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Post-COVID India Might Face A Mental Health Crisis: How Prepared Are We?

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This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

“People think that those who commit suicide are against life — they are not.
They are too lusty for life, they have a great lust for life;
And because life is not fulfilling their lust,
In anger, in despair, they destroy themselves.”

– Osho

The tormenting death of the famous Bollywood heartthrob Sushant Singh Rajput, along with nearly 300 unnamed suicide cases amidst the corona pandemic, clearly justifies India’s title of “the most depressed country in the world”, according to the WHO. This nationwide lockdown has unveiled the fatal socio-economic impact on the COVID-19 survivors, frontline medical workers, youth, differently-abled people, womxn, queer people, workers in the unorganised sector, and the aged population, who have to comprise with an ultra “high-risk” vulnerability to mental health.

But is the intentional killing of our aspirations, love, happiness and future by our own hands the only solution? How hard it is to ward off suicidal thoughts? Why should we allow the prison of our own silence to strangle our identity and the beautiful creation of our existence? How Herculean is it to seek timely intervention — tender support or a warm hug?

A renowned Hyderabad-based psychiatrist Dr. Gopala Sarma Poduri  tried to estimate the short-term as well as long-term economic cost of a suicide death for the Indian Journal of Psychological Medicine. He calculated that in the first year alone, each death costs Rs 2,65,000, which includes the immediate price of hospital expense, autopsy charges, police investigation and funeral expense.

This excludes the immense human sorrow, which definitely costs more than an arm and a leg. The long-term economic dimension included in it is the lost income that could have been earned by the person till their retirement, the tax that the government lost from that income, and many other things.

One of the prime reasons pushing India to the brim of a mental health crisis is the abysmal budget allocation for mental health and its operationalisation. In 2019, out of a gargantuan healthcare budget of Rs 62,398 crores, the allocation of funds for the National Mental Health Programme saw a decline from Rs 50 crores to Rs 40 crores.

Despite unbridled hue and cry made by health warriors, the situation in the 2020 budget didn’t improve. Budget 2020 has not increased a single penny for the NMHP, even though the total healthcare budget saw a 7% increase. This means that India invested only 0.05% of its health budget on the NMHP.

One cannot ignore the huge paucity of appropriate medications, doctors, expert trained paramedical staff and social workers working for mental illness. In hindsight, the total number of mental hospitals since independence have only increased from 31 to 47, with National Institute of Mental Health and Neurosciences (NIMHANS) located in Bengaluru ranked as the 4th best medical institute in India, according to the National Institutional Ranking Framework ( NIRF) medical ranking for 2020.

Concrete Steps Taken To Address The Elephant In The Room?

At the underbelly of this emergency lies the failure of the Government to realise the importance of appointing a minister-head for the mental health and well-being department under the Ministry of Health and Family welfare. As stated in the Mental Health Care Act 2017 (MHCA), each State is supposed to have a Mental Health Authority, but alas, this has been far from reality. The estimated total cost needed in the proper implementation of the MHCA 2017 is Rs 94,073 crores, which can easily be extracted from the PM CARES fund or other fiscal policies of the government.

Mental health warriors and many society-driven initiatives are undoubtedly creating waves of positive change on mainstream social media platforms. A popular phased model of community-based care for vulnerable persons with severe mental disorders is successfully run under INCENSE programme in a collaborative partnership between the two largest mental hospitals of India and two NGOs.

Similarly, public-private partnership projects or creation of mental health startup incubators under Startup India Scheme should be chalked out and adequately funded by authorised policymakers.

In this era of technological revolution, India should not fear venturing into uncharted territories of technology to seek a tangible way out. Digitally-mediated therapy, telepsychiatry, artificial intelligence, machine learning, chatbots and text messages can prove to be a one-click solution to prevent suicide without requiring physical presence.

Primary healthcare sector should be well-equipped with ASHA workers who are capable enough to provide psychological first-aid in order to help prevent mortality or long-term trauma of patients.

The extended lockdown has definitely seen a surge in the demand of alcohol, and number of domestic violence cases and unstable emotional behaviour. So, the primary healthcare sector should be well-equipped with ASHA workers who are capable enough to provide psychological first-aid in order to help prevent mortality or long-term trauma of patients. This ought to immediately swing into action in the States of Tamil Nadu, Kerala, Goa and Telangana because of their higher burden of mental disorders.

School-going children should be taught how to effectively call out people on their toxic behavioural patterns like – gaslighting, peer pressure, narcissism, and inculcated help-seeking attitude so that they don’t have to silently battle against the monster known as depression. In classroom programmes like “Happiness Hour” initiated by Delhi Government, students should be acquainted with stress-relief yoga, meditation, and solving personal problem creativity so that they can adopt these life skills as lifestyle choices.

It will be unfair to let the citizenry off the hook because stigmatisation of suicide and mental hospital by people around is also equally blameworthy. It is often seen, especially in rural landscape, that people with mental disorders or trauma are pushed to the fringes of society. The lackadaisical attitude of relatives makes patients feel undignified. Youths suffering from chronic stress fear opening up, and queer people are forced to lead normal lives with a mismatched identity, otherwise they will be abandoned too.

The bone-chilling suicide note written by a 16-year-old boy who hanged himself to death in UP on 17th June 2020 after gender-based bullying is a grim reminder that we are now at the eleventh hour of this swelling mental health catastrophe.  So, proper rehabilitation facility in small towns and villages is the utmost need of the hour.

People with pre-existing suicidal tendencies, bipolar disorder, anxiety, trauma, emotional distress etc should be kept under close supervision of their family members. Food poisoning items (pesticides), sharp objects( knife, scissors) and ropes should be kept out of their purview. Such sensitive cases require immediate medical attention but sadly, these concerns are raised only after someone’s demise.

This particular moment, as I am typing this (19th June 2020), I have already read about the suicide case of a couple after killing their children, and a 19-year-old Telangana girl hanging herself. My heart is thumping and I wonder what I can do to trade these lives so that they can be back again in this sea of people.

History has witnessed many stress-induced deaths all over the world in the wake of financial calamities. Reports of panic-stricken investors jumping from buildings caused a rapid increase in suicide rate from 17.0 per 100,000 people in 1929 to 21.3 in 1932 during the Great Stock Market Crash of United States. Let’s not forget the startling statistics of 12,602 farmer suicide cases in 2015 as mentioned in The National Crime Records Bureau (NCRB) report.

A predicted reality of post-COVID India would be crammed with millions of stressed, depressed, drug-consuming and self-harm inflicting humans unable to cope with the fatal consequences of mass unemployment, migration, starvation, homelessness and clutches of a debt trap.

Before it’s too late to change anything, let’s wake up from our highly-privileged slumber. I have purposefully listed some of the active suicide prevention helpline numbers operated by pan-Indian organisations below because I strongly advocate that help is just an effortless two minutes call or a text away.

Suicide Prevention Helpline Numbers

1.  AASRA Suicide Prevention and Counselling NGO: +91-9820466726

2. Sanjivini Society for Mental Health: +911124311918

3. iCall: +91 222552111 and +91 9152987821 ( Monday to Saturday, 8:00am to 10:00pm)

4. Fortis Stress Helpline: +918376804102

5. Sneha India Foundation: 044 2464 0050

6. SAHAI: 080 25497777 ( Monday to Saturday, 10am to 6pm)

7. Sumaitri: 011-23389090 ( Monday to Friday, 2pm to 10pm and Saturday-Sunday 10am to 10pm)

8. One Life: 7893078930

9. Vandrevala Foundation: +91 7304599836, +91 7304599837 and 18602662345

10. Connecting..NGO: 09922004305 ( Monday to Saturday, 10am to 6pm)

11. Cooj Mental health Foundation: +832 2252525 ( Monday to Friday, 1pm to 7pm)

12. The Samritarians Mumbai: +91 84229 84528, +91 84229 84529 ( 3pm to 9pm)

13. Arpita Foundation: +91 802365557 , +91 8105247529 ( 2pm to 5pm)

14. Parivarthan: +91 76766 02602

Note: The helpline numbers mentioned here are not sponsored or endorsed by the author or any organisation. This list is purely informational. 

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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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