Since the imposition of a nation-wide lockdown on 26th March, there have been more than 2 lakh confirmed cases of COVID-19 in India, alongside some 6,500 deaths. However, the central and state governments are ready for a phased reopening of all offices, businesses, and other services, starting 8th June.
Yet, COVID-19 hasn’t been the only health issue plaguing our country as well as many others, during this crisis. The World Health Organization (WHO) has been trying to address the issue of mental health during a pandemic, with multiple countries having imposed lockdowns. The organization even released infographics and a children’s storybook to help cope with the ongoing crisis.
While the UN has been emphasizing the importance of addressing mental health as part of government response to the pandemic, the ground reality in countries like India remains vastly different. The lockdown meant that while millions of people were working from home during this time, many others who did not have this option were rendered unemployed. Migrant workers were stuck in towns and cities, without income, practically stranded away from home during the crisis. This meant (at least temporary) homelessness and starvation for a large portion of the working-class population.
On the other hand, cases of domestic and intimate partner violence (primarily crimes against women) also witnessed a sharp spike over the last two months, given that most victims of the had no option but to be stuck at home with their abusers. The All India Council of Human Rights, Liberties, and Social Justice had moved Delhi High Court in April, in this regard. However, for individual victims to report such crimes or reach out for help during a crisis like this, is far from easy. These factors collectively are likely to cause a massive spike in cases of mental health issues such as depression and anxiety.
According to WHO reports, there is hardly one mental health practitioner in India, per 100,000 people. One specific report had stated that by 2020, about 20% of the Indian population is likely to be affected by mental health issues. To add to it, living amid a pandemic and being under lockdown for more than 2 months, is not likely to be beneficial even for the mental health and well-being of individuals from privileged backgrounds.
This period has seen a disruption in the ordinary ways of our lives, and an upheaval of our routines. Furthermore, the concepts of working from home and/or doing classes from home, has led to issues such as those of accessibility and digital divide – how many of us have the means to be able to work from our homes and remain productive? Unfortunately, capitalism dictates that there’s no rest even when the world seems to be falling apart.
Terminal year students across colleges and universities in the country have been grappling with the uncertainty of how their last semester, post-grad college admissions and placements will work out, in a post-lockdown scenario. This is coupled with the pressure of online classes and assignments, at least in some of the institutions. For the administrative authorities too, striking a balance between having classes without being unfair to those students who might not have equal accessibility, has proven to be a challenge.
As for employees of most private companies and corporations, the only thing this global crisis has done is added to pre-existing workloads. An employee at an essential service company based in Kolkata talked about how the lockdown meant that usual office routines went for a toss. Being at home, any time could be fit for a meeting, and many executives, especially in IT and consultancy sectors have been putting in as much as 14 to 16 working hours every day. Several companies including Reliance Industries and Swiggy have reportedly laid off employees during the lockdown. A part-time lecturer at a St Xavier’s College campus in West Bengal mentioned how the administration has been unable to pay salaries to many of new employees, who didn’t already have salary accounts at the time of the lockdown imposition.
It is not tough to deduce that an extraordinary crisis such as this, is likely to be a breeding ground for mental health problems, such as depression, anxiety, and mood disorders. This has far worse implications for a country like India because the issue of mental health continues to be neglected and stigmatized herein. This stigma and lack of awareness, however, isn’t solely restricted to the working classes or people coming from lesser privileged backgrounds.
Mental health issues continue to be associated with madness and hysteria, even in seemingly educated, middle, and upper-class circles. So on the one hand, we have an overwhelmingly large section of the population, with no material means to avail mental healthcare facilities. On the other hand, even amongst those who might be able to access such facilities, there is an acute lack of awareness.
The question that arises then, is whether or not it will at all be possible for our government’s response to the ongoing crisis to also incorporate the mental health dimension? The Indian Parliament did pass the Mental Healthcare Bill in 2017, with several provisions for the diagnosis and treatment of patients of mental illnesses. The legislation also mentions the right to homeless or Below Poverty Line (BPL) individuals to avail such services, even without a BPL card.
However, the implementation of these provisions on the ground has been far from ideal. Given the state of affairs of our public health infrastructure, the task of including mental health in the response to the COVID-19 would also have to be shared by NGOs, and private corporations.
Despite several NGOs and mental health institutes such as the National Institute of Mental Health and Neuro-Sciences (NIMHANS) having widely circulated their helpline numbers, it is still difficult for people to reach out for help. The stigma and lack of awareness regarding the issue are systemic and deep-rooted. Herein lies the importance of private companies and educational institutions focusing on the issue. The approach that we require is two-pronged – we need greater awareness and sensitization, alongside increased investment in mental health services.
Not all educational institutions are equipped to provide such help to students. As per the Indian Council of Medical Research, 12 to 13% of school students in India struggle with behavioural issues, learning difficulties, and emotional problems, as it is. The Central Board of Secondary Education had made it mandatory for schools to have counsellors on board, but less than 3% of private schools have followed through. The situation in government schools is far worse, and there is very little data available for schools under other boards. The time now might be ripe for educational institutions to finally include counselling within their structure.
It gets more complicated in the case of colleges and universities, but proper systems of peer counselling under the supervision and the creation of structured support groups or communities could also help in terms of filling in the existing gap. Founder of Suicide Prevention India Foundation, Nelson V Moses says that this could prove to be an opportune moment. If the existing health crisis can compel the government to collaborate with private organizations to invest in mental health services as part of public health infrastructure, it is also likely to be economically beneficial in the long run.
The Vice President of a Calcutta based private company says that the question of how people coming back to work will acclimatize at a time of crisis is of pressing concern. Throughout the lockdown period there have been efforts to schedule work in a way to ensure convenience, he says. However, in most traditional companies, the concept of working from home and maintaining productivity proves to be a challenge. A Wall Street Journal report stated that Indian millennials clock in more work hours than many of their counterparts in the west.
Most profit-oriented private companies make little concessions for employees’ mental health This means that the anxiety of working through a global health crisis is equally bad for all working professionals in the country, regardless of whether they’re working for traditional or new-age companies. However, corporate investment in mental health and counselling services can again, prove to be profitable for companies, by improving the workplace environment and boosting productivity.
The most important underlying point herein though is that in the face of the current pandemic, we might need to rethink our priorities and restructure our ways of living. One can easily argue in favour of the government and private investment in mental healthcare facilities at this juncture with the rationale of economic viability and long-term benefits.
However, to simply do that would be to dehumanize the issue even further than it has been for decades. It is not true that there is absolutely no concern for mental health in our country, but the condition is still dismal. For people from financially underprivileged backgrounds, availing the health facilities they are legally entitled to, isn’t possible unless they are aware of the fact that they might be having an illness in the first place.
Even with a sense of awareness, they might lack the vocabulary to articulate the same. This is wherein educated people in positions of privilege such as ourselves, have a foremost responsibility towards those who are less fortunate.
Government and private institutions, NGOs don’t function in a vacuum. They are part of a social order inhabited by all of us. Hence, the onus of creating awareness and sensitization, and reaching out to people who might be in need, is really on all of us.
As author Arundhati Roy had written in a recent Financial Times feature, this pandemic is potentially a “portal between one world and the next.” To quote her in detail, “We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks, and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.” This new order could be one wherein we finally cease to stigmatize mental health in our country and choose to be more empathetic towards our fellow human beings. Envisioning such a future isn’t even idealistic anymore, but given the unprecedented scale of this crisis, it is imperative.