In the second year of my three-year undergraduate degree in India, we had a course called Personality Development. It was a non-optional course, and once a week, some 35 of us sat in a small room to discuss various things with a facilitator, including stress, addiction, peer pressure, and, to a limited degree, sex. We were a reticent group, and spoke only because we knew that these discussions were graded. It would not be a lie to say that the classes were largely forgettable -- half a decade later, I can remember little of what we spoke in the small, sweltering classroom.
For the first two decades of my life, this was my only introduction to mental health. It was incomplete and uninspiring. The only reason I and many of my friends even attended these classes was because it was mandatory. At the end of the academic year, we wrote an exam and walked away, never to really talk about any of the things we discussed within the four walls.
We have one of the highest rates of suicide in the world, particularly among individuals aged between 15 and 29 years.
For most of my friends, I suspect, the education on mental health ended there, but we were the lucky ones. Most Indians have little formal or informal education about mental health at all and this is worrisome.
Mental health is an area of immense concern in India. We have one of the highest rates of suicide in the world, particularly among individuals aged between 15 and 29 years. Mental health issues account for more than a quarter of the burden of disease in the country. One study shows that approximately one in five Indians suffers from a mental health condition. Our country has a severe shortage of both expertise and infrastructure to deal with this.
Yet, it is only going to get worse. Approximately half of India's population is under 25, and close to 85% of the population are under 65. As the population ages the burden of adolescent, adult, and, later, geriatric mental health problems will increase.
There are two challenges that need to be met. The first is an overhaul of the mental health infrastructure in the country. We need to drastically improved access to facilities, provide greater support, and have better legislation that provides greater rights to individuals with mental health difficulties. The second is more intangible, and in a way, more difficult to address. We need a comprehensive education policy on mental health that destigmatises psychiatric problems, and sensitises people to the needs of sufferers. Only then will we be aware of our rights and make use of the facilities and infrastructure in place.
The issue with existing programmes is that they skirt the problems that need to be addressed... mental health is reduced to stress, peer pressure and addiction.
In October 2014, the Ministry of Health and Welfare, India, launched the National Mental Health Policy for the country. It was a panoramic and ambitious policy with a fairly comprehensive section on the promotion of mental health. The policy recommended training teachers and workers at Anganwadis and schools to be sensitive and respond to emotional and mental health needs of the children in their care. It recommended Life Skills Education programmes in schools and colleges to sensitise students to issues such as gender and stress. The programme, however, does not really address mental health problems. In other words, the programme is very much like the Personality Development course that was a part of my undergraduate degree. Similar programmes have been developed by CBSE and NACO, and all of them fall short of what is required.
The issue with existing programmes is that they skirt the problems that need to be addressed. In these programmes, mental health is reduced to stress, peer pressure and addiction. Sure, they are all vital components of mental health but there is a lot more to the matter than that. These programmes do not address several other issues -- the stigma surrounding mental health, the various types of mental health problems, who to talk to, and how to seek help. They don't effectively promote prosociality and self-awareness. They fail to tell us that it is alright to have mental health problems and that it should be alright to talk about them.
It is only with a mental health education programme will we, as a nation, really understand what mental health problems are. Even today, mental health problems in the country are attributed to evil spirits and are treated with exorcisms, complex rituals and prayers. Families disown individuals with mental health problems and patients are not aware of their rights. The stigma is immense, even among mental health workers.
Studies have shown that school-based mental health education programmes help prevent mental health problems, and can help in early identification and intervention.
Some countries are tackling the issue of mental health education head-on. In the UK, a recent petition to include mental health in the national curriculum has received more than 30,000 signatures. State schools in countries such as Australia and Sweden have programmes in place that provide a safe environment to discuss several mental health issues in schools with the aim to destigmatise mental illness and sensitise young children. Further, studies have shown that school-based mental health education programmes help prevent mental health problems, and can help in early identification and intervention.
We simply cannot afford to be a nation that lets mental health take a backseat. We need to be able to talk about mental health without stigma, identify mental health issues in ourselves, our friends and our family, and be aware of the options we have to seek help. Crucially, this should not be restricted to urban high-income groups. We need to start mental health education early, perhaps as early as primary schools, and we need to ensure that every student in India is taught the basics of mental health.
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