Helping hand for mental health | A battle of their own

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For most of her life, Richa Singh, 35, had been someone whom friends could confide in easily. Emotional tumult of teenage years, anxiety about the future or family spats, her friends had no qualms about opening up to her. She, too, would always lend a sympathetic ear. So, in 2009, when a friend and fellow student at IIT Guwahati decided to end her life, it left her shocked. For months, her friend had been stressed about not landing a job during a college placement drive but chose not to tell anyone. Nobody, including Singh, could have imagined that things would come to such a pass. The incident taught Singh an important lesson: people could be hanging by a thread and yet say nothing—unless they find someone they can talk to. Five years after her tragic death, Singh and another friend, Puneet Manuja, who himself is no stranger to the emotional toll of modern life, started YourDost, an online platform that connects people, especially youth, to mental health professionals and offers support.

For most of her life, Richa Singh, 35, had been someone whom friends could confide in easily. Emotional tumult of teenage years, anxiety about the future or family spats, her friends had no qualms about opening up to her. She, too, would always lend a sympathetic ear. So, in 2009, when a friend and fellow student at IIT Guwahati decided to end her life, it left her shocked. For months, her friend had been stressed about not landing a job during a college placement drive but chose not to tell anyone. Nobody, including Singh, could have imagined that things would come to such a pass. The incident taught Singh an important lesson: people could be hanging by a thread and yet say nothing—unless they find someone they can talk to. Five years after her tragic death, Singh and another friend, Puneet Manuja, who himself is no stranger to the emotional toll of modern life, started YourDost, an online platform that connects people, especially youth, to mental health professionals and offers support.

They are a whole cohort: young men and women who are familiar with the stresses of young life and have taken it upon themselves to help out other young people. India remains a country where mental health issues still invite jeers or judgement. In a 2021 Unicef-Gallup survey titled ‘The State of the World’s Children’, which studied 20,000 children across 21 countries, the results from India were instructive—one out of seven Indians aged 15-24 years felt depressed or had little interest in doing things, just a little below the global median of one in five. However, what was more worrisome was that only a minority among them—just around 40 per cent in India compared to around 83 per cent in other countries—felt that those facing mental health issues should reach out for help. Equally disheartening were the findings of a Lancet Psychiatry study in 2021. Not only did India top the list in the number of suicides in the world, but suicide was also listed as the leading cause of death in the 15-39-year age group.

YourDost claims to have helped over 8,000 people to date. There is also We The Young, started by Charit Jaggi in 2019. A mental health awareness platform, it allows users to share their experiences with others. “We [the youth] are the largest demographic in the country,” says Jaggi, 29, adding, “But our problems are unheard and underrepresented in societyâ€æ. Today, the youth are more aware and open to conversation [than the previous generations], but struggle to find someone to talk to. They are still limited by stigma and hesitation.” Hence initiatives like his.

What ails the youth

There was a time when only extreme scenarios like schizophrenia or bipolar disorder warranted a visit to a psychiatrist or therapist. Times, though, have changed, as has the very scope of mental disorders.

India is at a turning point: it has the largest youth demographic in the world—a fifth of the world’s young population resides in India. As of 2022, the average age of Indians was 28.7 years, far below the median of 38.4 for China and 48.6 for Japan. But this young population is growing up in circumstances far different from those in which traditional mental health systems evolved in India. “Mental health issues by themselves are not new,” says Bengaluru-based clinical psychologist Puroitree Majumdar. “But two things have changed—people are more individualistic and isolated today, and there is significantly more pressure from the environment on how to look, what to eat, where to work.” For instance, Majumdar has seen patients suffering from stress simply because there is no clear path to the job they want. And so emerge problems like loneliness or poor self-esteem, which though for generations were considered par for the course, must now be seen as legitimate mental health issues.

Nothing, however, has changed. “If my siblings or I say we are feeling mentally unwell, they [the parents] will react with angerâ€æ. They don’t understand our minds or its challenges,” says Delhi-based Rita Takkar (name changed), 16, who had to take counselling at school for an anxiety disorder. “I used to procrastinate a lot as I was anxious about simple tasks. My parents would think I’m lazy and addressed the procrastination, but not my mental health because the latter they think is for ‘crazy people’.”

The structure of the modern family has also changed. “Earlier, we were more into community living and meaningful offline relationships—you were never alone because there was a household to guide you,” says Dr Sameer Malhotra, head of the department of mental health at Max Hospitals, Saket, Delhi, and a member of several city school managing committees. “There was also a lot of physical movement that channelised youthful energy into something constructive. No social media to disrupt lifestyles, so one could quickly move on from small emotional challenges. Now, the young sort of stay stuck in them.” Over the past few years, he points out, his hospital has noticed a rise in psycho-emotional problems among youth, coupled with a reduction in coping mechanisms. Looking for quick solutions, the inability to understand the superficiality of online life, anger attacks, career and academic anxiety, substance abuse, and even existential crises where teens feel they’ve done it all and see no point in living, are a few of the recurring themes he encounters. “The young today have such heightened expectations of themselves that unmet needs are leading to frustration and intolerance,” he says.

The young themselves are not entirely untouched by stigma either. In 2021, Live Love Laugh, a mental health support foundation launched by actor Deepika Padukone in 2015, conducted a study titled ‘How India Perceives Mental Health’ involving 3,497 people in the 18-45 years age group across nine Indian cities. Though the study showed considerable improvement in terms of the number of people who thought that individuals with mental illness can eventually excel in their career and personal lives (from 32 per cent in 2018 to 65 per cent in 2021), 10 per cent of respondents still said they would not befriend a person with mental illness. The share of people who said they would limit their interaction with such a person or even urge others to avoid them was 9 per cent each.

Even if an individual does ultimately decide to battle such judgement and stigma and seek help, obstacles abound: there is either too little awareness, or help is simply unaffordable. Hitesh Sanwal, now 30, experienced anxiety and depression when he was 19. During the course of his treatment, he realised how strong the stigma and lack of awareness around mental health were. “I came from an educated and privileged background and even then I didn’t know much about mental health till I experienced related issues,” says Sanwal. That led him to start Youth for Mental Health (YMH) in 2019, a platform to advocate and advance mental health awareness through various campaigns and initiatives. Since its inception, YMH has organised over 30 initiatives and is also an official partner for the global campaigns of the World Federation for Mental Health, which founded the World Mental Health Day in 1992. “Today, YMH has one of the largest student networks for mental health, with volunteers from over 100 campuses. The aim is to encourage young people to freely express themselves, reduce stigma and seek support for their well-being,” says Sanwal.

For most others—and they form a much larger chunk of India’s young population—help may simply be out of bounds. Juhi Sharma, 33, understood this while working with children from some of the most marginalised sections of society, from children living in urban slums to those who have been raised in brothels or shelter homes.

On an average, a single, hour-long session with a therapist or a psychiatrist in India can cost anywhere from Rs 1,000 to Rs 5,000 in a private setting. India has laws like the Mental Health Care Act to provide relief, but accessing treatment remains a challenge on the ground. The Live Love Laugh study also underlines that as many as 55 per cent of the respondents faced difficulties in accessing mental health treatment due to socio-economic factors. “Depression, anxiety, substance abuse—for marginalised sections, there is virtually no support for trauma,” says Sharma. She started Emotions Matter, an organisation that works to spread awareness and help marginalised sections access mental health support, after a volunteering experience at a shelter home in Delhi in 2012. “We are sitting on a ticking bombâ€æ. Mental health is paramount for a dignified life—it should be roti, kapda, makaan and mental health. Everyone should have a path to resolve trauma,” she says.

It’s a problem youth from even privileged backgrounds sometimes face, despite rising awareness. “Young people, even if they’re ready to fight stereotypes and seek support, largely depend on adults for finances. If their parents don’t believe in mental health support, how will they get the money to afford therapy?” says Sanwal.

Having counsellors at institutes is one way to make treatment both affordable and accessible. But until the stigma around mental health is eradicated, no real transformation can begin. And in that, shared experiences can play a huge role. Jaggi, whose organisation encourages people to do exactly that, says, “We started with just five stories, and today, we have covered over 5,000 stories that have reached 50 million people, all organically. Storytelling is not only relatable, but when people speak out, it is a cathartic moment for them, and it inspires others to do the same.” The organisation receives around 500 emails a month from youngsters, about how a story encouraged them to talk about their own experience. Interestingly, many are from men. “For men, voicing their emotions is discouraged from a very young age. So, a platform that lets them express themselves freely is a step forward,” says Jaggi.

Challenges galore

Over the years, such efforts have revealed both what youth want and the challenges mental health support groups face in helping them. In 2016, It’s Ok to Talk, a project started by Sangath, a non-profit organisation that promotes mental wellness, held an offline event in Delhi. When they realised that using the term ‘mental health’ in the project title repelled a few, they started using words like ‘stress’, ‘feelings’, or ‘emotions’. “We have a long way to go before ‘mental health’ stops being associated with ‘mad’ people,” says Sweta Pal, project director at It’s Ok to Talk. Privacy, too, emerged as a significant factor. “This generation does not feel comfortable if someone else is going to know about their experience. In fact, many youth prefer to be anonymous, so our website lets people share their story anonymously,” says Pal. YourDost, too, sees maximum traffic between 9 pm and 3 am, when most youth are alone.

Often, families object to their children being termed ‘mentally unwell’ and threaten counsellors, or are wary of getting medication for the fear of their child getting addicted to antidepressants. In some cases, it can take weeks for a person to open up, and the investment by the counsellor has to sustain through this period to build trust. It’s particularly difficult to help youth from underprivileged backgrounds when both public officials and families insist that education and jobs must be the focus, not trauma. “People still don’t understand the work I do,” says Sharma. “Sometimes, I’m judged by the scale of my work. I tell them scale is not the point, quality is. If I helped save just 15 lives, those 15 lives really mattered to me.” It is also heartening when someone she has helped pays it forward, in any way possible. Like Kunal Kumar, who grew up at a brothel in Delhi. Counselled by Sharma for his mental trauma, the 22-year-old went on to start Maan Foundation, an organisation that works for the rights and dignity of sex workers. One youth saved can save an entire future.


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