Globally, India is probably best known for having the fastest growing market in the whole world. But there is a dark side to that glory. Cultural shifts and pressure from the corporate world stemming from the country’s liberalisation of markets in the 1990s is bringing India to a tipping point, as it is currently the most depressed country in the world.
Most Indians and members of the South Asian diaspora are aware of the stigma that mental health issues hold in our communities. This stigma can be reflected in the gap between the number of Indians who are in need of help and the overall lack of professionals that are available throughout the subcontinent. According to a reply by the Ministry of Health and Family Welfare in the Lok Sabha in December 2015, there are just 3,800 psychiatrists, 898 clinical psychologists, 850 psychiatric social workers and 1,500 psychiatric nurses across the entire nation.
With all of these complex and intersecting factors at play, I wanted to sit down with a professional in the field to talk about the intricate causes of current issues surrounding mental health and the influence of social stigma on the desire for individuals and families to seek treatment.
Radhika Samaradivakera has a Master’s degree in Social Work from Columbia University and is currently working as a Program Officer for the Azad Foundation in Kolkata. She has extensive experience of counselling patients on an individual basis and answered some questions for Youth Ki Awaaz about the present and future of India’s relationship with its mental health.
Priyanka Pardasani (PP): When it comes to the stigma of counselling or getting help, do you notice similarities between the South Asian diaspora and communities in India?
Radhika Samaradivakera (RS): I wouldn’t say they’re absolutely different, there are a lot of similarities when it comes to stigma. Because even South Asians in the US see it as a stigma. I’ve seen that amongst South Asians in the US, but I also feel like they’re much more open since they’ve been living there for some time now. Because they see other people going for counselling sessions, they’re kind of used to it. They realize that people over here go to these things and it’s not something that will make you look like you’re crazy or weird. That’s why I guess over there (in the United States), South Asians may be a little less conscious about counselling. Over here (in India) it’s changing, but it’s still really stigmatized. Just today, in our [annual] review, my colleague’s other program officer was saying how she doesn’t use the word ‘counselling’ because as soon as she asks people if they want to sit for the monthly counselling session they say, “No, no I don’t need that.”
PP: Do you feel like the liberalization of India has affected the mental health of the country overall?
RS: Since the ’90s, the IT sector has grown and they recruit so many people every year. Everyone is glued to their computers and working more than eight hours a day. The increase in industrialization and in the IT sector, along with so many other sectors since the ’90s, has been moving India towards development, increasing its GDP. These things do affect people’s mental health. Your life becomes faster, you work, slog, eat, watch TV and go to sleep. It’s like a scheduled life. And in India, the culture is that you should work hard, and only then you will do well in life. People really believe in that.
PP: Do you think adapting to this new work culture and the mentality of keeping up with the ‘in’ purchasing trends is causing a lot of mental health issues among Indians?
RS: India is also following the whole consumerism economy of the United States. The attitude is that “if this person has this phone, then I need to have that phone too.” People just keep buying and buying and buying. And yes, because the economy is doing well, people’s salaries are increasing and that’s why they feel like can buy more. My father’s generation was like, ‘let’s save’, and that money can be used somewhere.
Currently, hanging out at malls is a really fashionable thing over here, so if you hang out in the mall and you see people buying things you’ll automatically start buying as well. Starbucks in Kolkata opened up a few days ago, everyone went crazy. There’s a big correlation between a consumer society and the mental health of that society because people keep buying and go into debt, and they don’t save, which ultimately causes stress.
PP: Do you see the stigma surrounding mental health as a purely cultural issue, political issue, or religious issue?
RS: I would mainly put this issue under culture and make it about education. In high school, you do have the option of taking psychology, but there should be more awareness about what mental issues and problems really are, not just theoretical study. I think more awareness is required, and I feel like there are many organizations who do work on that. They put up seminars and talk about what mental health problems really are, but I feel like it should be more in number, they should reach out to more people.
PP: Do you think that if mental health care was more accepted in the mainstream then more people would seek the help that they need?
RS: The more it becomes mainstream, the lesser people will feel conflicted about it. They might think, “He’s doing it, she’s doing it, so I can also go for it.” Mental health problems in India are seen as a very big deal. People don’t understand that you can mentally fall ill the same way you fall ill physically. As soon as it’s something mental, it’s different. If someone is depressed and lying down in bed, people will just pat their back and say, “Get out and do something!”, “What do you mean by depression? You’ve got all the money, you’ve got everything, so why are you so depressed?” People don’t try to understand that it’s not that easy.
PP: Where do you see the most acceptance for counselling among the Indian community?
RS: In more educated families, people are opening up to it. I was approached by one of my mom’s friends, she asked me if I knew of any place to go to because she thought her son had ADHD. She didn’t see counselling as something negative and told me, “I want every kind of help I can give to my son, and many people don’t understand that but I’m willing to take him to a counsellor or a psychologist.” There are people who have accepted it and don’t see it as a bad thing, but that’s and a very small number.
PP: What does the future of mental health treatment look like in India? Do you see more non-profits and NGO’s opening up? How do you see it working in terms of structure and organization?
RS: Already there are a few agencies that provide mental health counselling sessions, there are also individual psychologists and therapists. When I was in school, there was usually a counsellor who would come to school and talk to you. There will be more agencies opening up, I’m sure, that are focused on providing access to psychiatrists and psychotherapists. However, I only see these changes affecting the middle and upper-middle class, as most of the country is in poverty and so deep into traditional belief. Many people don’t really believe in mental health counselling sessions, they believe in a priest, they’ll ask for help from God. With India, population-wise there’s a long way to go to make mental health issues normal.
PP: Any last comments about depression and other mental health issues affecting Indians?
RS: Depression is also related to the economic and political status of the country. We have an overworked population and the world’s highest youth population. Mobility has increased, young people stay away from home and work in cities away from their parents, and life is becoming more lonely. Then there’s this pressure to work. Unfortunately, all of the people who are suffering mostly don’t come out because of stigma, patriarchy, and especially for men – because of ego.
This interview has been edited for brevity and clarity.