When Radha’s* 13-year-old daughter was struggling with bouts of sadness and body image issues, she decided to consult a senior psychiatrist in Chennai. During the session, the psychiatrist instructed her to be firm with her daughter.
“But her valid advice about not pampering children was interspersed with sexist remarks,” says Radha. “The psychiatrist kept saying ‘Will her husband tolerate such behaviour?’ and ‘What will she do when she goes to her in-laws’ house?’”
She recalls, “I weakly protested, saying that my daughter should be helped irrespective of her future marital situation.”
Radha’s story takes me back a few years to my own session with a psychiatrist in New Delhi. To help fight my depression, one of the ‘positive encouragements’ I was given was, “You have to get married one day.” I balked. Even at my most vulnerable, I was being held to a heteronormative standard, completely negating my identity as a queer woman.
As it turns out, this ‘standard’ – of women moving on, getting married to a husband, and whatever else is supposed to follow – is a goal many mental health practitioners assign to women who come to them.
Kamala*, a senior resident in medicine now based in New Delhi, talks about a similar experience while seeing a therapist in Kerala: “It was soon after my parents’ marriage fell apart. He insisted on meeting my mom, my sibling, and me together, as well as separately. When I mentioned that I don’t wish to have children, he chastised me, saying I should have children so as to show my sibling how a family can be a good space.”
Unsurprisingly, she felt burdened by the suggestion. For women seeking a safe, non-judgmental space away from patriarchy’s prying eyes, encountering a practitioner with a deep gender bias can be a rude shock.
This treatment isn’t just about having pre-conceived notions about roles women are supposed to stick with as wives and mothers (sometimes against their will!). It’s also about an unquestioned acceptance of the existing power systems.
23-year-old Delhi University student Ishani* said she became aware of this happening in 2014, when she first began accessing mental health care. She had been going to an older male psychiatrist, whom she describes as “always sweet, but also quite patronising”.
“My relationship with my dad was at an all-time slump. I tried to talk about how patriarchal my dad can be, and the psychiatrist was super dismissive. He would say ‘Arrey, beta, he’s your father. You should listen to him, no? He wants the best for you!’”
Commenting on the incident, she says, “I know my dad wants the best for me, but that doesn’t excuse his sexist microaggressions!”
Since then, Ishani has shifted to another practitioner, who happens to be a woman: “She is quite progressive and supportive, and I’m more comfortable talking to her. I guess gender does have a role to play here.”
This is not to say that things are gloom and doom. In fact, there is no doubt that they are indeed better. Today, calling a woman “hysterical” and slapping her in irons is no longer standard medical protocol. We’re progressed to looking more seriously at pre-menstrual dysphoric syndrome, and pregnancy and post-partum-related depression – all pertinent to the health of cisgender women, as well as many trans and non-binary folks.
The World Health Organization has found that “the burden of depression is 50% higher for females than males”, and that more women than men are living with anxiety disorders.
We also know that sociological factors, like the gender power paradigm, do play a huge role in this. A 2015 study by American researchers shows how sexual objectification and the threat of gender violence impacts a woman’s mental health. But facing sexism right there at the therapist’s office only hinders the recovery process.
According to Ipsa James, a Delhi-based clinical psychologist, these shortcomings are systemic. It begins with how future mental health professionals are groomed. She says that – with the exception of NIMHANS (Bangalore) and TISS (Mumbai) – there aren’t enough quality colleges, and those that do exist are reluctant to have psychology students talk about sex, leave alone gender.
James also highlights several structural problems in the field. “Most hospitals focus on psychiatric issues, not the psychological ones.” She also adds that brain-drain poses yet another problem. “Certified psychologists who have studied abroad do not have the license to practice in India.”
All of this considered, snafus in the therapist’s office are then inevitable. Sensitivity is severely missing, and not just about gender. Few practitioners, if any, are LGBTQ-friendly. And sometimes you come across truly bizarre instances.
When 26-year-old Vedika* accompanied her boyfriend to therapy, the practitioner’s behaviour lacked the kind of finesse one might expect. “In the middle of the conversation she handed him Rs. 100 rupees to get a cold drink. As he left, she asked me if he troubles me. I was stunned.”
This practitioner was one of the most well-rated mental health professionals in Mumbai, but Vedika recalls the equally strange way in which the session ended: “She advised me to follow the path of Ganesha. And when she noticed my boyfriend was Catholic, she said ‘You can follow Jesus also.’”
Truly, things like these do not inspire much faith (pun unintended).
But access to good mental health care services should be and are any person’s right. In fact, this is precisely what the Mental Health Care Bill (2016) pushes for.
James shares her thoughts on what ought to be done to change things: “The government should make it mandatory for colleges to have sensitivity workshops.”
She also comments on how interest among practitioners seems to be low. “I attended a sensitivity training workshop for psychologists in Delhi last year, and so few people came.” And this simply has to change.
Just last year, Richard Brouillette made a very important case for why therapists should talk politics. In short, it’s because politics has a direct impact on the mental well-being of a person. So too, is it with gender discrimination.
It’s time that mental health practitioners became more understanding about their patients and how living in an oppressive system actually contributes to their psychological distress.
Over 56 million Indians are living with depression. It doesn’t do for anyone to feel discouraged from accessing mental health care. Our healthcare professionals need to be sensitive and considerate, and truly create a safe, non-judgmental, and understanding environment for their patients. And if addressing sexism at the therapist’s office is a step in this direction, then it’s a step we should be taking.
It’s time to break the silence around mental health, and talk openly about our health care needs. For more stories, follow #LetsTalk on Facebook and Twitter, and add your own.