By Sidrah Naiyer
Published on March 7, 2017
World Health Organisation defines Mental Health as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. Thus, can there be health without mental health? Can there be human capital without building mental capital?
Most of the mental disorders begin during the early adulthood which is marked with a series of physical and psychological changes. 364 million people (30 %) aged 10-24 years and 231 million people (19 %) aged 15-24 years constitute the young population of India. The young will provide us the population dividend. If a large number of the youth feel unhappy, do not believe in themselves, worry excessively and are unable to address stress in everyday life would they succeed? There is a critical need to recognise, acknowledge and address the mental health needs of the young people.
What contributes to the mental health problems in the young? Our society provides a deselecting social context. The way we define success places an immense pressure on young people. Everything is conditional to performance from very early on in life. Perform to be selected to enter the educational system, perform to be valued in personal relationships and then perform to work. A young person in this deselecting environment becomes his worst critic. If she as a woman she is likely to have faced bullying, violence, poverty and lack of opportunities to make decisions. We, as a society, do not give time to the youth to acknowledge and respect themselves.
It is a fast paced world. Every experience is immediate. It is natural for people to feel overwhelmed by apprehension of losing out. The burden of obligations and responsibilities, income disparity, loss of private space, decreased job security, breakdown of joint families, etc. There is lack of stability and emotional support in life of young people who are faced with new challenges every day. Pressure to perform and excel, insecurity about one’s own self due to high competition, substance use, social media portrayals of friends, lack of meaningful relationships which have been replaced by digital ‘friends’ and ‘followers’ on social networks.
The young thus develop a permanent fear of failure or the dichotomous opposite arrogance of instant success. We expect the young to replicate trans-generational ideas of success which results in meaningless races instead of purposeful pursuits.
It is a shocking reality in our country that every 4 minutes a person commits suicide. One in four people need mental health services and about ninety percent of people in India do not have access to mental health support. In a study conducted in Chennai, it was found that 88% of people who committed suicide had diagnosable mental disorders but only 10% had seen a mental health professional (Vijaykumar, 2007). There are other evidences that suggest that chronic stress and adverse life events are also huge risk factors for suicide. Suicide is also associated with issues related to gender and relationships, social disadvantage, financial distress and substance use (Prasad et al, 2005).
It is imperative that we do not wait for people to develop mental illness or reach the brink and develop a system of universal mental health services to help people cope effectively with the stress. Few strategies may help strengthen mental health services.
Supporting families to be mental health friendly: The young in a family need to be understood and accepted while they search for their own identities. Families are a great resource which should be educated about ability centric appreciative parenting rather than directive judgmental environmental that exists today.
Reducing Stigma and Discrimination: By ensuring that mental health needs are as acknowledged as universal a society could challenge the stigma and discrimination faced by those who access and use mental health services. Mental Health concerns are not just concerns about health or availability of services but also about the taboo that mental illness carries because even the availability of resources may not be a motivation enough for our youth to seek help.
Integration of mental health with public health initiatives: We need to understand that mental health and physical health are both human rights. There has been parity in resource allocation for mental health interventions too. Mental Health Interventions need to be ‘communitized’ and be focused on preventive and promotive strategies rather than medical curative and custodial care.
Availability of Human Resources: Almost half of the mental disorders in people begin before the age of fourteen (WHO, 2014). We have a population of more than one billion and only 0.3 psychiatrist per 1,00,000 people. India needs a new cadre of mental health professionals who are available in the schools and universities.
Ensuring Right Based Approach: A strong legal framework which protects the rights of the people seeking help needs to be in place.
There is a dire need to strengthen the existing policies and programmes related to mental health. It is very crucial to address young people’s needs if they are to fulfil their potential and contribute fully to the development of the society. But it is not just the system that needs to work; we as people should come together and pledge to try to understand mental health. Let’s pledge to be be people who listen and not judge so that our loved ones can share their concerns with us.
(Sidrah Naiyer is an Associate Psychologist at Saarthak Mental Health Services, she is currently based in Delhi.)