“Peace of mind is expensive because it requires access to an individualised psychological development plan. It requires an investment of time, effort and want to. It has no substitute.”
Beretta Scott King
No one can truly comprehend the entirety of someone else’s context given the individual personalities and cultural backgrounds that make up each person. Numerous studies on twins indicate that even the closest of genetic and environmental factors do not add up to the same experiences for two people.
Given this complex reality, mental health must be addressed with a holistic approach. Holistic approaches are characterised by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease (Shafran, Roz et al, 2017).
Indian Geographical and Historical Context
India’s population was 139.34 crores according to World Bank’s 2021 census (Data Commons, 2022). This is a diverse population across caste, class, gender, disability, languages, religions, education etc. Meanwhile, mental health support is limited to 3800 psychiatrists, 898 clinical psychologists, 850 social workers and 1500 psychiatric nurses nationwide, according to the Ministry of Health & Family Welfare in Parliament in 2015 (Pathare S. et al, 2018).
These numbers do not reflect at all on the quality of mental health services available to those who are able to access support. The complexity of mental health support in India is rooted in a culture that stigmatises Western notions of mental health, choosing instead to rely on Ayurveda, Yoga and other spiritual forms of traditional practice.
The problem with this approach is that traditional forms come nested in patriarchy, casteism, classism and other puritanical behaviours that can be exclusionary. Additionally, there is an exploitative element to various self-proclaimed Gurus who manipulate their disciples into spiritual bypassing while turning a healthy profit (excuse the pun).
However, it is also important to consider that there is good reason for people to spurn western assessments given the foundations of mental health legislation in India. In the colonial context of the British treating their coloured populations as savages, the first legal act in India was the Lunacy Act of 1858, which offered guidelines to protect the general population of India (a majority of which was the British population) from the Lunatics – idiots, people of unsound mind (Gloria, Kristine, 2021)
The interests of the “mentally ill” were taken into account only in 1987 – 35 years after Indian independence – with the Mental Health Act, and most recently refined with the Mental Health Care Act of 2017. While this act has decriminalized suicidal ideation, taken away Electro-conversion therapy (mostly) and chaining, much remains to be addressed. Significant gaps include clear definitions of roles and procedures on the national and state levels, post-admission care for patients and the inability of the state to provide promised care considering gross lack of resources (Neredumilli, PrasannaKumar, et al., 2018)
In the past years of the Pandemic, the situation has been magnified by stressors from uncertainty on all levels which only highlighted the gap between the privileged and marginalised the world over, and in Indian society in particular.
Approaching Mental Health in India today
The historical context of mental health assessment in the western context came from the medical model and the social model, both developed in the 1970s. Their incomplete approaches were melded with the bio-psycho-social model, used to assess mental health based on biological traits, personality and skills, as well as the social identities of a person. There are multiple layers to this assessment, because trauma impacts the very biology of the brain, and epigenetics can turn into genetics through intergenerational trauma that acts on physical, emotional, social, cognitive, behavioural and political levels.
In the context of India today, based on the history mentioned above, we are a culturally traumatised society where our colonial and neo-imperialist past and present impact our educational, economic, legal, religious, social and cultural institutions, which in turn impact our relationships and communities, which impact our social and personal identities (Jayakumar, Kirthi, 2022)
India is a society that was originally rooted in community, with strong extended family and village institutions. Colonialism uprooted these systems to bring a more individualised approach. This has led to social systems that mimic the community formats of the past but practise the capitalistic, individualistic, patriarchal systems of control in attitude.
Where does that lead us?
It is time for a radical change, with interventions on every level. This would require a multi-disciplinary approach, where fractured systems of the past and the present, local and global, internal and external work together for new and adaptive ways to support ourselves and each other.
This could look like bringing ‘trauma informed support’ awareness and training to different systems- the legal system from police to judiciaries; the educational system from basic mental health education at kindergarten levels to specialised training and support; economic systems from government offices to corporations; religious systems that offer spiritual alternatives to medical mental health support etc.
It is time to look at mental health as an aspect of human wellbeing and find ways to disentangle the knots of past trauma to weave a tapestry of understanding. This means communicating with different people in language that they will understand, with examples that make sense to their lives.
It means knowing that every person has agency over their own choices, and empowering and supporting them to heal themselves at their own pace while rooted in loving community.
It means really listening to each other and learning how to separate the jargon and the trends from the heart of the matter so that we can learn to feel safe and vulnerable with each other.
It also means making space for the inevitable grief, anger and frustration that are released after being withheld for generations.
In contemporary times, one way to create this space is to make use of the digital avenues available to us. There are multiple social media platforms, apps, blogs, podcasts and websites dedicated to disseminating mental health awareness globally.
This trend has begun in India too, and people are starting to share mental health awareness content that is relevant to the Indian context, albeit mostly in the urban realms. This is especially important when the content includes intersectional storytelling of gender, sexuality, caste, disability, neurotype, class, language etc. Some platforms doing good work in this regard are Agents of Ishq, PARI, Much Much Spectrum, Mavelinadu Collective, The Blue Dawn, Adivasi Lives Matter etc.
Another important movement in India is the rise of communities and peer support spaces for affinity groups – people who can connect with each other based on shared experiences. While these shared experiences can be fun and light, like board games meetups, they can also address shared experiences of marginalisation, sometimes in fun and intense overlaps.
The question becomes, what are ways to embody safety, pleasure and joy so that we move towards a shared, positive future, while maintaining a culture of apology and forgiveness from communities that have been on different parts of the oppression spectrum in the past?
The answer is long-winded and complicated and always emergent – in response to circumstantial situations that arise on a moment to moment basis. There are no magical solutions – only people willing to be curious and learn how to find peace of mind for ourselves and our communities, our societies, our planet and all her beings.
Back to the beginning
This essay started with stating that peace of mind is expensive. It is expensive because generations of people across the planet have acted selfishly by treating nature and other people as resources for centuries. As we face the backlash of those unaccounted for actions by facing unprecedented emergencies, we pay the price – and someone must.
It is for our generations to preserve the ones to come by working through the traumas that have settled into our personal, interpersonal, community and societal systems. It is hard work and it is worthwhile – it is also the only way that we can adapt and iterate ways of being together and sharing resources on a planet that is enraged and in crisis.
The process must necessarily be slow, mindful, spiral and complex, with an individualised psychological development plan for each person. It is important to note here that while the care for every person looks different, the work of giving and receiving care must be enacted in community, following the African principle of Ubuntu – I am because we are (Mangena, Fainos, 2022)
May we learn how to embody Ubuntu for ourselves and each other with grace and humility, moving towards a diverse, equitable and inclusive world. May we realise that the only way to that world is through holding ourselves in accountability and empowerment: here and now.
References
Pathare, S et al. “Peer support for mental illness in India: an underutilised resource.” Epidemiology and psychiatric sciences vol. 27,5 (2018): 415-419. doi:10.1017/S2045796018000161
Shafran, Roz et al. “Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics.” Healthcare (Basel, Switzerland) vol. 5,3 44. 16 Aug. 2017, doi:10.3390/healthcare5030044
“India – Place Explorer – Data Commons.” India – Place Explorer – Data Commons, datacommons.org/place/country/IND?utm_medium=explore&mprop=count&popt=Person&hl=en. Accessed 17 Dec. 2022.
Jayakumar, Kirthi. “Understanding Intersectionality.” Medium, 26 July 2022, medium.com/the-red-elephant-foundation/understanding-intersectionality-a1da46e2e0b2.
Neredumilli, PrasannaKumar, et al. “Mental Health Care Act 2017: Review and Upcoming Issues.” Archives of Mental Health, vol. 19, no. 1, Medknow, 2018, p. 9. Crossref, https://doi.org/10.4103/amh.amh_8_18.
Mangena, Fainos. “Hunhu/Ubuntu | Internet Encyclopedia of Philosophy.” Hunhu/Ubuntu | Internet Encyclopedia of Philosophy, iep.utm.edu/hunhu. Accessed 17 Dec. 2022.
Gloria, Kristine. “Loneliness in India: Recognizing the Role of History, Technology and Culture.” Communications & Society Reports – Home, 2021, csreports.aspeninstitute.org/documents/Loneliness-in-India.pdf.
This essay was written as an assignment for One Future Collective as part of the 2022 Peer Support Program