By Ibasaralyne Thabah Synthiang
Inside a classroom filled with young adults if one pays close attention one would notice that there would be a student who would seem out of place, while the other students talk and laugh, playfully tease one another. There is often a loner in the midst of a vibrant group who sits right at the very last row and seems least interested. Even though the other classmates would try to involve the young person in conversation, this ‘person’ would mumble something or not bother at all. This ‘person’ would often have low attendance and upon questioning he would say that it is due to inability to sleep, not getting along with the classmates, relationship problems, stress and the list goes on. Very few reasons are due to physical health.Such cases are not mere symptoms to be forgotten but are often signs of a larger mental health issue.
During a programme held with a community in East Khasi Hills District, a young woman from the community attended the programme as a keen observer but started having seizures. There was commotion and people surrounded her just to get a glimpse at her discomfiture but not knowing what to do to help. Then someone shouted “oh kaioh ksuid, leit wad ia ki bahaing” (she is possessed, go find her relatives).The distressing part is that whether it is inside a classroom or in a community, these are not isolated cases and because we are not aware of how to provide help, they often go unnoticed and untreated until sometimes it is too late.
The mental health scene is not encouraging. Studies from NIMHANS have revealed that the most prevalent problems are Depressive Episode & Recurrent Depressive Disorder (2.6%), Agoraphobia (2.3%), Intellectual Disability (1.7%), Autism Spectrum Disorder (1.6%), Phobic anxiety disorder (1.3%) and Psychotic disorder (1.3%). The fact is that prevalence of mental disorders is greatest among younger people aged 16-24 years than at any other stage of the lifespan, although they are often first detected later in life. Nearly 9.8 million young Indians aged between 13-17 years are in need of active intervention.
The Meghalaya Police data showed that in 2016 there were 166 suicide deaths in the state out of which, 54 males belonged to the age group between 14-30 years and 24 females in the age group of 14-30 years. People take the last step of ending their lives because more often than not, there is no one to turn to for help. Now was the family able to give help. In fact most families with a member suffering from mental health problems live in denial and are reluctant to seek help. A recent study of young people aged 15 – 24 years in the state of Himachal Pradesh revealed that adolescents suffered from a wide range of mental health conditions one being suicidal ideation (5.5%).The reasons often cited for suicide ranges from family problems, failure in examinations, drug abuse/alcohol abuse, a love affair gone wrong and in some cases the causes were not known.
Since various mental health conditions can affect anyone at any time, no group can escape the vulnerability to mental disorders. The risk is higher among those of low socio economic backgrounds, the unemployed, victims of violence, indigenous populations, children and adolescents. Moreover, parental mental disorders or substance abuse, discord and marital violence and breakdown also contribute to children being vulnerable to mental health issues. Battered women were found to have more depressive symptoms than other women, being the target of violence puts women at increased risk of depression, suicide attempts, psychosomatic disorders and physical injury. Mental health conditions was also recognized as occurring commonly among older people as well, and as having an important impact on their quality of life, and on the lives of their family members.
Institutions providing mental health care and services are limited. Most of the mental health services available are concentrated in Shillong. In rural areas, mental health services are almost absent although there are psychiatrists posted in few district hospitals. Mental health camps conducted by organizations such as SANKER or Bethany Society do provide some mental health care in rural areas. The gap between the need of mental health care and services and their availability is very large. Research in the field of mental health especially pertaining to the state is also limited. There are a few strides that institutions have taken. For instance, the Martin Luther Christian University has a project to develop a community mental health programme in rural Meghalaya using the community based participatory approach. The aim is to enhance the capacity of the local people to manage mental illnesses using local resources and to refer to appropriate mental health providers whenever necessary. What was learnt through the experiences with the project is that there is a stigma attached to mental illness. People shy away from availing mental health services because of the fear of being labelled ‘mad’.
Mental Health awareness and education are important components. It is only when we are aware about the importance of mental health that we will we be able to influence others positively. This can start with the inclusion of Mental Health education in the curriculum of schools, colleges and universities. As mental health is an important component of the Social Work curriculum students taking this subject have become more sensitive to mental health issue. Since they have clarity about this condition they do not mind sharing their experiences such as situations that causes them stress and give real life examples to connect mental health conditions they have identified in their very own lives. Can educational institutions Mental Health in their curriculum to shed light on common mental illnesses and also hold workshops inviting experts to speak on the subject? The good news is that sensitized students are trying to intervene; with a few even utilising a simple CAGE questionnaire, the name of which is an acronym of its four questions to screen the prevalence of alcohol use among their fellow mates with the intention of helping those that might need help.
As professionals and as teachers especially we need to be observant, to listen without being judgmental and refer individuals with mental health conditions to seek professional help whenever required, making them understand that seeking professional help if they cannot cope is like visiting a doctor for physical ailments where there is no shame or and no negative connotation. Promotion of mental health education is vital; the more we talk about something, the more we are aware, and the less we fear.
There is a need to prioritise the Mental Health scene in the state with emphasis on preventive initiatives rather than just the curative aspect. Our emphasis is usually more on the physical aspect of health, forgetting the other two components which are our mental and social wellbeing.We have to start focusing on Mental Health because the three components of health are closely interwoven and each are essential fibres of life and interdependent; one will not do without the other.
The need for a Mental Health Policy for the state is crucial and the policy should emphasize on young people, their families and the cultural context. Speaking out about focused interventions on Mental Health is the need of the hour. One sees this happening already with various institutions which are educating young minds on the subject. Today research relating to Mental Health is being conducted and experts are speaking about the importance of Mental Health.
Can we start then by simply getting involved? We can do our part by not discriminating against persons with mental health conditions, we can start by not using belittling statements about ourselves like “I am mad or crazy”, “I’m OCD”, “You are a Psycho” and the like. We can be advocates for mental health in our own ways. As stated earlier we should not be ashamed of seeking professional help if required. Also we can identify and refer others to seek such help and/or lend a listening ear to those who may be going through a tough phase in life or to care-givers of mentally ill persons. Dr R.Srinivasa Murthy, renowned Psychiatrist, NIMHANS opined, “Everyone could help and contribute to mental health by thinking out of the box and building from available resources.”
(The writer teaches in the Department of Social Work, MLCU)