To acknowledge and celebrate only a particular day or a week pre and post ‘10th October’ for mental health is not enough to bring about the necessary changes and reforms. While we acknowledge the fact that discussions, debates and actions have set the ball rolling around the work on mental health, there is a very long way to go.

The kind of attention and importance this crucial space deserves is still missing in the Indian context, and a number of factors could explain that. To begin with, while we may still discuss mental health in the individual context, the fact is it is hugely affected by one’s socioeconomic, cultural and environmental conditions and has a multi-layer impact of caste, class, gender and sexuality.

Several layers of inequalities across the population indicate that mental health is a collective issue, and it is political. Mental health problems pose one of the greatest concerns for public health, and the poor, underprivileged sections of society bear the biggest burden of mental illness (James et al, 2018).

Grim Reality

There are a lot of talks around the importance of mental health; however, the reality is grim as the mental health sector in India are overly under-resourced in every possible way. There is a huge dearth of mental health professionals in India (psychiatrists, psychiatric nurses, psychologists and psychiatric social workers). We desperately need trained professionals in this field to be able to adequately tackle the everyday challenges that only keep increasing. While it is a fact that there is an urgent need to have an adequate number of mental health professionals to meet the challenges of India’s growing population, it is crucial at this point to ask again, how do we ensure that the reach of these services is actually visible and implemented to every segment of the population and not limited to just the privileged sections.

The allotment of funds for the mental health sector is severely inadequate, to begin with. There is high inequality in the distribution of funds to government-run organisations that focus on mental health, with the primary focus being given to NIMHANS, Bengaluru, and LGBRIMH, Tezpur. No doubt, these institutions are pivotal in this sector, but so are the other government-run organisations that focus on mental healthcare. Such concentrations and inadequacy of funds will eventually hinder the successful execution and access of mental health services to the wider population. Accessibility and implementation of mental health services are two facets that definitely influence the success of work in this area.

Grassroots Levels

Policy and curriculum reforms, advocacy, research, right form of practice and judicious allocation of funds to propagate mental health at the grassroots levels are the need of the hour. The narrative needs a change from ‘let’s speak about mental health as it is a taboo topic’ to ‘let’s make this initiative work to bring in mental health as a topic that students learn in schools while adults adopt it as a part of lifestyle at the workplace’. Targeting myths, stigma, stereotypes and fundamental changes in everyday conversations is difficult but possible. To bring in reforms, we need data on areas requiring reforms. The actual impact and understanding of mental health issues are still far from the layman’s reach. Thus, thorough research to understand where and what the knowledge deficit is can help create effective plans.

Educational institutes and workplaces are two areas that have brought in some reform in the way they look at the mental well-being of the members of their ecosystems. Despite mandatory school counsellors and making workplaces sensitive towards mental health, the implementation is at a snail’s pace and there is a fundamental flaw in understanding the entire process. The NCRB’s Accidental Deaths and Suicide in India (ADSI) report 2021 shows the drastic rise in student suicides during the coronavirus pandemic in 2020 and 2021 and its steady rise.

While mental health initiatives, programmes and policies started by workplaces, organisations and educational institutions are important, it is significant to understand that these should not be treated as ‘blanket solutions’ for deeper, unhealthy, unaddressed toxic spaces in which people find themselves whether at school or work. Acknowledging and addressing triggers, causes and consequences of problems people face and why they face are of paramount importance before launching a programme to ‘solve’ the issue. The methods would be ineffective if the problem at hand is misunderstood.

The Norm

We need to accept that physical well-being is closely linked to mental health well-being and vice versa. Accepting that a student might want to skip classes as they are having a rough day emotionally or a bad mental health day has to start becoming the norm. An employee availing leave for a few days to rejuvenate their mental health is another vital step.

According to Dr Malik Merchant, Consultant Psychiatrist, Wockhardt Hospital, “The concept of a mental health day is a novel one worth pondering. The practice of mental health hygiene should not be just to prevent mental illnesses but should be of help to attain optimum functioning of a person”. The concept of mental health leaves and access to workplace/school counsellors among many others are not relatable and distant concepts for the majority in the Indian context. The effort must continually be to work towards bridging this ever-widening inequality across all segments of the population.

Science has helped us understand and develop new information and tools that have revolutionised the way we live. It is important to make sure the reach of every service and development is done for the entire population. Policy reforms at every level are needed to bring about systemic changes to address the huge gap in mental health needs. There needs to be an understanding of individual differences, from the basic fundamental levels to the societal level and beyond. The ‘one size fits all’ approach will never work for this space. The importance of mental health when inculcated as a part of our lifestyle can bring in long-lasting change.

When each of us is equipped with taking charge of our own mental well-being, a proactive society emerges because there is autonomy to manage one’s mental health. The sensitivity towards our own mental health is immensely essential in being empathetic towards others around us and we need the right systems and structures in place to make this a reality for all.

Forum Lalka is practising Senior Psychologist at Mindtemple, Mumbai. She is also a Queer Affirmative Therapist and has QPR training in suicide prevention.

Moitrayee Das is Assistant Professor of Psychology at FLAME University, Pune