By-Vama Oswal
Health, fundamentally defines our existence, even when the womb is nurturing life.
Imagine, an individual who is perfectly healthy physically, but emotionally adrift following the loss of a parent. Functioning outwardly as they take care of their family, laughs when appropriate, they grapple with emotional numbness, midnight binges and morning lethargy. Although, she goes to work duly but it gets to a point where she is unaware of that fact that her productivity is decreasing. She just seems to get caught up in the spiral. Yet, on the face of it, she is perfectly healthy, physically! Mental health often hides beneath this facade.
Countless people in our society share a story of health without mental health. Society’s dearth of recognition, acceptance, and awareness concerning mental health adversely affects community well-being. Here’s the proof. Take a moment to ponder upon a common question we ask- “How are you?” We are often riddled with the fear of judgement to reply honestly about our feelings and hence we swear by with “okay”, “fine”, “good”, etc. Do we really want a society where we can’t even enquire about the well-being of others genuinely? This is why mental health is paramount in and for our society.
There is a dire need to assess the access to mental healthcare services in India. My school with over 2500 students only had 1 counsellor cum psychology teacher, whose idea of counselling was being ‘nice to students’. Today, there are 4000 students with 2 counsellors courtesy the regulations by the education board.
The reality is far from utopia for people grappling with psychological issues. There are roughly 0.75 psychiatrists for every 100,000 Indians whereas the required number is atleast 3 psychiatrists. (Garg, et.al., 2019). In 2011, Anant Kumar wrote, “even if all 3000 psychiatrists available in the country are involved in face to face patient contact and treatment for 8 hours a day, 5 days a week, and see a single patient for a total of 15-30 minutes over a 12 month period, they would altogether provide care for about 10%-20% of the total burden of serious mental disorders”. The National Mental Health Survey of 2017 reports 193 million Indians suffering with mental health conditions. Shockingly, this number surpasses the population of most countries. For a country glorifying having the largest number of youth, not providing them with proper well-beings services does not skew towards a brighter future. Additionally, while urban sectors still manage to find some resources, the difficulty is to reach out to the rural and remote regions.
Costs further hinder access. The Mental Healthcare Act of 2017 mandates the government to provide mental health facilities to all citizens, but the reality paints a different picture. Many individuals, especially those from marginalized backgrounds, cannot afford the care they desperately need.
Furthermore, social stigma continues to be a roadblock to seeking help. The shame associated with mental health issues prevents individuals from reaching out, exacerbating their suffering.
Incorporating mental health strategies either for awareness or as a form of preventive intervention within spaces of daily life increases the chances of reliability and upkeep. We normalize physical health maintenance because it’s intertwined with daily tasks like eating healthy. The abstract and relatively invisible nature of mental health it is tricky to navigate. Digital platforms are pivotal for mental health advocacy, offering accessibility and anonymity for support and information dissemination. However, digital mindfulness is also necessary. Spread of misinformation which is counter intuitive to the very cause of mental health, addiction, online harassment and privacy concerns can be detrimental. Balancing the benefits with careful monitoring ensures positive digital contributions to mental health advocacy while minimizing adverse effects. Leveraging digital platforms for storytelling and creative expression widens the reach of mental health advocacy efforts.
Presently, the professionals are leading the charge at spreading the awareness. Perhaps, within the community we can have ambassadors of change eg. a young college student, a mother, a retired business person or even an elderly speaking up more about it to reach out to the masses in a language their community understands best. The potential that a chain reaction of community based ambassadors can create is immense and must be explored.
A government in India is made by the people and for the people, yet little is being done in the latter facet. An increase in the petrol prices by a rupee could prompt an urgent parliamentary session. But, every year, so many people die due to suicide, and yet we didn’t see any concrete steps being taken by the administrations. In 2021, 164033 deaths due to suicide were reported (Singh, 2022). Our leaders can only step up when we, the people who elected them, speak up. Mental health care must not be seen independent of general healthcare. This not only reduces stigma, but also plays a role in building holistic awareness and increasing access to healthcare services by the community. Governments should allocate more funds for research, training centers, and educational programs in psychology, enforcing stricter regulations and fostering ongoing professional development.
Quickly mushrooming mental health startups and organizations must realise that this is a human venture before a commercial venture. A sense of unhealthy competition leads to a dip in quality, impulsive hiring of untrained psychologists and so on. To a large extent, it is up to the organizations employing the healthcare professionals to work toward their well-being as that will have a domino effect on the care the patients receive form the professionals.
While training school teachers on understanding childhood development and disorders, one of them said at the end. “Ma’am, I’ve noted the warning signs, but it’s hard to remember it all when a class of 50 students is creating noise and is inattentive. They keep crying and cribbing about little things. Nowadays children are so weak. Our generation was stronger.” The takeaway- Understand the baseline awareness and need of the audience. We must focus on building some basic human understanding about mental health before we delve into technical jargon which fazes out the layman. It is understandable not to expect a 100% acceptance rate of the information. But, it’s unreasonable to teach sentences before the alphabet? In many cultures, religion can sway over people’s lives. Mental health advocacy must navigate this terrain sensitively, as cultural and religious beliefs can impact perceptions. While working at a drug rehabilitation unit in Punjab, oftentimes we had to cope with cases of the patients ‘leaving against medical advice’ because of religious pilgrimages that they or their families would undertake as a part of ‘healing’ them. This prompted us to initiate awareness drives in villages from the grass root level and encourage the panchayats to hold orientations and workshops especially with the village elders. This was significant since the village elders are seen as knowledgeable and wise people so, when they understand mental health as a reality, the reality on ground actually shifts in our favour. Our work over 6-7 months resulted in better treatment interventions for the patients.
Additionally, embracing storytelling as a means of communication can break down barriers and foster understanding.
Mental health exists even without the presence of illness. Innovations in mental health advocacy should encompass prevention by working with schools, parents, and communities to create supportive environments through programs like social emotional learning. With the advancement in technology, innovations in virtual reality and AI-driven interventions also hold promise especially for the elderly with Alzheimers, children with ASD, ADHD or developmental disorders. Innovation in mental health advocacy extends to embracing diverse therapeutic approaches like Expressive Arts based Therapy etc. Mindfully collaborating with artists, musicians, and performers to create mental health awareness campaigns and events can engage a wider audience. Art exhibitions, concerts, and live performances can convey messages of hope and healing while raising awareness about mental health challenges.
Mental health is not a luxury; it is a fundamental right that forms the bedrock of our overall well-being. It is a right that also enables you to make the most of other rights too. The story about the future of mental health is not dull. The murmurs around mental health have now turned into a resounding and a more united cheer. BUT, it’s not the time to take a break. Regardless of who you are or where you come from, mental health belongs to everyone. And, it is up to us to take care of it.
References:
Garg, K., Kumar, C. N., & Chandra, P. S. (2019). Number of psychiatrists in India: Baby steps forward, but a long way to go. Indian journal of psychiatry, 61(1), 104–105. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_7_18
Kumar, A. (2011) Mental health services in rural India: challenges and prospects. Health, 3, 757-761. doi: 10.4236/health.2011.312126.
Singh O. P. (2022). Startling suicide statistics in India: Time for urgent action. Indian journal of psychiatry, 64(5), 431–432. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_665_22