Since 1992, October 10 has come to be observed and celebrated as World Mental Health Day. It is primarily a day to educate, raise awareness, and eradicate stigma, although we need to do much more. Although the Mental Healthcare Act, 2017 was approved just a few months ago to rousing applause, most of the country’s institutions still have colonial and draconian practices where human rights and dignity are just words to be disregarded.
Indeed, even though India is a signatory to the UN CRPD (the UN’s Convention for the Rights of Persons with Disabilities), it continues to flout many of its articles, particularly when it comes to the capacity of persons with mental illness or living independently in the community, articles 12, 16 and 19.
Today, I will not speak of Erwadi where 28 inmates of a faith-based asylum who were chained to their beds died in a fire in 2001, charred to death. I will not speak of the many atrocities that continue to this day, under the guise of well-meaning doctors or familial caregivers. I will not mention Behrampur, where just last year, another psychiatric hospital had naked inmates eating off the floor.
Today, I want to write of mental distress being looked at differently. Can’t we see that mental distress is simply unease at living in a hostile world? Often a reaction to abuse or sexual trauma? Would it not be more abnormal to be subjected to trauma and not have a reaction? In most cases, mental distress can be looked upon as a temporary altered state, which given time, treatment, therapy and attention, will self-correct, like most illnesses do.
Treatment can include psychotherapy, arts-based therapy, faith healing, medication, yoga, bodywork, and more. Of course, the most powerful healing tool we have in our hands is to stop or get away from the situation causing distress, or to be able to change it somehow — so in the case of an abusive relationship, leave, or in case of stress at work, be able to be mindful about how much your body and mind can take, and make the requisite changes.
In India, unfortunately, as it is with most of the world, the lens with which we view mental illness (even the word illness denoting something is wrong) is the biomedical lens and only one view of “normal”. Who decides what is normal and what an aberration is? And what of the stigma once you are labelled? Everyone who has been through the system – and even those who have not – know that stigma can often be more damaging than the condition itself.
A more socially and politically accepted term which is now preferred by a lot of us working in the mental health advocacy space is ‘psychosocial disability’, which denotes the source of the pain. In addition, by taking mental distress out of the realm of “illness” and doctors, we are able to be more compassionate and have empathy, which again will cause less stigma.
Furthermore, the biomedical approach wants you to focus on the chemical imbalance in the brain and the use of psychopharmacology to address these. The use of SSRIs (selective serotonin reuptake inhibitors), which among them has the bestselling antidepressant, Prozac, although beneficial does not come without side effects, something that doctors and psychiatrists often fail to mention while prescribing.
For sure, just like when there is heart disease, liver disease or diseases of other parts of the body, there are changes in the brain. But any good doctor could first prescribe lifestyle changes, therapy, exercise, and then try more aggressive treatment, perhaps drugs. Just as you can get your cholesterol under check by changing your diet and exercise routine, so can you look at issues with the brain, using lifestyle changes to get better. But because of the politics of money and the power of Big Pharma, most doctors prescribe drugs as the first line of treatment. One of the possible solutions is more consumer awareness, more discussion about enabling choices, and changing the power equation, i.e., taking away the power of the white coat and the power of the psychiatrist.
In addition, a big misconception is the feeling people have that once they have a mental health condition, they can’t get better. This is perhaps a combination of looking at mental health treatment (the very word treatment implies medicine!) through the predominant biomedical model and the huge power imbalance when it comes to psychiatry. Asylums are a very colonial hangover and they continue to be run in silos. Even though the laws have changed on the outside, inside asylums – sorry, they prefer to be called psychiatric hospitals – archaic and draconian practices are still common. Patients are still shackled and nurses carry batons without being afraid to use them.
Become your own best source of information. Do not blindly believe what is told to you by doctors. And know that you have the power to choose. Take charge of your health, start with the body – use nutrition, exercise, massage, and start listening to the body. The mind will follow. And realise that poor mental health is poor health. Look at the entire body with the head as just one part, and work on it holistically.
To conclude, my message is simple. Just as physical health can affect anyone and no one is immune, mental health is for everyone. It affects us all, some more than others. It is when these changes or distress impacts your functioning that people start noticing something is wrong and may seek help. But be in physical or mental, the bottom line is health. And distress in either will cause illness and disease (dis-ease).
Take charge of your health, use common sense and lifestyle modifications to start, become more aware of your choices. This World Mental Health Day, I urge you to become more aware of mental illness, of the rising numbers, of the frightening fact that it is closer to you than you realise. Stop judging people because of their labels. And embrace all shades of “normal”.
We have also come together with Suchita Bhhatia, a Mumbai based filmmaker to help create some short films which will bring awareness to this cause, to let you see how mental health issues are invisible illnesses, just because they do not seem visible like a broken leg, it does not mean they affect the person less. These films also aim to show you how mental health issues do not discriminate and how everyone is at risk. These films came about when a member of Suchita’s family was diagnosed with a mental health issue. She says that the event defined our lives and turned it upside down. The links to these films is here although we are in the process of creating a walk-in exhibition soon.
Disclaimer: The author does not discount serious mental health conditions like schizophrenia, bipolar disorder, and others but urges you to look at another way to see how they originated. By looking at their source, addressing trauma, there could be other ways of healing that are more holistic and permanent.
Jhilmil Breckenridge is a poet, writer and the Founder of Bhor Foundation, a mental health charity which is involved in advocacy, working against stigma and using poetry as therapy.