social impact of mental illnesses on households and individuals a 2021 study by the observer research foundation highlighted a significant shortage of mental health specialists in india particularly clinical psychologists who serve as the first point of contact for those seeking mental health care 0 75 psychiatrists per 100000 people only 898 clinical psychologists compared to a demand of 20250in 2001 following the tragedy in erwadi ramanathapuram where 26 mental patients who had been kept chained in a religious asylum were burnt to death the supreme court ordered a national survey of mental health resources the survey conducted by the ministry of health and family welfare between may and july 2002 revealed a concerning shortage of mental health professionals with adeficit of 77 for psychiatrists 97 for clinical psychologists and 90 for psychiatric social workers the state of the surveyed mental hospitals was also deemed unsatisfactory though tamil nadu has made significant progress in its district mental health programme dmhp the shortage of mental health professionals continuesto address this worsening problem the national mental health policy 2014 and the mental healthcare act 2017 were implemented these policies aim to raise awareness reduce stigma and provide affordable highquality care for mental illnesses however the study indicates that more measures are needed to ensure early diagnosis and effective management of mental health issues to alleviate the financial burden of healthcare expenditure on households the insurance regulatory and development authority of india recently mandated that health insurance policies in india must include coverage for mental health treatmentsthis is a significant step forward however there are also some challenges to this policy change including the high costs for insurance companies limited coverage for preexisting conditions and lack of mental health providersdespite the increase in patients seeking treatment for mental health there are still a stigma surrounding mental health issues in india including tamil nadu with many continuing to believe that disorders are not real or can be overcome without professional helpthis high cost of mental health care in tamil nadu is particularly concerning given the stigma still associated with mental illness in many parts of india people may delay seeking treatment due to social stigma which can result in more severe symptoms and complications leading to increased treatment coststhe study highlights the need for increased investment in mental health services and the implementation of effective health insurance policies to reduce the financial burden on households training primary care physicians and nurses to provide basic mental health care services and integrating mental health screening into routine checkups could help identify and treat issues earlierthe writer is a consultant psychologist at sarvalayam mind care