By Malika Noor Mehta
Art by Vamika Sardana
Introducing TLP's Dictionary for Mental Wellbeing
“How are you?”
The question usually invites some of those tedious responses - “I’m well” or “I’m ok, how are you doing?” – or something similarly banal. Perhaps, we don’t believe the questioner wants to actually hear us dissect the nuances of our own psyche. Or perhaps, we just could not be bothered to explain the highs and lows we experience throughout the day, everyday. Or perhaps, we just do not have the words to explain how we are truly feeling, and that lack of language prevents us from even considering the existential nature of the question itself. Yet, if we allowed ourselves a moment of thought, a second to find the words, and a minute to truly articulate ourselves, the question does carry weight. How are we? How are we, really?
As the world came to a screeching halt because of the COVID-19 pandemic, our minds went into overdrive – a dizzying juxtaposition by all accounts. What will happen to our jobs? When will our children return to school? What about our teachers’ safety? When will we see our loved ones who are stuck in remote corners of the world? Will we ever be able to socialize normally? What about the millions of migrants, unemployed, leaving cities in hordes, walking back to their villages in the unrelenting heat? What about those living in 5-square-foot homes, sharing bathrooms, where social distancing is simply anathema? What about the skyrocketing rates of domestic abuse? What about …
“Minds on overdrive” might be an understatement.
We are all grappling with such questions, figuring out how to adjust to this new normal. In such a world, it is hardly surprising that mental health and wellbeing have acquired a new, unrivalled significance.
Even before the pandemic, India faced a crisis in mental health. In December 2019, The Lancet Psychiatry, a renowned medical journal in the United Kingdom, published a study estimating that 197.3 million people face mental health issues in India alone. Of this, 45.7 million suffer from depressive disorders, and 44.9 million face anxiety-related issues. This study excluded neurological conditions such as epilepsy and dementia, as well as substance abuse disorders. Furthermore, it did not account for the mental health burden associated with suicide risk. Against this backdrop, 197.3 million is likely a gross underestimation of the number of people impacted by mental health concerns in pre-pandemic India. We do not have a reliable estimation of the current numbers, but one can only imagine the exponential increase since COVID-19 emerged.
Given this crisis, are we doing all that we can to help each other and help ourselves? The answer in short: probably not.
Stigma permeates the mental health arena in India. Admitting that we feel anxious or depressed is an immensely uncomfortable task for many of us.
In a survey my colleagues and I conducted among our urban, educated, middle-to-upper class network, 60% of our 215 respondents admitted that they face mental health challenges, but only 30% stated that they feel comfortable talking about their issues openly. In some of the qualitative responses we received, many admitted that shame and stigma were the primary reasons why they refused to discuss their mental wellbeing. While our respondents were of an economically privileged group, stigma does not distinguish itself along caste or class lines. People of all ages, genders, and socioeconomic circumstances experience the shame of admitting that they are in pain.
The overarching issue of stigma stymies further development in the mental health field. For example, there are currently 0.75 psychiatrists for every 100,000 people in India, an astounding data point given the enormous mental health burden within the country. This dearth of professionals is strongly correlated to our population’s inability to tackle their mental health issues. Why spend years qualifying yourself in a field and profession that no one in your country will utilize (a myopic point of view, in my humble opinion)? Given this dearth of professionals, the country has never felt an urgency to develop strong and coherent regulatory guidelines for the mental health field (something that could change due to the pandemic). Finally, our predominant language, Hindi, does not provide us with the vocabulary to express our mental health concerns. And even in English, we only stumble our way through. Without language, where does one even begin?
Discussing this topic is hard, but to do so without the appropriate words is even harder.
It is exactly this question that has motivated The Lipstick Politico to develop its very own Mental Wellbeing Dictionary. Discussing this topic is hard, but to do so without the appropriate words is even harder. Combatting the prejudices that mar the mental health arena begins with each of us acknowledging our problems, discussing them with our loved ones, and embracing our imperfections. This is what TLP’s Mental Wellbeing Dictionary will help us do.
In a conscious attempt to contribute to the mental health ecosystem, our dictionary will serve as a toolkit that helps each of us better articulate our issues, reclaim our agency, and unapologetically discuss our mental health needs. Through writing, art, and social media, all of us working on TLP’s Mental Wellbeing Dictionary hope to combat stigma, raise awareness and build safe spaces that cultivate a foothold for mental health discourse within our culture.
About the Author
Malika Noor Mehta is a mental health entrepreneur. Before the pandemic, she was engaged in creating a fellowship program that placed mental health counsellors in low-cost schools in Mumbai. Her interest in mental health stems from her teaching experience at Teach for India and her time in Jordan and Greece, creating trauma-sensitive education programs for Syrian refugees. She holds a Master in Public Policy from the Harvard Kennedy School of Government. In her free time, she loves to write and take photographs.