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“More than a Day, More than the Pandemic”: A Collective Investment in Mental Health

Prologue

The world is chaotic, thanks to the last eight months of the pandemic-havoc! Health is considered necessary for the growth, development, and productivity of a society. The maxim “There is no health without mental health” underlines the importance of mental health and psychological wellbeing. The National Mental Health Survey (NMHS) of India-2016 stated that mental disorders contribute to a substantial disease burden with a wide treatment gap.  More than 85% of people who need mental healthcare are not able to access it. Even without the pandemic, the World Health Organization (WHO) anticipated that approximately 20 percent of the population would be suffering from mental illness. This would mean more than 200 million Indians may already be under the ‘mental health burden.’ In the current pandemic, the situation seems to worsen. 

In the current scenario and with the limited mental health services and ongoing COVID-19 crisis, we observe more individuals expressing emotional and psychological issues at the individual, family, and societal levels. There has been a rumbling academic and scientific discourse related to the psychological and social effects of the outbreak on various platforms, but how much of that has percolated through the age-old stigma in the community! With resource constraints in primary healthcare, the plethora of misinformation and disinformation, the distorted portrayal of ‘mental health issues’ in popular media and ‘romanticizing’ psychiatric disorders: enthusiasm and discussion related to the importance of psychological health, unfortunately, is short-lived and stays confined to certain ‘Special’ days and moments for ‘celebration.’ The recent-most example is that of a celebrity suicide which highlighted the need for suicide prevention and help-seeking for depression but was rapidly overshadowed by more ‘sensational’ media-feeds, conspiracy theories and political propaganda. Ironically, just a month back, we had observed the ‘World Suicide Prevention Day’ on 10th September. A year ago, the same Mental Health Day was themed “Suicide Prevention”! When we speak about ‘awareness,’ it’s a collective responsibility. It needs to be enhanced at all levels: individual to the society. This World Mental Health Day, the theme is “Greater Investment in Mental Health, with greater access and mental health for all.” Though words are wise, it is only possible through a collective understanding, self-care, empathy towards mental healthcare needs for others, fighting stigma and myths related to mental well-being and mental illness.

Mental Health: What do you mean?

Mental health is the culmination of one’s emotional, psychological, and social well-being, affecting how one thinks, feels, and acts, thereby determining how we handle stress, interpersonal relations, and decision making. This means mental health is vital in every stage of life, from childhood to adolescence to adulthood. 

To clarify one of the most popular myths and reiterate the World Health Organization (WHO):

“Mental health is not merely the absence of mental illness.”

Like any other form of health, psychological health is also a continuum with certain diagnosable psychiatric disorders on one end of the spectrum. One can have impaired mental wellbeing with chronic stress, distress, disturbing life-events, difficulties in interpersonal relationships, problems at the workplace, disturbed mental peace, sleep difficulties, etc.: all of which need help, though not a ‘specific disorder or illness.’

Further, cherishing a good ‘mental health condition’ is not about being perennially happy, but the ability to balance one’s emotions without disturbance in daily activities and healthy coping against stress.

In this life course of an individual, when one experiences mental health problems, their thinking, mood states, and behavior gets affected. The factors that contribute to mental health range across the biological, psychological, and sociological aspects. The National Mental Health survey states these as explanations for the common mental disorders like depression, anxiety, insomnia, etc., high prevalence of psychoactive substance use, and the increasing high suicidal risk in the country.

Identifying the Signs

The National Alliance on Mental Illness states that there is no easy way of stating the difference. It further says, there is no easy way to test the presence of mental illness or understand a standard pattern of the actions, thoughts, or behaviors. Each condition has its symptoms, but the common signs are pictorially depicted below.

Again it is important to note that for every diagnosed psychiatric disorder like depression, anxiety, schizophrenia, autism, etc. there are thousands of others who are excessively stressed, in mental distress, are unhappy, going through difficult life-events, are having sleep disturbances, are not feeling happy for long, etc.  All of them are signs of having impaired mental wellbeing (not a disorder). They still need help to prevent reaching the ‘breaking point.’

2. Mental Health for All: An Inclusive Society

Dr Debanjan Banerjee is a Psychiatrist, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru and Life Fellow, World Psychiatric Association. He is M.D. Psychiatry (NIMHANS), FIPS, FIASP, FIAGMH, D.M. Geriatric Psychiatry Senior Resident, NIMHANS, Associate Editor, Frontiers in Psychiatry: Aging Psychiatry, Assistant Editor, Journal of Psychosexual Health (SAGE), Assistant Editor, Journal of MHE, NIMHANS

 

Ms Vasundharaa S Nair is a Psychiatric Social Work PhD. Fellow, NIMHANS, Bengaluru

 

 

The views, thoughts, and opinions expressed in the article belong solely to the author.

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