s

Sleep 1.0000
Strain 0.6662 1.0000
Depression 0.6504 0.7073 1.0000
Confidence 0.5138 0.5381 0.6201 1.0000
Worthlessn~s 0.4646 0.4751 0.5306 0.7241 1.0000
Concentrat~n 0.5749 0.5159 0.5303 0.4863 0.4404 1.0000
Role_play 0.3707 0.3329 0.3318 0.3834 0.3482 0.4695 1.0000
Decision_m~g 0.2533 0.2818 0.2370 0.3007 0.3245 0.3599 0.4935 1.0000
Overcoming~s 0.3016 0.4010 0.3622 0.4259 0.3661 0.3747 0.4057 0.5417 1.0000
Daily_acti~s 0.5461 0.6255 0.6364 0.5794 0.5163 0.5817 0.4304 0.3657 0.4962 1.0000
Facing_pro~s 0.2509 0.3254 0.3765 0.4218 0.3908 0.3489 0.3395 0.5322 0.7099 0.5139 1.0000
Happiness 0.5307 0.5672 0.6103 0.6041 0.6193 0.5452 0.3799 0.3502 0.4489 0.6742 0.4694 1.0000

Table 10: Binary Logistic Regression Analysis showing the determinants of Mental Health
Disorders

Independent variables Odds Ratio

Place of Residence Urban®
Rural 1.255***
Age 15-19®
20-24 1.1***

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Religion Hindu®
Muslim 1.081
Others 1.036
Caste SC®
ST/VJNT 1.0244
OBC 0.894**
General 0.884*
DK/No caste 1.333
Wealth Quintile 1st quintile®
2nd quintile 0.934
3rd quintile 0.869**
4rth quintile 0.784***
5th quintile 0.63***
Family type Nuclear®
Non-nuclear 1.106***
Employment Status Unemployed®
Employed 0.909***
Sex of Respondent Male®
Female 0.946
State Maharashtra®
Rajasthan 1.252***
Bihar 0.701***
Jharkhand 1.526***
Andhra Pradesh 0.644***
Tamil Nadu 0.767***

Constant 0.193
Note: Dependent variable is Mental Health Disorder with two categories namely absence and presence coded 0
and 1 respectively.
® indicates reference category
* for p value <0.05, ** for p value <0.01 and *** for p value <0.001

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Fig 1: Prevalence of Mental Health Problems, India, 2011

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Fig 2: Age Pattern of Specific mental health problems

Age Pattern of Specific Mental Health Problems

25
Sleep
Reported Mental Health Problems (%)

Strain
20 Depression
Confidence
Worthlessness
15 Concentration
Role play
Decision making
10
Overcoming Difficulties
Enjoying Daily Activities
5 Facing own problems
Happiness
Mental Health Disorders
0
15 16 17 18 19 20 21 22 23 24
Age in completed years

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Fig 3: Age Pattern of Specific mental health problems

Fig 4: Percentage of youth (15-24) with Mental health disorders (based on three and more
symptoms during last one month)

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Fig 5: Percentage of youth (male15-24) with symptoms or behaviours suggestive of mental health
disorders experienced in the month preceding the interview, according to residence

Fig 6: Percentage of Youth (15-24) with Mental Disorder by Social Groups ( based on
three and more symptoms)

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
Status
Mental Health Disorder (%)
20
15
10
5
0

Fig 8: Percentage of Youth (15-24) with Mental Disorder by Marital

Status

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai
 Mental Health Disorder (%)
20
15
10
5
0
Higher Secondary Total Primary Non-literate
Secondary and
above

Fig 9: Percentage of Youth (15-24) with Mental Disorder by Educational Status

Mental Health Disorder (%)

45
40
35
30
25
20
15
10
5
0

Fig 10: Percentage of Youth (15-24) with Mental Disorder by Religion

*Assistant Professor, Department of Geography, Adamas University, Barasat

** Professor and Head, Department of Migration and Urban Studies, International Institute for Population Studies, Mumbai

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