Family Planning and Mental Health

Family planning, as the name itself indicates, is not merely limitation of family size. It includes an important and often overlooked concept : that of spacing. A study conducted a few years ago (Kumar, 1976) noted that none of the interviewees seemed to have any ideas about spacing. It is this ignorance, lack of education and consequent poor implementation of a major national programme amongst the Indian population which has prompted one to assess the impact of an uncontrolled rise in population on health—particularly mental health. The population question is, theoretically, two fold : one has to guard against too rapid an increase of population, and also against a decrease. However, practically, the Indian scene is primarily conceined with the former. Control of population has become a problem second to none. About population explosion we need not go into details—facts are available with most of us. Malthusian predictions, made in the 18th century, are coming true today. Saunders (1925) referred to an optimum density of population. The limits of this concept are already being surpassed in this country. The so-called natural checks (high infant mortality rate, high death rate) are themselves being checked as a result of better medical care and change of economic environment. v According to the theory of demographic transition, a stage will come when birth rate will parallel death rate. However, this will take a long time—and do we have the capacity to wait ? Evidently, no. High population density may itself cause untoward psychological effects upon humans. Although available data does not allow us to conclude upon direct psychological effects of overcrowding, animal studies have definitely shown adverse sequelae of the same (Calhoun, 1962). In animals, over crowding can influence both behaviour and physiological function. In man, there is a clear correlation between a very high population density and the prevalence of mental disorders, although no definite causal relationship has, as yet, been established (WHO ; 1974). Even if evidence of a direct effect is lacking, it is clear that indirectly (through poverty, jobs, housing, disease, crime, etc.) it may result in considerable stress being placed on man—resulting in higher rates of mental illness. India is passing through an extended period of economic crisis, and an early respite from the vice-like grip of poverty and underdevelopment seems unthinkable. Amongst the myriad of reasons being offered, the one which stands out prominently is : the unequal …