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The Assumption About How Mental Health Issues Originate Creates Further Inequality

Posted by Sudhamshu Mitra in Mental Health
June 22, 2017

Trauma is a structure, not a feeling,” says Alok Vaid-Menon, a gender non-conforming artist. These words have been echoing in my head for a while.

It is time we put a magnifying lens on those words and understand what they actually mean. After having experienced depression and loneliness, and having seen many of my peers going through varied mental health issues, I have witnessed a trend. The trend is that mental health issues are assumed to originate within the minds of the individuals. It is that mental health issues are seen as abnormalities of the general order of the society. They aren’t viewed as manifestations of the general disorder that are present in our society.

I have seen this assumption in my peers, in my family members, in the media, in policies, in organisations and even in myself. The notion is that something is wrong in my mind because I am seeking a therapist. This notion extends to the idea that the solution to my mental health issues lies within me alone, that is within the individual.

Neurosis, is then something we all share; it is universal,” says Ernest Becker in his book “Denial of Death”. All of us are products of the society that we live in. The form of the society that we live in and grow up with impacts the way we think about the world and the way we interact with each other. Therefore, one needs to take a very close and nuanced view of the society in order to really understand what causes mental health issues and thus, the underlying neurosis in all of us.

The Impact of Neoliberalism

Firstly, the idea of neoliberalism has surely created an impact in the way we think about the world. “There is no such thing as society,” said by Margaret Thatcher, is the core of a neoliberal idea. Therefore, we need to look after ourselves. Self-help books, self-help groups, the terminology of self-help, coaching-centers, entrepreneurship, the emphasis on meditation and yoga classes for mental well-being, the American Dream where you can achieve anything with hard-work, precarious work conditions are all mainly because of the cultural project of neoliberalism. The emphasis is on the self and not on the idea of a community. This phenomenon has permeated into notions of mental health too. The individual is burdened with dealing and overcoming mental health issues, instead of the society taking collective responsibility. Organisations and corporations emphasise productivity of work over the mental health of the employee. Herein, also lies the stigma related to mental health issues. The individual blames himself or herself for having mental health issues. It is easier to blame the individual than to expect the government, society, corporates and other organisations to take collective responsibility. Taking collective responsibility would mean that one would have to see the inequalities that persist in our societies.

Inequalities Persist

Secondly, many reports- Sachar Committee Report, Mandal Commission, Swaminathan Commission Report, India Exclusion Report (2015, 2017) and studies on caste and mental health have time and again brought up the severe inequalities that are present in our society. Muslims, SCs, STs, come under the categories of having the lowest and worst indicators in health, education, employment, nutrition, housing, and access to these resources. These reports have also brought to light caste, gender and religious discrimination and biases that exist in our minds and translate into the ways we design policies and our interaction with individuals from marginalised backgrounds.

If one starts understanding the realities of transgender people, sex workers, gender non-conforming individuals, individuals with different sexualities, single/widowed women, people with disability, migrants and informal workers, one has to encounter the stark and dark realities of the society that we live in. How is it, that after all these years the varied indicators explained above are still low?

According to the World Health Organisation (WHO), mental health is defined as a state of well-being in which every individual realises his/her own potential and can cope with the normal stresses of life. The normal stresses of life can only be better coped with by having basic nutrition, health, education, and housing – which many are excluded from.

Mental health issues can never be looked at without understanding the structural aspects of the society that we live in, which is ridden with caste, gender, religion and region based inequalities.

This also means that the policies of the organisations we work in, work-culture, the relationships we build with individuals and with ourselves, and the parenting techniques that we employ play a vital role in creating a culture to nurture and improve mental health for all.

Lastly, the governmental policies play a key role in building institutions that can be relied upon. There has to be a clear-cut focus on implementing Mental Health Care Act 2017 and the National Mental Health Program(1982) throughout India. This should be in parallel to implementing the recommendations of all the reports mentioned above, which have been formulated through rigorous research and analysis. Also, initiatives that emphasise the idea of a community like that of neighbourhood groups of Kudambashree should be analysed and replicated based on social scenarios of different places. There is surely a lot to be done. The responsibility lies with all of us to work together.

Trauma is a structure, and not a feeling.” But, if we can reimagine and recreate structures, can we overcome trauma together? That’s a question we all need to deeply ponder on.

This article was first published here.