January 2021
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Health News
Please Open Up, Tell Something
The mental illness is not well defined, but it does include emotional, psychological and social welfare, and influences our thinking, cognition/ comprehension and ability to work. It is significant to note that the World Health Organization (WHO) includes mental health along with the physical health in its definition of health. That is to say health is a comprehensive concept involving physical and mental health along with social welfare, and does not signify only absence of some ailment or desired physical attribute. This definition goes on to declare that it is the fundamental right to savour good health without any discrimination of caste, creed, political belief, and social or economic status. The world over, especially the developing nations including India, in public health, the emphasis has been on physical health of the people; but, especially of late, issues pertaining to mental health and behaviour have started dominating other issues in the arena of public health.

Increasing Population of Mentally Ill People

The World Health Organization Report 2019 informs that in one form or the other, 7.5% Indians are mentally ill. The report also hints that by 2020, around 20% population of India will be affected by mental ailments. Despite such a large segment of our population suffering from mental problems, the mental health has not been recognised as a disease, or at least as an important disease, requiring urgent special attention. Even today, quite often, the mental health is not recognised as a very special ailment requiring holistic treatment, including medication; and often blaming the victim, it is tried to be wished away as imaginary! Whereas the truth is that like any physical ailment, the mental ailments also influence one’s health adversely; and in fact the treatment involves much more than mere medication. Because amongst a sizable section of our population, mental ailment is still considered a taboo, therefore as long as feasible, people often try to hide it, resulting in mentally ill patients not getting the required treatment at early stage, and thus for a long time, forcing them to lead a very tough and undesirable life – that can be easily avoided with proper treatment.

People often try to hide mental ailment, because in a section of populace, it is considered a social taboo. The result is that those afflicted with mental ailment are forced to lead a very tough and unenviable life.

The LANCET Psychiatric Report released on 23 December 2019, presents the survey of mental health of different states of India, for the period 1990-2017. It is for the first time that such a comprehensive and incisive report on mental health, covering India state-wise for almost two decades, has been brought out. It is a gold mine for the policy makers and the people working in the area of mental health, and would also help attract attention of the people-at-large towards this very important, but neglected, issue that is affecting ever more people with passing time.

The report presents a highly disturbing state of affairs; that in 2017, every seventh person in India is grappling with the mental ailment of one kind or the other. That is mental ailment had gripped around 19.7 crore people in our country in 2017. And, in all probability, this figure would have only increased during the intervening three years’ interlude. The depression, anxiety, bipolar, schizophrenia, autism, conduct disorder and intellectual disability are prominent variants involved here. A total of 4.57 crore people are suffering from different ailments connected with depression. The situation is so bad that at any given time, 4.49 crore people live with anxiety, which reduces human life span by a few years anyway. Report also informs that disability caused by mental illness, has increased from 2.5% to 4.7%.

Adolescents Falling Victim at a Fast Pace

The April 2017 report of the World Health Organization (WHO) 'Mental Health Status of Adolescents in South-East Asia: Evidence for Action' informs that 5.8% population of India is in the age group of 13-15, out of which around 25% adolescents suffered from depression for two weeks or more. Over and above, 8% adolescents are victims of anxiety and the same percentage suffers from loneliness; 10% are friendless and 11% consume harmful substances.

In view of the gravity of the situation, in March 2017, no less a person than the Prime Minister in his ‘Man ki baat’ (heart to heart talk) talked to adolescents openly about the mental health issues. While making adolescents aware about mental health, Prime Minister also advised family members and friends to openly discuss mental health issues with the adolescents. In addition to the expert advice from well educated professionals to the afflicted children, the ailments resulting from the menace of peer pressure and bullying in schools can be effectively handled through free and frank discussion on this issue everywhere, be it in the family, amongst friends or society-at-large.

Need for the Support from Family and Society

With regard to the above, Uroosa Khatun, the Counselling Psychologist cum Gender Expert – with vast experience that includes working with the students of Kendriya Vidyalaya in Delhi – underscores this: “In many cases the children and their family members are given this advice only that the intra-family communication must be maximized. Quite often, disconnect between the child and the parents, aggravates mental ailments”. Many times both the parents, especially in metropolitan cities, are working; and, hence, they are unable to devote the time needed for the mental development of their child(ren). The problem gets aggravated in case of families with a single child, because the absence of a sibling creates huge void for the child. The child, therefore, starts feeling lonely, and this point onwards starts getting estranged from the family.

Amit (name changed) while studying in the eleventh class of a Central School of Delhi, time and again used to contemplate about committing suicide. He was extremely worried about it; but none in the family was aware about his vulnerable situation. The situation reached to such a pass that while alone in the room he started feeling as if someone was cajoling him to commit suicide. And, his condition used to worsen after the lights of the room were switched off and the room became dark. After a session on mental health was held in the school, some of Amit’s friends apprised the Counsellor of the school about their friend.
Gradually he started lagging behind in studies. Some teachers started blaming the child, and attributed his falling performance to his disinterest in studies and his genuine problem an excuse to escape from studies. However, during a discussion Cunsellor Uroosa Khatun came to know that someone in the family of Amit had committed suicide; and the principal of the school supported the child and ensured continuation of his counselling. Because Amit’s ailment was in an advanced stage, therefore in addition to counselling medication also became necessary. To handle this challenging case, Uroosa Khatun’s previous experience of working with Salaam Balak Trust that deals with the homeless children, proved very useful.

During this period, the school also started the process of making the parents and teachers aware through organizing Training Sessions from time to time. Some teachers kept aloof, but most appreciated this initiative and took advantage of the sessions to deepen their understanding of the issue of mental health. On the other side, the parents also became better informed than before. Amit’s counselling continued for almost a year, and significant positive changes were noticed in his personality during this period. The parents and teachers, especially principal and counsellor, were pleasantly surprised to see Amit composing poems; and, in the Board exams of twelfth class, his performance was good.

Adolescence is Crucial

The family also needs to understand that the adolescence is a very crucial stage of life. It is during this stage that every child, be that a boy or a girl, undergoes qualitative physical, mental and emotional changes. And, if appropriate support is not provided by the family and the society at large, then there is great danger of the child going astray. Kaustaubhi Shukla, presently clinical psychologist of Sampadan Multi-specialty Clinic in Greater Kailash, has had long association with the children, especially those of the residential schools, says: “Soon upon entering the adolescent stage, the children are unable to handle their changes; and, “coupled with the pressure of studies, family and society due to various reasons, the children in this age group are prone to catch mental ailments. She told that education system breeds mental health issues most; and the boys and girls both are its victim. However, the girls are quicker to share their woes whereas boys take quite longer.

Uroosa Khatun, a long time counsellor with the Central School or Kendriya Vidyalaya, a co-educational institution, informs that “Often the discrimination between the son and daughter also breeds resentment and anger among the kids and results in their suffering from depression. Most of times in famiies more attention for girls make the issue worse. It is therefore a must for the parents to ensure that there is no discrimination, even unknowingly, on the basis of gender”. That is to say that one needs to be cautious and alert and critically review one’s practices to see if one is guilty of gender bias!

The peer pressure phenomenon is more widely prevalent in big cities, especially metropolitan ones like Delhi. The advertisement blitzkriegs and mammon-worship in society-at-large breed degenerative tendencies in the society and influences all, especially children and adolescents. The show-off of material wealth – through eating junk food outside home, watching movies in multiplexes, using branded, and therefore highly expensive, items such as clothes – becomes the unthinking yearning for the adolescents.

In schools, especially in the age group of 12-17, bullying also commences; and that also results in severe consequences at times; and it is spread all over – from classroom to washroom to playground to transport for school. Both the counsellors are unanimous on continual talk with the child being the best antidote to this malaise. The parents must understand that in order to arrive at any decision with regard to any issue pertaining to adolescents, they must be involved in the discussion and their views given due consideration. Even if the child does not pay heed to the advice of the parents, even then all-out efforts should be made to arrive at a consensus through discussions and persuasion, because after all family is the first important institution that plays a vital role in the overall development of the child. However if in addition to the mental health care at home, the counselling sessions can be organized in the schools, then that will go a long way in saving children from mental illness.

Narjis Husain

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