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Sunday, June 21, 2020

Mental health is a collective responsibility: The person is not the problem - INDIAN EXPRESS


Mental health is a collective responsibility: The person is not the problem

Imagine: We have created the toxic society in which young people are struggling to survive.


Written by Shelja Sen | New Delhi | Updated: June 21, 2020 9:45:50 am


XReach out, hold tight: We need to reflect on how to help each other overcome mental-health impediments. (Source: getty images)

Right from an early age, we are recruiting our children into believing that there is one right way to live their life. In a talk or in a workshop, I generally ask the audience if they know somebody who has experienced mental health struggles. Some hands shoot up right away, then others start raising their hands tentatively, looking around and taking solace in the sense of solidarity until all the hands go up. Then, I make it a little more difficult and check if they know somebody who has dealt with suicidal thoughts. Majority of the hands go up again. It is all around us — in our homes, our schools, colleges, workspaces, public places — staring back at us, asking us to look, listen. But we turn away, leaving them with their silences. Maybe sometimes, that silence and shame becomes too much to live with. It takes the death of a public figure to remind us how much mental health matters. For the coming weeks, there will be a flurry of Instagram, Facebook and Twitter posts by well-meaning people, but then it will all go away, as it generally does. Do we realise how difficult it is for people living with depression or anxiety to be their own advocates at every step, especially when they have been convinced that something is inherently wrong with them — that they are the problem?

The person is not the problem, the problem is the problem

Right from an early age, we are recruiting our children into believing that there is one right way to live their life. They are constantly struggling against the illusionary yardstick of success. They are being sold the idea that the higher they go, the better they will be. But then they wonder why every rung up leads to more misery? Off-the-chart suicide rates of IIT aspirants in Kota coaching centres should shake us out of our collective stupor of what we see as the making of a “good life”. A study conducted by Assocham in 2018 found that 42.5 per cent of employees are struggling with depression and/or anxiety in their high-pressure jobs. They possibly climbed the ladder of success and security to find it is a myth. They have internalised the propaganda that the only way they are worth something is if they get into a good college, “be productive” and get into a financially stable career. Therefore, it is no surprise that the chilling statistics indicate that one in four young persons is struggling with depression or anxiety and that India tops the world in youth suicide.

Read| Imagine: It’s our society that is broken, not our kids

The person is not the problem, the problem is the problem, and the problem is social!*

Shiv is a young man I met who had been lured into the society’s idea of success. In our discussion, he started realising that his company’s work culture of constant pressure, of “never being good enough” was pushing him into depression. As we unspooled this problematic notion of success, he realised, “My life can’t be just about meeting the next target, pay my bills and die.” He renegotiated his purpose in life, had a clear chat with his boss on what he would be able to deliver and started doing things that aligned with what he valued the most. For example, getting together with his old band and jamming every weekend and not “wasting precious hours of my life thinking of how to get ahead.”

There is much talk about the “epidemic” of mental health problems reaching unprecedented proportions. We have been made to believe that it can all be understood as “chemical imbalance” but that does not hold much water in the face of growing research and begs the question, “Who has a chemically balanced brain and what does it look like?” To the point of being provocative, I can say it is pretty fictional and not helpful as it locates the problem within the person. It is an extremely complex problem within our socio-cultural context which needs a nuanced understanding. Our identities are formed at the intersection of gender, sexuality, age, caste, class, religion, looks (let’s not underestimate the demand for “fair & lovely”) and the most important of it all — social acceptance and social success. Mental health problems as chemical imbalance absolves us of the collective responsibility we need to take as adults. This pushes us to think it is not our problem and we end up making the problem individualistic, leading to, what I call, the 3 Ds.

Dismissal — trivialising the problem with normative judgements such as “Stop complaining all the time”; “This is so silly”; “You just need to be stronger”.

Defining — making the problem the single story about them — “I don’t think you will be able to do much in life if you are so weak.”

Dumping — mental-health problems hide issues of gross social injustice. For example, women being diagnosed with depression when they react to marital abuse, young girls who feel rejected and suicidal as they do not fit the rigid definition of “fair & lovely.” Their mental-health problems are just a mirror of a society that is unfair and damaged.

Sometimes, all people need are these simple messages:

“I see you” “I hear you” — People are multi-storied so let’s not define them by single stories of “failure” and “unworthiness.” This does not mean we have to “be positive” and “look at the silver lining” as that can be quite dismissive. It means to listen to their problems and also keep sight of their stories of courage, hopes and dreams.

“Tell me how I can help” — We might not know what to say or do, so asking might help. It is easy to get into the “let’s fix it” or advising mode but step back from it, as it might stop them from accessing their own skills and abilities to find their solution. “I have your back” — If each person knew that there is somebody out there who will accept them the way they are no matter how damaged they are feeling.
It is not a mental-health problem but a problem of social justice

As a narrative therapist (Narrative Therapy was pioneered by Michael White & David Epston), I strongly believe that the solution is not an individual’s or a family’s responsibility. It is a social problem, and, therefore, we need to take the lens of social justice. There is an old legend-now-turned-to-a-metaphor that canaries were sent down into coal mines to test for gas leaks. Our young people are the canaries of our present time. We have created the toxic society in which they are struggling to survive. Maybe, this pandemic is an opportunity for us to let go of the deadwood of social expectations of success and carve out something new collaboratively. Rather than quick solutions, here are some questions we can reflect on:

What do you think are the social beliefs and norms that contribute to the rising mental health problems?

How fair are these social norms and expectations?

In what ways can you resist these expectations and support others?

We need nothing short of a social movement to make this happen. We have lost too many lives and too much time. Nobody is going to come and sort this out for us. We have to do it ourselves.

*Quoted by David Denborough, narrative practitioner, in a workshop

(Dr Shelja Sen is a narrative therapist, co-founder Children First, writer, and, in this column, she curates the know-how of the children and young people she works with. Write to her shelja.sen@childrenfirstindia.com)