Mental health problems in our country are not just widely ignored but they also come along with social stigma. We have to change the way we think

Recently, during a conversation, the line “Depression is a rich man’s disease” was mentioned. This was followed up by the fact that the poor do not have the mental bandwidth to get “depressed” as their concerns are almost always more about material things. This is patently untrue and, in fact, a casual observation of suicide statistics across the world will prove just that. Sure, a majority of farmer suicides, about which we often wring our hands, are due to financial stress but the very act of taking one’s own life, sometimes murdering even our loved ones, requires a certain sort of psychological stress. A very cogent argument can be made that to really reduce farmer suicides, one does not need financial bolstering as much as sending an army of psychologists to rural India. But we do not even have enough psychologists to cover major Indian cities, let alone our villages.

It is estimated that about one in eight Indians needs some sort of mental healthcare at some point in their lives. Only about 10 per cent of them receive help. And while not all help is needed from certified professionals, there is a severe shortage of even trained counsellors, particularly in educational institutions. When it comes to trained clinical psychologists, there are just about a 1,000 doctors across the country with an extreme bias towards the large metropolitan areas of Delhi-NCR and Greater Mumbai. An article that appeared in the Times of India, which talked about the horrible statistics on mental health, mentioned that there are more Indian psychologists in the UK and the US than in India. The number of social workers and nurses specialising in mental health is equally low. And what about criminal psychologists, the types you see glorified in American and British crime dramas? Almost none.

One reason for this extreme shortage is that mental health issues are treated as an embarrassment by many Indian families. They fear having a crazy person, who will have to go to a pagalkhana. This would stigmatise the family in society and nobody would want to associate with them. But the truth is that for every severe case of mental illness, with outward symptoms, there are hundreds of cases of perfectly normal, seemingly happy people who are deep in the throes of depression. This could be due to some traumatic event in the past; it could be due to unhappiness in love or due to one’s career and sometimes it could be due to nothing at all, really. And the reason I know this is because I have been there myself, down a dark hole of nothingness but outwardly, everything seems fine.

I was fortunate in the sense that I had access to professionals and medication and while it was not all about a switch in my head, I did, with help from others, snap back. But on the face of it, one might wonder why someone like me, a child of privilege in this country, would feel the way I did. I do not know frankly, despite issues while growing up, particularly around my parents’ separation. That is something I managed to deal with. My career was fine. Yes, it could have been better but really, in terms of everything, things were not bad per se and on the face of it, if you had met me back then, I was the same gregarious, talkative person you’d see today. Yet, inside, I was in a horrible place with thoughts of self-harm and killing myself. And it is not me alone, actor Deepika Padukone, too, opened up with the challenges she faced surrounding mental health.

There is no reason to feel depressed and to go down the rabbit hole of clinical depression. Being depressed is not about being unaware to express joy or happiness when one needs to, but yes, there is a sense, at least for me at that time, of extreme loneliness. And possibly the recalibration I had to make with my relationships, particularly at a time when so many are facile or purely transactional, helped.

The biggest help, however, was not just seeing someone but having my mother ensure that I went to a doctor. And that support was critical because many people, who need help, do not have that kind of support from their families. And this is what must change, whether it is a teenager or a 50-year-old. Families need to understand that if someone is actively seeking help, he/she should be provided the support. The problem should not be swept under the carpet and they must not insist that mental issues are a passing phase.

While talking and understanding why someone is going through such problems is a start and friends and families make a difference, a mental health professional, often by virtue of being a new voice of support, a new place to offload the issues that one has and also someone who will not judge, is the go-to remedy. Oversight is a mistake that friends and families make, not necessarily deliberately but just by virtue of being humans. Sadly, the lack of support or understanding often worsens matters and drives sufferers to self-harm or worse, suicide.

It is also important that the Government promotes the establishment of more institutions and trains more mental health professionals. This has been addressed to a certain extent in recent Budgets. However, the fact remains that mental health still ranks low on the list of healthcare priorities in a country as large as India where basic healthcare needs are far more pressing.

This requires a new sort of thinking and the highest levels of policy-making. People must understand that this is a pressing problem because millions of Indians suffer mental illness. Ergo, it is also important for those, who have been through such problems, including myself, to talk and write about these issues to ensure that those going through clinical depression realise that they are not alone, they are not screwed up in the head or whatever else they are told.

There is a lot of cutting-edge research being done into mental health issues, particularly post-traumatic stress disorder and the treatment of those problems with unconventional means such as MDMA and marijuana. Not only should India catch up with such research, we should establish more institutes that can deal with these problems and do our own research.

But most importantly, we have to realise that we have a problem when it comes to mental health and we have to help those who might have stopped by the wayside of life. If someone says that he/she needs help even if they do not verbalise it, do not ignore it. Be there for them and direct them to the help that they so desperately need.

(The writer is Managing Editor, The Pioneer)