This article presents the scenario of mental health in India, covering some of its underlying causes and potential solutions.
The government budget for the fiscal year 2021–22 introduced “health and well-being” as the first of its six pillars. What is it that well-being entails? Well-being is not just the absence of illness, mental or physical, but includes personal growth and fulfilment. However, in a country where 7.5 per cent of its population, or 90 million Indians, are affected by mental health issues, and less than 4,000 mental health experts are available, it is imperative to address the reasons behind rising mental health issues and the adequate ways to approach them. Therefore, we must ask ourselves: What is mental health? Why is mental health important?
India is placed at 139 among 149 countries according to the World Happiness Report 2021.
Mental Illness: An Introduction
From epilepsy, intellectual disability, autism, and other developmental disorders in childhood; anxiety, addiction, eating disorders in the later years; to dementia, Alzheimer’s, depression in old age: all these common manifestations of mental illness can be witnessed throughout different phases of life.
A phenomenon that goes back centuries, if not millennia, mental illness has gone through significant changes in the way it has been perceived. One ancient theory that is still encountered is the operation of supernatural forces or evil spirits in the minds of those who portray “abnormal” behaviour. As bizarre as it sounds, manifestations of this theory can be seen all over the subcontinent, especially in rural hinterlands.
In the ancient western world, philosophers such as Socrates, Hippocrates, and in particular Plato developed the organismic approach, according to which disturbed behaviour arises out of conflicts between reason and emotion.
Even today, mental health in India continues to be associated with stigma and disbelief, with over 90 million people impacted. This results in lower quality of life, physiological issues, and behavioural problems, among others, for the people impacted directly and indirectly. Thus, it is extremely important to realise why mental health issues are so persistent in India.
The Relation between Mental Illness and Poverty
In India, the “culture of poverty” is extremely prevalent. “Culture of poverty” is a belief system that convinces a person that they will remain poor and this will be passed on from one generation to the next. In addition to this is the persistence of poverty where there is no external intervention, termed as “poverty cycle”, which explains why the same sections of society perpetually remain trapped in this vicious circle.
Factors like low level of income, lack of proper education and skills, and lack of adequate health and nutrition result in inadequate employment opportunities for the poor. It has been found that they live with a sense of hopelessness, powerlessness, injustice, and deprivation, and experience a loss of identity. Thus, mental health in India is tied closely to poverty.
However, a major but often-overlooked factor perpetuating the cycle of poverty is depression. The poor experience social exclusion, high stress, malnutrition, violence, trauma, among other things, which paves the way for depression, leading to loss of employment, increased health expenditure, substance abuse which leads to economic deprivation, lack of basic amenities, and further on, inevitably trapping them in poverty. Therefore, depression and poverty, to some extent, are interrelated.
How Social Media Affects Mental Health
The association of dopamine with social media is common knowledge. For almost every social media user, deriving validation from the number of followers and likes, some amount of dopamine, the same hormone that makes people feel good when they smoke or drink, is released. Highly addictive, social media-induced dopamine is the reason most youngsters use social media instead of going to a friend or relative in times of need.
This phenomenon certainly hampers natural coping mechanisms, urging people to turn to social media in tough times, inducing a lot of anxiety. Moreover, being a generation that is well equipped with putting a filter on everything, the pretense inherent to social media can take anyone on a path of self-doubt and comparison.
In recent times, social media is also responsible for generating widespread panic in today’s time and age. Even before the first coronavirus case was reported in India, the “epidemic of social media panic” took over: people began “panic buying”, emptying aisle after aisle of grocery stores, resulting in a dearth of essential supplies. Seeing posts of empty shops on social media created panic regarding food shortages. Inaccurate news of the virus transmitting through the air and lingering on different surfaces was plastered on news feeds, causing unhinged distress.
How Can India Address Mental Health Issues?
Now that we have established that mental health in India is a serious concern, it is important to layout solutions for how to improve mental health too. The most imperative actions required are to generate mental health awareness in India and promote mental health for all. Training community health workers or frontline workers, especially in rural areas, has been significantly beneficial in the case of diagnosing and treating physical illnesses.
In a country where over 30 million people are unemployed, it is quite possible to train individuals who are available to provide health care for the mentally ill. The rare number of mental health specialists could be dedicated to training and mobilising a huge number of people. The cost of this would prove to save a vast number of lives.
One such model in existence is ASHA (accredited social health activists). ASHA is a group of high school-educated village women trained as community health workers. Community-focused and community-driven models like these need to be scaled up to ensure that the needy receive adequate support.
Relying on the phone screens and virtual world has led to the rise of modern age mental health issues. In our hyper-connected times, we lack the human touch and support that sometimes is essential to help us through a tough phase. Thus, apart from the stakeholders generating awareness, people should also exercise control over the time they spend online, especially on social media. Yoga, meditation, physical exercise, and a healthy work-life balance are quite helpful to keep mental health issues in check.
Lastly, working together to tackle the stigma around mental health is a much-needed step in India. Considering the sensitive yet prevalent nature of the illnesses, stakeholders like healthcare providers, government, civil society, media, etc. must all come together to devise solutions that are suited to the Indian context. Considering the central role of the immediate kin community and joint-family-based households for the majority of Indians, it becomes essential to focus on community-driven solutions. These communities should be inclusive and safe for individuals with anxiety.
Thus, a community of care and well-being can help India address the flood of mental illnesses that sweeps across its streets and towns.
Check out how this organisation is working with government schools across Delhi-NCR to help children become emotionally stronger at https://ulaunch.in/2020/07/11/minds-at-play/.
Article by Vihita Nevatia, Team ulaunch.