The swift urbanization sweeping the globe, with projections indicating that nearly two-thirds of the world’s population will inhabit urban areas by 2050, poses significant challenges to mental health. By 2030, India’s urban population is expected to surge to 40.76%. This urban shift, driven by rural-to-urban migration, is fraught with stressors exacerbated by the effects of climate change, which can have profound implications for mental well-being. Economic and social vulnerabilities increase the risk of mental health conditions such as depression, anxiety, and alcohol use. Furthermore, climate change-related displacements and extreme weather events can compound the mental health challenges faced by communities. Regrettably, mental health support mechanisms are often neglected in climate risk mitigation approaches.
Imagine a day where we all become “invisible.” As humans, we yearn to be seen, heard, acknowledged, and to belong. When we go unnoticed or unheard, it shakes the core of our identity. Externally, despite the appearance of progress and functionality in urban chaos, the absence of productivity, communication, and interaction would be palpable. This is the harsh reality for new migrants in cities, often marginalized on the peripheries of burgeoning megalopolises.
The term “invisible” is fitting here because mental health issues often go unnoticed due to the absence of “visible” symptoms. A lack of awareness and understanding about mental health contributes to apathy and creates an environment where addressing mental health concerns without judgment becomes challenging. Stigma and discrimination further widen the gap in accessing mental health support and care. This marginalization extends not only to individuals but also to the mental health conditions that remain unseen and unaddressed, stifling open discourse.
This year, as we observe World Mental Health Day on October 10, the theme “mental health as a universal human right” takes center stage. It emphasizes the need for equitable planning and quality healthcare delivery to ensure access to mental health care and services for all communities. This theme builds upon the 2022 World Mental Health Report, which recognized that “mental health is an integral part of our general health and well-being and a basic human right.” The report highlighted the intrinsic and instrumental value of mental health, enabling us to connect, function, cope, and thrive.
As we discuss the importance of mental health well-being for all, the faces of many research participants from different communities and urban areas come to the fore—lactating mothers in Ahmedabad, migrant families in the urban slums of Delhi and Bangalore, sanitation workers in Tamil Nadu, vegetable vendors in Bhopal, and gig workers delivering groceries and food. The acute lack of awareness and availability of mental health services in urban primary care settings is glaring. Services often remain confined to specialist care in tertiary institutions. The transition to urban life is complex for migrants who grapple with social, economic, and cultural adjustments.
The recent WHO South-East Asia Regional Paro Ministerial Declaration on mental health challenges acknowledged low investment in mental health (below $1 per capita in several countries), a shortage of trained health workers, significant treatment gaps, lack of services in primary care, stigma, and data paucity as challenges in the region. The declaration called for a shift from a disease-centric approach to a focus on well-being, recognizing broader mental health determinants and placing communities at the center of our responses.
Change can begin within our institutions and the people we work with. Creating an environment that promotes positive mental health for lactating mothers, children, sanitation workers, and informal economy migrants is imperative. Dignity in life, aspirations for the future, and health as a common good should guide our commitment to inclusivity, liberalism, and support for the evolving dynamics of human lives in urban settlements.
Collectively, we must transition mental health from a realm of invisibility, where it remains unnoticed, misunderstood, unspoken, and uncomfortable, to visibility, normalization, discussion, and mainstreaming. In a year when we’ve become the world’s most populous nation, this day should serve as a reminder that mental health and well-being must be at the core of our health planning, especially in urban settings.
