In our society, mental health continues to be a ‘hush-hush’ affair that shouldn’t be talked about, lest the neighbours hear about it – “it’s all in your head anyway, so really, if you could please stop thinking about it, it’ll be fine soon enough, right?”
Well, as the mental health crisis amidst the raging COVID-19 pandemic has shown us over the past few months, it really won’t just be fine.
The World Health Organization, National Health Service and American Psychiatric Association have repeatedly pointed out that the pandemic has been a harbinger of a marked surge in the levels of stress, anxiety, depression, insomnia and fear. Social media, with post-after-post with requests for oxygen cylinders, and heartbreaking stories of patients and overworked healthcare workers, unsettle our mental space. Television media outlets, with their barrage of red, flashy, sensational headlines, are outright panic inducing.
Research work is replete with studies from around the world indicating that the pandemic has seen an increase in the rate of suicides, and that pandemic-related stress may increase susceptibility to developing various mental disorders. And when we are not panicked, paranoid, or afraid, we seem to be frozen in a state of stagnation, lack of motivation, emptiness, and simply a lack of wellbeing. As Adam Grant, psychologist at Wharton, recently described in the New York Times, this “state of blah” is called ‘languishing’. As we remain within our concrete confines, attending meeting after meeting, class after class, unmoving, isolated – days stretch into weeks, weeks stretch into months, and languishing, with its many implications for poor mental health outcomes, might just be what we’re feeling.
While the pandemic has undoubtedly increased the range and prevalence of mental health concerns in the country, the need for mental healthcare in India was already immense, even during the pre-pandemic times. As per India’s first (and only) National Mental Health Survey conducted in 2016, nearly 14 crore adults and 98 lakh children could be diagnosed with mental illnesses and needed treatment. Yet, the mental health infrastructure in the country, to put it mildly, is rudimentary.
India has a severe shortage of mental health professionals, and needs an additional 30,000 psychiatrists, 37,000 psychiatric nurses, 38,000 psychiatric social workers and 38,000 clinical psychologists to scale up to the global averages. We simply lack the educational infrastructure that is required to generate such a high number of trained professionals. The country has a meagre 285 seats for an MPhil in Clinical Psychology (the minimum qualification for to practice), and 700 seats for an MD in Psychiatry, laying the ground for the dearth in trained specialties. To make matters worse, mental healthcare infrastructure is apparently a bipartisan low priority.
The budget that we allocate to mental health every year is truly abysmal. The regulatory bodies and legislature for overseeing the state of the mental healthcare are beyond lax.
So, what happens when there is a clear need for mental healthcare services and no trained professionals available? Precisely what we have seen crop up in the past few months – a vortex of treatments that lack any scientific evidence to back them, google-made-experts with no qualifications, absolutely no accountability, and ample room for harm and exploitation.
It takes seven long, hard years of training and practice to be able to treat mental health conditions as psychiatrists or clinical psychologists – but today we have social media influencers healing with ‘deep listening’, life coaches and handwriting analysis specialists, teenagers holding anonymous ‘therapeutic’ sessions, and those who claim they can make depression go away with herbal teas. When any of these numerous quack solutions are called out, there are no repercussions at all – no malpractice suits, no fines or jail time – mostly because we lack laws or governing bodies in this regard.
Clearly, there is a looming hopelessness to the situation with a pertinent need for urgent and radical change both structurally and socially. I still do see a silver lining to what the pandemic has brought to the forefront, however. More people today are talking about the importance of mental health than ever before. Awareness and advocacy are on a slow but uphill climb. Mental health professionals have found platforms where they can reach out to those in need. There is new sprung dialogue about increasing the accessibility of mental healthcare across community and socioeconomic lines, with many practitioners and organisations providing care free-of-cost during the pandemic. There has been a spike in the number of functional crisis helplines in the country.
In essence, the much needed, long delayed conversation about mental healthcare in India has finally gained amplitude, and it is contingent on us – mental health professionals, legislators, educators, media, and simply every citizen – to ensure that it manifests in tangible change in the years that follow.
Preeti Kodancha is a post-graduate student of Clinical Psychology with an intersectional, community perspective to mental health and mental health policy.