Meet Nisha and Mina. They are both 19 years old, enrolled in the same college and have a lot of plans for their future. They’re both lively, enthusiastic, keen to learn, and full of life. Although they appear similar to each other, the girls differ in certain crucial aspects. Mina’s parents are bureaucrats, and she is an only child, born and raised in the city. She has always had constant love and support from her parents, a fantastic set of friends, and unlimited opportunities to explore her talents. Meanwhile, Nisha is originally from a remote part of the country and recently relocated to a big city a year ago. She is the first person in her family to pursue a college education. Her family members are all involved in agriculture-based work, and she is the oldest of three siblings. Although her family has always been a constant source of support for her, her life has always been challenging as she has had to overcome poverty, prejudice, and discrimination to reach where she currently is.
Both girls begin to face certain difficulties. Mina finds herself struggling to adjust to her new college life and is unable to keep up with the academic demands. Nisha’s mother informs her that inadequate rainfall this year has led to their crops failing, and they’re in debt. Both girls start to experience low moods, excessive worry, and a host of physical issues like difficulty sleeping and feeling easily fatigued. Mina speaks to her friends and family, decides that she would like to speak to a mental health professional, and books a session with a therapist. Nisha hears about the same from Mina and decides to visit a therapist too, but she does a quick Google search, only to find that each session costs Rs. 700. Something she cannot afford. She is devastated upon seeing this and continues to feel worse every day, while constantly worrying about her family’s well-being.
October 10th is marked as World Mental Health Day, and its goal is to ensure awareness about mental illness while providing treatment for all. The theme of this year is 'mental health is a universal human right’, which is aimed at protecting and promoting mental health as a fundamental human right for all. In this regard, the role of inequalities concerning mental health must be assessed. If anyone takes a look at existing research on the topic, they will find thousands of studies that explain how poverty affects the experience of mental illness. Going by Nisha’s experience, the fact that she cannot afford private therapy puts her at a disadvantage compared to Mina, whose privilege ensures access to the help that she needs. Poverty is probably the single most crucial social determinant of mental health. It affects whether one can actually access mental health services, whether one can take a break to relieve themselves of stress, or the kind of support networks one has. The working-class person is more likely to work round the clock to make ends meet, is unlikely to be able to afford health insurance, and has very limited time for self-care of any kind. This is likely to create high levels of stress and predispose them to disorders like depression and anxiety. Living in poverty also creates an absence of protective mechanisms against stress, for example, being able to afford breaks in the form of vacations or leisure activities.
How does inequality influence mental health?
Living in poverty also increases the risk of experiencing traumatic incidents like abuse and assault and makes people vulnerable to developing addictive disorders. Research from all over the world has shown that the prevalence rate of substance use disorders is higher among ethnic minorities. It is not a surprise that ethnic minorities also live below the poverty line, have fewer opportunities for education and employment, and live in neighborhoods that are considered as ‘dangerous’, as they are often filled with people involved in criminal activities. The COVID-19 pandemic is one of the best examples of how inequality affected mental health. At the start of the pandemic, for many people, the lockdown came as a respite. It helped many people to rediscover their hobbies, spend quality time with their families, and help them to get the work-life balance they had been craving for so long. However, for the migrant workers, domestic workers, and daily wage labourers the sudden announcement was as good as a death knell. It left millions of people jobless, homeless, and vulnerable to exploitation. It forced the weakest people in the country to fend for themselves and walk back thousands of kilometers to their homes where hundreds perished on the journey. During the pandemic, a spike in mental health problems was also reported and 2021 saw a sharp rise in the number of deaths due to suicide, as per data from the National Crime Records Bureau (NCRB). Daily wage workers remained the largest profession-wise group among suicide victims for the year. Needless to say, the ripple effects were still being felt by various communities a year after the beginning of the Covid 19 pandemic.
As a society, we must understand that mental health is a public issue and not a personal issue. Making it a personal issue helps policymakers escape from taking responsibility to ensure equity for the marginalized. Sometimes equality is not enough, as it fails to take into account the considerations of those who are already marginalized. Equity is the way forward, as it provides fair opportunities to all and creates an even playing field. Without equity, there is no equality and both can be ensured only when mental health is looked at from the lens of public health.
Mental Health in India
In India, untreated mental illness is the most common cause of years lived with disability (YLDs). As of 2017, it has been estimated that India has 197.3 million people who live with mental illness. In 2017, mental diseases accounted for 4.7% of total disability-adjusted life years (DALYs) in India, compared to 2.5% in 1990. Mental health and socioeconomic advancement are mutually beneficial, and it has been observed that the negative economic consequences of not treating mental illness outweigh the costs of providing treatment. While there has been a great deal of awareness and increased acceptance of mental illness in India, the approach to treatment still remains individualized, as if it is a problem that only occurs among the privileged.
In India, government spending on mental health accounts for only 0.06% of the total health expenditure, which accounts for barely 4% of the national gross national product (GNP). The availability of personnel, hospitals, and related infrastructure is highly limited. The immediate need of the hour is increased government funding to hire mental health professionals, create hospitals, and have standard operational procedures for treatment. There has to be a shift in how mental health is viewed in India if people like Nisha are to receive the help they deserve. Mental health for all cannot be ensured if the social causes of mental illness are not addressed.
Free OPD Clinics in West Bengal (Run by the Department of Health and Family Welfare)
Other Free Online Mental Health Therapy in India
Honoring Mental Health Day: A Journey Towards Wellness
Spriha Society firmly believes that every day ought to be recognized as Mental Health Day. We cordially invite you to join us all year long in promoting awareness, goodwill, and compassion. Let us keep dispelling the stigmas associated with mental illness, honor the courage it takes to ask for help and work to create a society in which everyone can develop mentally and emotionally.
Never forget that you are never alone on this special day or any other day. Speak to your loved ones, get help from a professional if you require it, and never forget how important your mental health is. We can all work together to make the future brighter and more understanding.
Thank you for being a part of the Spriha Society community. Your involvement means a lot to us! Let's keep making a positive impact on mental health together, one step at a time.