In order to ensure that Mental Health in India is addressed holistically, it is necessary to reduce the amount of stigma associated with Mental Illness. Less stigma in the community will encourage individuals to seek support and address their mental health concerns.
Inferring from the The Live Love Laugh Foundation National Mental Health Survey 2018: How India Perceives Mental Health report, where nearly half of the respondents used discriminatory terms like Crazy/Mad/Stupid or Retard to describe people with mental illness; and around 60% of respondents believe that 60% believe that mental illness is caused by lack of self-discipline and willpower, we think and believe that it is important to focus de-stigmatization programs at the following four levels:
At the School/College level
Educational institutes at all levels play a fundamental role in socialisation. In this environment, children learn to distinguish between the acceptable and unacceptable norms of behaviour in society. Students are most susceptible to peer pressure and bullying in this same space. Having programs in school that condemn the use of discriminatory terms and bullying, and which outline exactly why these words and phrases should be avoided, can help reduce the anxiety and depression caused by bullying. It will also help in the development of empathy in these children, and further decrease the amount of stigma attached with mental illness. Additionally, if students are constantly told that it is okay and acceptable for them to seek support from peers, mentors and mental health professionals, schools and colleges can aid in creating a more inclusive culture.
At a Professional level
Discrimination at the workplace is another issue faced by people with mental illness. Studies indicate that people suffering from mental health concerns are often turned down for jobs and passed over for promotions, which they attribute to their openness in talking about their mental illness. Disclosure about mental health issues in the workplace may also lead to other discriminatory behaviours expressed by managers and other colleagues such as micro-management, associating mistakes to mental illness, gossip and social exclusion. The stigma and its resulting behaviours have the following assumptions that may underlie them: that people with mental health problems are unable to meet the demands of work due to a lack of competence; that people with mental health problems are dangerous or unpredictable; that working is not healthy for people with mental illness; and that providing employment for people with mental illness is an act of charity.These assumptions vary in their intensity depending on the particular situation. To help reduce workplace stigma, therefore, one or more of the following strategies could be adopted at the workplace:
At a Clinician’s level (General Practitioners/GPs)
Many mental illnesses can have physiological symptoms. Depression, for example, can result in rapid weight loss or weight gain, and a lack of energy or motivation. In this case, if the person suffering is unable to pinpoint their source of discomfort, they might choose to consult a general practitioner. This is particularly true for cultures like India where most families have a family physician or doctor that they are most comfortable with. Therefore, it becomes essential to ensure that general physicians are sensitized about mental illness. By having physicians pay more attention to symptoms relating to mental health concerns, we can aid in debunking the myth that physical health is more important than mental health. Furthermore, general physicians, when sensitized, can act as a bridge between the person suffering and a psychiatrist or mental health professional. Having a GP who is supportive of mental health practices and practitioners can reduce the amount of self-stigma a person suffering might have; further reinforcing the idea that is it okay to seek for support.
At a Community level
At a community level, besides using education and sensitisation towards people who suffer from mental health concerns, encouraging more contact between the general public and people with mental illness is crucial to help destigmatize mental illness. This helps to humanize people with mental health issues, and normalize the presence of the illness in question, thus leading to the individuals in the community developing more empathy. Promoting this contact can further allow individuals to understand that people with mental illness are not responsible for their condition, and helps reduce the feelings of distaste and anger towards them. The community has the responsibility to make sure that every single person with mental illness is supported, taken care of, and not discriminated against.
In order to change the way individuals with mental illness are viewed, systemic change is required. Stigma of any kind can be a huge hindrance: self-imposed or external. It is important for individuals to recognize that they themselves partake in imposing stigma on themselves as well as others. Therefore, bringing about any kind of change will require a combination of individual and systemic adjustment and development.
