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Had A Judgmental Experience At Therapy? Tell Us About It

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By Sadaf Vidha and Prateek Sharma:

A recently developed survey is out to record people’s experiences with bigoted and unethical mental health professionals.

At a time when we can write the longest review for the purchase of a hairpin, there exists the dark and vague world of unmonitored mental health care.

A newly established Mental Health Care Act suggests the briefest idea of what we call a people-centric approach, but the sector still remains highly unregulated from different perspectives. One such perspective involves professionalism, ethics and the progressive outlook mental health professionals are genuinely expected to have. This issue has been spoken of very rarely in India but is now gaining the attention it needs.

Keeping this in focus, we have developed a survey that intends to collect the experiences of people who have undergone therapy or any mental health treatment in order to determine the prevalence of social discrimination and unethical qualities in practitioners.

How Social Discrimination Is Active In Mental Healthcare

As those working in the field of mental health, we are aware that ethical issues are rampant, but as feminists, we have also realised that a spectrum of attitudes directed towards gender, sexuality and lifestyle choices do not get recognized, at times even by the person experiencing it.

Sexist “advice”: “You’re 31, you should be married and settled. Living like this is what causes the anxiety.

Women have been hearing these phrases for the longest time, but coming from a therapist, its effect drives a deeper conflict. Sexism and misogyny have no place in therapy, and statements polluted by them can have a wider scope ranging from marital status and blaming “non-traditional” relationships to slut shaming and fat shaming.

Colluding with family members: This happens when the professional, without any independent analysis of their own, just takes the word of family members to be correct. This has been used quite often in the past to dump men and women that the family did not want to care for. One big problem was men taking the help of psychiatrists to label their wives as “insane” for divorce proceedings. Sometimes, instances of abuse coming from the family are also protected by professionals for the sake of sanctity.

Homo/transphobia: While ventures offering ‘conversion therapies’ have reduced in the community, general homophobia and transphobia continue to prevail and the LGBTQ+ community is on the receiving end. Because India is not a country friendly enough for a person to comprehend their sexuality, it is accompanied by stress, for which people often seek help. As soon as the trust is shattered by a remark that indirectly points a finger at someone’s orientation or persona, what was once known as help turns into hatred.

Gender roles imposition: There is very little awareness about how ‘giving advice’ has no place in therapy, since the person seeking therapy needs to regain the ability to make decisions that are productive for them. When gender norms and societal roles become a part of therapy, they tend to do more harm than we think. “What an ideal wife/husband/mother/father/child SHOULD do” always collaborates with personal and traditional beliefs.

Common Unethical Features Of Practice

Lack of structure and transparency: There is no clarity given in the number of sessions/visits required. Often, the medication, its effects, and side-effects are not a part of informed consent. There are times when psychiatrists don’t speak of more affordable versions of these medications, which later becomes a huge problem for the patient. Therapy and medication go hand in hand but sometimes psychiatrists often leave out non-medical interventions like psycho-social rehabilitation, which actually has a vital role in healing.

Medical malpractice: Much has been written on the institutional problems surrounding mental health. This includes bad conditions of mental health institutions, patients kept in an unclean way without much activity, wrong diagnoses, forceful Electroconvulsive Therapies (ECTs), patient deaths, forceful admission and medication, ECTs without anaesthesia, or ECTs when not required and so on.

God complex in practitioners: As much as a therapist (or the client) is free to have any religious beliefs, their imposition has no place in the work therapists do. The ‘former Vastu consultant’, the ‘chakra healer’, are some of the examples you must have come across.For something that is scientific and human at the same time, the imposition of such beliefs without caring much about the worldview or specific experiences of the client causes major problems.

Lack of therapeutic skills: Some basic skills are required when in a therapeutic relationship with someone undergoing mental health issues. These include critical thinking, trustworthiness, reflective listening, respecting the client’s anatomy and having the client’s best interests at heart. This also implies working on your own issues so that they don’t get transferred to the client.

There could be numerous reasons as to why these anomalies exist in the first place. Be it the lack of awareness, a licensing body or an ethics committee, the notion remains that they do exist and need to be addressed. To do that we would like to hear from you.

How Does The Survey Work?

The survey takes an in-depth look into people’s experience with mental health care, examining different aspects of ethics and determining the existence of judgmental behaviour based on how discrimination and bigotry against minorities operate in India. Being detailed in approach, it also prioritises ease of use for the respondent in terms of filling in, and prioritises the experiences of gender and sexual minorities.

Domains like gender-based discrimination, sexuality, confidentiality, listening skills, attitude towards suicide, abuse and irrational areas like trivialisation of someone’s misery are extensively covered in the form.

Towards the end, it asks the respondent (with negative experiences) to articulate their experience(s) in a few words, since narration has always been a helpful source of qualitative data.

The survey form is designed in a way that positive experiences can be recorded as well. We believe that it is equally important to bring to light the existence of a progressive and ethical mental healthcare practice.

The analytics that went behind building the questionnaire enables the person to avoid questions that do not resonate with the kind of experience they had, and at the same time point out what qualities they liked or did not like in the professional they visited.

Research has always been a productive approach towards making important decisions for both society and one’s own life. By doing this, we are not only attempting to help people be more informed about progressive mental health care, but also to highlight a sensitive concern that the society remains unaware of.

You can reach the survey via www.therapypal.in or clicking here.

The collected data will be analysed and the results will be published as a paper.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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