Anjana Hareesh’s Death Reveals a Crisis in Mental Healthcare in India

On May 16, 2020, the news broke that Anjana Hareesh, also known as Chinnu Sulfikar, had died by suicide. A 21-year-old student from Kerala, Anjana was bisexual. In a recent Facebook Live, she had spoken about how her family allegedly tortured her because of her sexual orientation.

In the months prior to her death, Anjana said she was beaten and locked up in her natal household, taken to ‘de-addiction centres’ without her consent, and put on heavy medications in order to ‘cure’ her – all of which wreaked havoc on her mind and body.

Eventually, Anjana managed to escape with her friends, and got in touch with Sahayatrika, a human rights organisation that supports LGBTQIA+ persons who have been assigned female at birth. As Sahayatrika tried to find enough support to secure Anjana’s life away from her family, they had to deal with many hostile and unsupportive institutions in the process.

A few days later, Anjana died by suicide.

This story is not new – we have seen so many of us die as a result of the implicit ways in which life is made unbearable for us. Natal families shroud their violence in the name of care, love, disappointment and honour. Schools feed gender non-conforming students dysphoria when we are forced to wear uniforms that don’t match our chosen gender. Offices and workspaces find reasons to not offer you a job or fire you if your sexual orientation and/or gender nonconformity is discovered.

Also read: Standing ‘Bi’ the Sidelines: On Not Feeling ‘Queer Enough’ 

The existence of social stigma and ridicule is phenomenal in its sheer magnitude: it persists in homophobic WhatsApp forwards, and in casually calling someone “chhakka”. Everywhere we go, we get to hear the deeply patronising statement: “You are not normal.”

As a result, members of the LGBTQIA+ community often find themselves crossing paths with mental health and medical professionals, who are considered to be the pallbearers of “curing abnormality”. It is no secret that homosexuality was considered an illness until 1973, and gender dysphoria continues to be an illness today. When we arrive at the doorsteps of a doctor’s clinic, a hospital ward, or a psychotherapist’s office, we are often met with hostility and unkindness.

In spaces where people are expected to be vulnerable with their minds and bodies, we are repeatedly looked at as people to be diagnosed and treated, as people with an illness. In India’s context, with unregulated and untrained mental health workers, and the heavy weight of societal stigma, Anjana’s case is the norm.

As someone who trained in mental health, but eventually chose a different path, I find myself reflecting once again on why I chose to quit the field in light of Anjana’s death.

I pursued my bachelors in Psychology from Delhi University, and followed that with an MA in Psychology from Ambedkar University. During this time, I interned and worked at hospitals and NGOs offering subsidised mental health services. I familiarised myself with diagnosis and started learning different models of helping patients. I also learned how deeply gendered the diagnosis was — men and women coming in with the same symptoms would routinely be diagnosed with different illnesses more fitting to gender stereotypes.

Further, an overworked and underfunded system (India has one psychologist per 2 lakh people) meant that most mental health professionals could not afford more than five minutes on a patient. Many psychologists who worked in private hospitals or ran their own practices often focused on charging high fees or prolonging treatment, just as their professional cousins in medicine do. All of this means that patients are rarely seen as human beings in these institutional settings, and resoundingly so.

However, none of these were reasons for my exit from this field. These are formidable challenges facing mental health work in India today, but they are all problems which could have solutions, should we choose to invest in and implement them. For me, the biggest problem with mental health’s curative model is that we choose, repeatedly, to see a problem born in a social setting as an abnormality that is inherent to the person.

Also read: My (Now Ex) Boyfriend Told Me He’s Bisexual – Here’s Why He Should Wear It With Pride

When women come to the clinic and we diagnose them with depression, we are unable to see how this is caused by the weight of fulfilling gender roles that curb her desire for freedom. When men are maladjusted in their relationships, we fail to identify the root cause as being constantly told that “boys don’t cry”. When LGBTQIA+ persons talk about anxiety and suicidal thoughts, we refuse to focus on the years of stigma they continue to endure. Instead of seeing their survival as strength in a world that seeks to kill them, a therapist’s mind reinforces their abnormality. This puts pressure on the patients in the clinic to improve themselves, to move into hope, to rectify their patterns of negative thought. But the problem, more often than not, lies outside.

In my years of training in mental health, I learned that what needs to be diagnosed is society, not the individual. I still remember the day I decided to quit. I sat in a small white office when the phone rang. On the other side was a gentleman in his 60s, calling to say that reading the news each morning depresses him. I followed protocol and ran a checklist of symptoms, but I did not have any model of cure.

Soon afterwards, a young man in his 20s called, wanting to see someone because he wanted to commit suicide for the third time for being gay.

He survives today, but Anjana does not.

iCall is a telephone and email based counselling service run by School of Human Ecology, Tata Institute of Social Sciences, that offers free telephone and email-based counselling services, to individuals in emotional and psychological distress, across age, language, gender, sexual orientation and issues, through a team of qualified and trained mental health professionals. You can call them on 022-25521111, available Monday to Saturday 8 am to 10 pm.

Shraddha Chatterjee is a doctoral candidate at York University. Her preferred pronouns are she, her, they or them.

Featured image credit: Twitter