“Mental health is not a destination, but a process. It’s about how you drive, not where you’re going.”
Noam Shpancer — Author of The Good Psychologist.
Simple yet pertinent words from a global expert that could not ring truer in today’s VUCA (Volatile, Uncertain, Complex, Ambiguous) world. According to a study done in 2017 by The Lancet, one in seven Indians were affected by mental disorders of varying severity.
The COVID-19 pandemic has only accentuated this further. While the awareness about mental health has gone up in the last decade because of the efforts of NGOs, relevant societies (ARDSI, NNDC, etc) and pharmaceutical companies, it is far from ideal. The myths, taboo and embarrassment associated with these ailments continue to be the barriers towards addressing mental health issues.
Let us look at 4 different age bands and the various facets around mental health with each one of them.
School going kids (9-17 years): It has now become a trend to say that “50 is the new 40”, but an unfortunate truth today also is “10 is the new 25”. The average school going kid today is far more stressed both physically and more so mentally than their counterpart from a generation ago. Access to technology while making them digital natives has taken away the simple pleasures that childhood have to offer. They have been spending most of their time staring into screens and outdoor sport has been replaced by video games. This has serious repercussions on cognitive and social skills. Lockdown forced ‘School from home’ which necessitated a new learning environment added to their woes.
School Mental Health Program (SMHP) has been running in India for a couple of decades but very intermittently and in a piecemeal manner. They help in overall development of the student, increasing resilience and training them to overcome failure. The need of the hour is a comprehensive program wherein the government and the schools come together to create a framework that is sustainable over a long time. This means the coming together of all stakeholders, viz: the policy makers, school boards, teachers, parents, mental health professional and students. The Covid-19 ‘global pitstop’ should be used to rebound stronger and more so for students of this impressionable age.
Young Adults (18-25 years): This is where it starts getting trickier. Career crossroads, muddled thinking when it comes to higher education, love life pangs and coming of age identity search. A heady concoction that manifests predominantly during this phase. This is also the age where the suicidal tendencies tend to be higher. Not delivering the expected results in university and rejection in love are the two strongest triggers. Anxiety and depression also set in as they gear up to face the real-world challenges. It is a completely different reality from the rose-tinted lens that the protected and sheltered world the parents provided for.
This being a vulnerable phase, the support system becomes very critical. The role of the parents and the close friends are important and probably need a bit of swapping. The parents need to come down from the pedestal of a guardian to being a confidante. Likewise, the inner circle of friends, need to step up and play the role of guardians when they sense some vulnerability. Meaningful relationships and open conversations will go a long way in preventing untoward incidents and irreversible damage.
Middle Age (35-45 years): The term ‘mid-life crisis’ is broadly accepted and finds its way into informal conversations. This masquerades a bigger problem that runs far deeper. However, slowly but surely this age band of people are waking up to the reality and consequence of neglecting mental health. In that respect Covid-19 was a bit of a blessing in disguise. It got the people to step down from the ‘treadmill of life’ and evaluate what their priorities were. Organisations also prioritised the mental well-being of their employees which were being ignored for long. Yoga, meditation, relaxation technique programs have become a part of the workday (WFH or in office) for the employees and are being funded by the organisation. There is also increasing emphasis on the work-life balance. People are encouraged to take up recreational activities or restart a hobby lost due to professional life.
This is where the government needs to ride this wave. Developed countries roughly allocate around 5-18% of their annual healthcare budget on mental health. Meanwhile, India which is taking strides towards being a developed country, the equivalent numbers- an abysmal 0.05%. The policymakers, service providers and educators alike must create robust systems that address the country’s severely underserved mental health needs.
Senior citizens (above 60 years): This is the group where the needle moved first. It has got to do with age induced ailments like Dementia, Alzheimer’s and Parkinson’s to name a few. The awareness, the visible symptoms, the role of the Healthcare Practitioner (HCP), the caregiver’s alertness to seek medical advice and the Patient Support Programs (PSPs) run by the pharmaceutical companies and NGOs have all contributed to the understanding and the treatment of the Central Nervous System (CNS) problems.
The prime factors that affect their mental health are-retirement, financial Issues, loneliness (children outstation or abroad) and dependence on others for mobility and transport issues. While medical science has advanced, the ratio of 5000 psychiatrists catering to a population of 21 million geriatric population in need of mental health services is not encouraging. In addition to clinical prognosis, spending time with them and making them feel wanted is panacea. At this age there is an increasing feeling of lack of self-worth and that needs to be addressed at a personal intimate level.
Beyond the one-on-one interaction between the HCP and the patient and the caregiver and patient it must move to a larger level. There is a need for developing community-based rehabilitation programs, capacity building and developing a holistic primary healthcare system.
The most important aspect of taking care of mental health is acknowledging and admitting the need to do so. Once done, the journey becomes easier with the help of the right support system, medical intervention, and a balanced lifestyle.
There is also a need to distinguish between the most common mental health issues that can affect anyone- viz. anxiety and depression and mental illness/diseases that have deeper physiological/genetic roots- viz, ADHD, autism spectrum disorders, psychosis, schizophrenia, bipolar disorder, Parkinson’s, Alzheimer’s, etc.
Over the past few years’ public figures from the glamour and sports world have come out and spoken openly about the need to address mental health issues. Virat Kohli recently acknowledged- “Trust me, faking to be strong is far worse than admitting to be weak.” Live Love Laugh Foundation started by Deepika Padukone is one such pioneering initiative. It encourages people to talk about their mental health problems and supports them in their journey to better mental wellbeing. These are small but important steps towards reducing the stigma associated with mental health. Eventually we all should embrace the Ubuntu spirit and strive towards treating each other with respect, dignity, and kindness.
10th October is celebrated as World Mental Health Day and this year the theme is ‘Make Mental Health & Well-Being for All a Global Priority’. Each one of us can play our part in taking care of our own, our immediate family and close friend circle’s mental well-being. Speak up, listen well, seek advice and be there for your loved ones- it can make a world of difference.
One hack that works well at an individual level is having a hobby, passion or recreation beyond work that becomes a stress buster. Try learning to play the drums with your young son or rediscover the love for brush strokes that was lost after school days. These help in correcting the hormonal imbalance that causes anxiety and depression. We need a balanced DOSE- Dopamine, Oxytocin, Serotonin, Endorphin, commonly referred to as the Happy Hormones thus creating a happy state of mind.
Writing did it for me. I do not write to impress others but just give words to my thoughts and feelings. The outcome may not always be magical but sure leaves a smile on my face. A few lines by yours truly to illustrate the point, it may just leave a smile on your face too.
Quitting is easy, smiling is tough.
Life looks choppy, unforgiving, and rough.
Your inner daemons consume you.
The world seems just fine, without you.
When everything around you seem to crumble.
And you are expected to pull through, unflinching and humble.
Ask for help, it seldom makes you small.
You only get stronger after every fall
Remember, bigger the setback, stronger the comeback.
Once you come through, there is no looking back.
As the saying goes- You just live once.
Well, to which I say, “If you have lived it well, once is enough.”
Cherojit Goswami is the Senior Vice President of Ogilvy Health & Wellness in India.
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