Every one in seven Indians has suffered a mental health disorder, according to a study published by the Indian Council of Medical Research (ICMR) in 2019.
By all accounts, the mental health crisis has got worse since 2019 globally — considerably worsened by the Covid-19 pandemic that struck the world in 2020.
Even if one overcomes the stigma around mental health issues to seek treatment, then one has to navigate the highly cluttered space full of magic pills and healing programmes. The process to find a mental health professional and what works for you, whether a psychologist or a psychiatrist, can be a long-drawn process.
A simple rule to safeguard yourself from fraudulent persons or practices is to see whether someone promises something that appears too good to be true.
“Refrain from opting into something that feels too good to be true, such as a workshop that will heal you in a Rs 99 session or a master course on ‘fixing’ your relationships or emotions in Rs 499, or sessions to ‘teach’ you how to never feel sad again. These are often scams,” said Aanya Wadhwani, a New Delhi-based psychologist.
To understand how you should go about seeking mental health treatment and navigate the nuances of mental health, Firstpost’s Madhur Sharma sat down with Wadhwani, the founder of Grah Pravesh, a Delhi-based therapy and healing centre. Excerpts:
While availability of treatment, particularly in remote areas or marginalised communities, is an issue, another issue is getting on the path of treatment. Most Indians have no idea how to go about seeking mental healthcare.
For physical health, they know what doctor to seek and how to verify their registration. For mental health, they simply don’t know whom to approach, whether a counsellor, psychologist, or a psychiatrist, and how to assess if they are genuine professionals.
Please tell us how one should start the treatment. What are different kinds of mental health professionals and how should one decide whom to approach?
This is an excellent question! There are a few things of importance here: one, getting to know if I need professional help, two, knowing the kind of help that will benefit me the most, and three, knowing how I should go about finding the said professional, and four, finding if the professional is genuine and right for me.
To assess if you need help, check if you feel discomfort or pain in any area of your life –- some people will find themselves thinking about the same thing constantly or feeling so many emotions that it becomes uncomfortable. So, if you’re uncomfortable in any area of your life, and talking about it with your friends or family is not helping anymore, you’d likely benefit from a mental health professional.
Now, how do we assess who can help us? The first step is to get to know what each professional does. A simple Google search goes a long way, and here’s a search that I ran for this article:
So, google the difference between professionals and, most often, you’ll get the right answer. At the same time, Google may not be able to answer who can help you best. For that, it’s best to consult any one trusted professional who can assess and redirect you to the professional right for you.
When it comes to finding a genuine professional, it’s best to ask a safe person in your life if they know someone — that way you’re getting a reliable enough answer. But if that’s not possible, look up a therapist on LinkedIn and read about their work and their qualifications. A master’s or PG diploma in psychology is a must for a practising therapist.
You will also see many professionals on Instagram, but refrain from opting into something that feels too good to be true, such as a workshop that will heal you in Rs 99, a master course on ‘fixing’ your relationships or emotions in Rs 499, or sessions focused on teaching you how to never feel sad again. These are often scams. Look for something that assures space, safety, a listening ear, and non-judgemental care.
Now that you have explained the different approaches to mental healthcare, please tell us when someone should consider seeking professional help.
For many people, it takes a long time to realise that their anxiety is not ’natural’. A lot of people complain that they get into an overthinking spiral. Are these mundane things just a part of life or a reason enough to seek professional help? What do you think should be the criteria to seek professional help?
The things you’ve mentioned, such as anxiety, and overthinking, are all natural parts of human existence. They are our protection mechanisms. Other such things can be feelings of anger or depression or a habit of binge-eating and binge-watching — the list goes on and on.
Anxiety gives us a heads-up that there’s possible danger ahead that one we can’t see yet but can anticipate. Overthinking, or more exactly excessive thoughts, is beneficial when you have a lot to plan and much less time for it. Feeling anger protects us from harm that might come our way. Feeling depressed can be a sign that our body needs to slow down and rest now. Indulging in binge-eating is usually a sign that we need to ‘distract’ ourselves from something painful.
So if all these are ‘normal’ parts of existence, why does one need to seek a mental health professional? At one point, a person who’s experiencing this dysfunctionality now must’ve been protected by them. Maybe, these mechanisms were important for their survival. And while they may be safe now, these mechanisms may turn dysfunctional later. So, when you can’t stop using these mechanisms, it’s because your body doesn’t feel safe enough to stop using them. And this is the time you consult a practitioner, who can help you feel safe again.
Loneliness has emerged as one of the biggest concerns of young people. The Covid-19 pandemic worsened the loneliness crisis. How do you see the relationship between loneliness and mental health?
Support systems alone can act as a preventative layer against past and current stressors. Research suggests that if someone experiences something very painful and they are immediately able to confide in someone who lends them a compassionate ear, it reduces their chances of overthinking, anxiety, or other after-effects of traumatic events.
This means that if someone is experiencing acute or chronic loneliness, they won’t be able to get the required support to get through the ordeals of existence, let alone the pains that trauma and violence bring from simply going through the world we live in. This can and will have long-term implications for mental health of people who have little to no safe spaces in their lives.
While mental health professionals can’t replace family and friends, they can help in supporting through the rough times, increasing readiness and capacity for new connections and maybe even reviving old ones!
Mental health treatments remain out of bounds for most people. An ICMR study found that up to 20 per cent of families with a member having a mental condition were pushed into poverty. As most health insurance programmes and schemes do not cover therapy sessions or mental health consultations in general, do you believe a systemic change is required in how insurers and state look at mental health?
Yes! Yes! Yes!
Therapy sessions are usually not covered under insurance plans. That being said, 24-hour hospitalisations as a result of mental illnesses are usually covered. Doesn’t that say how the state and health infrastructure view mental health? That they would cover when things progress to the extent that you need to stay in hospital for one full day due to your mental health being devastated that much, but primary or secondary intervention methods are not worthy enough to get coverage?
A systemic change is definitely warranted. Ensuring accessible and quality mental health support, in not just state hospitals but also non-health spaces, such as schools, corporates, study centres, etc. is the need of the hour. Insurance companies must work with private practitioners and mental health organisations alike to provide support to people who directly need it but cannot afford it.
The theme of Mental Health Day this year is the importance of mental health at workplace. In your professional experience, how much do you believe workplace matters in the overall mental wellbeing of a person? Are you increasingly getting patients or case studies where people’s mental health primarily worsened because of workplace issues?
In my practice, I have a client who works solely about concerns arising from the workplace environment. There is no other area discussed. Nothing is as stressful as work. Of course, other things must bother them, but is there any space to look beyond work? No. Does that mean other problems cease to exist? Never.
Any person who is a part of the working population spends more than half their waking time with their work. It’s bound to affect mental health, if your colleagues mistreat you, your boss is inconsiderate, or you’re forced to work in spaces and roles that harm you. At this point, a toxic or even chronically uncomfortable workplace is fatal. The tragic death of the 26-year-old Ernst & Young employee in Pune is a painful example of it.
There is a common perception that once you start taking medication for mental health conditions, it never stops. Even TV shows and films have featured plotlines where people become addicts to medication and the treatment ends up making the person worse. How do you address such a perception regarding mental health medication? Is it a misconception or is there some truth to it?
The use of psychiatric medications surely has side-effects, but often helps improve functioning and well-being and rarely spirals into addictions. Misuse, however, can definitely lead to dire consequences.
The best way to avoid misuse is to consult a trusted psychiatrist —not a general physician— in order to get your meds right. Don’t change dosage by yourself and let the doctor tell you how to go about it. Do consult regularly as per their recommendation. Take your time to look for someone whom you feel comfortable with and stick to one doctor only.
In recent years, several high-profile persons have publicly talked about mental health issues. Do you believe such public conversations have helped destigmatise mental healthcare?
Absolutely, yes. While there’s benefits of public conversations about mental health, it’s so important for them to be verified and credible sources. So, best to do our own research before trusting everything you hear on TV, but it’s nevertheless a good place to start.
For those who may be suffering from mental health issues, what message do you have for them?
It’ll be a long road ahead of you, but on each corner you’ll find yourself bit by bit. The first step is the hardest, and you’ve already taken that by reading this.
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