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Priyo Bandhu (Dear Friend) is a Bengali audio play I love. It tells the story of the friendship and love between Joyeeta (Nima Rahman) and Arnab (Anjan Dutta), through their correspondence, starting with silly notes passed in class between schoolchildren, then as eagerly awaited and deeply cherished letters bridging the gaps of space, class and experience between them as they navigate the choppy seas of young adulthood, responsibilities and relationships. I was listening to one of Parashpathar’s many beautifully nostalgic songs from the play today, and one episode was brought back to me in stark context.

Joyeeta is going through a bout of depression. Her husband takes her to see a psychiatrist, who finds nothing wrong with her, at least nothing that having a child won’t solve. She reacts with outrage, as I would, as almost any woman would in her situation. Now you may argue that this is fiction, and no one says things like that any more, but I could tell you stories from real life, and not just from India.

I am not saying that the fictional anecdote above is typical of what passes for psychiatry in India. I have been treated by two psychiatrists and seen one clinical psychologist for CBT in India, and they were excellent, professional to a T (to contrast the above story, one of the doctors ended our first consultation advising me not to make any major decisions for a while), and did me a world of good. But sometimes, when I hear of other peoples’ experiences,  I think I have been lucky.

There is one way in which I know I have been extremely lucky. In that I got professional help for depression at all. Because my family are educated and well-to-do and live in an urban area, I was exposed to enough information to be convinced that depression is a medical disorder, not a character flaw, and when my life got bad enough, I had enough sense of self-preservation to ask for help. And I got it, and there are no words to express how thankful I am for that.

But I am in a tiny minority. According to Govt. of India statistics and estimates, 1 in 5 people in India live with a common or serious mental illness, requiring professional help. In a country of more than a billion people, we have about 5000 qualified mental health professionals. That includes psychiatrists, clinical psychologists, psychiatric social workers and psychiatric nurses, concentrated mostly in urban areas. In fact, there are more Indian-trained psychiatrists practicing abroad than in India. Treatment gaps are huge. Upto 50% in case of severe illness, and 90% in case of common mental illnesses. And in areas and demographics with lack of access to proper health care, people resort to faith healing and other quackery, with no effect at best, and sometimes serious negative effect.

Awareness of mental health issues is worse. There is significant stigma attached to anything to do with mental health, from seeing a psychiatrist to talking about ones experiences, in public, or within ones social, professional and even family circles. This needs to change. And that is why I am writing this, intending this to be read by everyone I know, and maybe even some people I don’t know, despite all my apprehensions, despite other extremely pressing demands on my time right now.

Depression kills. Literally. Depression is a contributing factor to deteriorating physical health, leading to death, in the elderly. And India has one of the worst rates of depression in the world. It’s not just the elderly. Suicide is the second-most common cause of death among people aged 15 to 29 in India. I do not think I know a single person on whose life suicide has not cast a shadow.  We need to act.

Helplines help. A sympathetic, non-judgmental stranger at the other end of the line can be easier to talk to than friends and family. All such services tell the same story, one of under-funding and under-staffing. We can change this, by volunteering and/or donating. We can also combat the stigma around these issues, by speaking out about our experiences. We can encourage our loved ones to seek help when they seem to need it.

Mental health is real health. No one asks their friends why they have diabetes, and are they sure they’re not imagining it, or tell their family members to fight cancer with will power and prayer alone. Yet, when it comes to mood disorders and depression, well-intended, yet completely useless advice is the order of the day. We could educate ourselves on how to be effectively supportive, when people we know are facing mental illnesses.

There has to be a middle ground between airily brushing away someone’s concerns and telling them they are fine, and treating every acquaintance who seems a bit sad like a suicide-risk. We need to learn how to find it and stay in it, for sensitivity can be learned. You never know, but if you get a chance to directly or indirectly cause one person to hang on, for just a little longer, for tomorrow may be better, then you may be saving their life.

I am linking to some articles and resources which I hope will be of help. Please pass along anything that could be added to this.

And please pass this on to anyone you wish to. You don’t know where and how it may be useful.

Articles and blog posts:

http://www.mindsfoundation.org/what-is-mental-illness/india/

http://blogs.wsj.com/indiarealtime/2013/06/11/indias-suicide-problem/

http://elizabethexploresindia.wordpress.com/2013/04/12/large-treatment-gap-in-the-world-of-mental-health-in-india/

http://www.dnaindia.com/health/1848694/report-finally-a-national-survey-on-mental-health-disorders-in-india

A list of helplines you can help:

http://www.maithrikochi.org/related_organisations.htm

 

For R.