Updated: Jul 8, 2020
Over the past few weeks, our country has been mourning the loss of Sushant Singh Rajput, a Bollywood actor. His death seems to have started a conversation about mental health everywhere but as a mental health professional myself, I find these conversations hollow. And I have my reasons.
We have lost and keep losing students in many more numbers in this country but I don’t see many conversations about it then. But when we lose artists and celebrities to suicide, be it Chester Bennington from Linkin Park, or Avici and others then our social media is flooded with posts on importance of mental health. We have youth suffering from a myriad of mental health issues like depression, anxiety, phobias and eating disorders. In our country, 15-39 is the age group where most suicides take place. And, we do not address these issues but we wish to address why their productivity is lost, they were so smart how could they do this, was it a conspiracy, is it nepotism?
I would strongly urge our society to stop this selective activism and caring for mental health when it seems feasible and convenient for us. Historically, mental health has never been a priority in this country. From our government to educational institutes, hospitals and us as citizens, we have not done our best to make mental health a priority. I also urge you to understand that social media does not substitute a mental health expert and contemplating why he did take his own life, is not appropriate. I'm tired of seeing how a person's decision even after his death is not his own and people take that opportunity to make their own theories.
I for one, also want to take this opportunity to help you understand what goes on before someone takes their life. It is not black and white, it has got nothing to do with your intelligence, it is not as simple as saying s/he gave up. The possibility that s/he was suffering and he didn't know where to go is more probable. Anyone who contemplated suicide is undergoing immense suffering, a suffering that you and I will not be able to understand.
Suicide as an option is also considered when one feels there is no other way left out of their suffering. Our mind when undergoing such suicidal thoughts is a hotbed of negativity, helplessness and more importantly, hopelessness. It doesn’t matter if you are able to sit and figure out other ways that could be taken and find hope, it only matters that in that moment that person feels devoid of hope. And this is exactly why it is so important to reach out to people regularly, so they can see these other hopeful ways.
In my personal opinion, if you are someone who really cares about people being pushed in a corner, then let’s work together to improve our society. Just writing prescriptions to be more empathetic is not enough to teach more empathy. I would like to urge you to stop encashing the cause of mental health, we need to understand where such decisions come from. Not all of us have that sense of safety and social support, so it is all the more important to try beginning with listening and understanding and then maybe we will see true change.
If you are serious about the cause of mental health, prioritise your own mental health first and try not judging the people who approach you about theirs.
If we want to change the scenario of mental health in our country then we need to address everything that's rotten, instead of deciding this person failed because s/he died by suicide. It is important to understand that people battling mental illness go through enough shame in their lives so blaming the victim here, saying he could have reached out, asked for help, found another way is not appropriate. Sushant Singh Rajput did not fail, we failed. And, I believe we have been failing for a number of reasons.
For one, the expenditure in the latest Union budget for mental health has been a mere 40 crores. In a country of our size, this budget allocated to mental health is minuscule and in fact, even less than that of Bangladesh. Apart from that, there is this constant discrimination, stigma and misinformation. We as citizens, do not know the difference between psychology and other healing practices let alone the difference between a psychiatrist and a psychologist.
As per law, insurance was supposed to be given for mental health in 2017 under the Mental Healthcare Act, 2017 but it has not seen the light of the day since. We have some good policies in words but with mental health, it's always hundred years backward in comparison to other priorities that our government feels need to be addressed. There is a lot of work that needs to be done to create more awareness and somewhere it has to come from the establishments like the Ministry of Health and Family Welfare.
I believe we have a long way not just us as citizens but also, us as practitioners. There is no proper enforcement in monitoring mental health practices in our country. The laws made for illegal and unethical practices have low penalties and the Rehabilitation Council of India has not been very successful over the years to monitor production of quality mental health practitioners. To add to this, we have very few institutes and even fewer licensed professionals coming out of these institutes. Hence, the demand is never met and we are only able to produce roughly 300 trained mental health professionals a year (this is a hopeful estimate).
Coming to mental health care services, these are mostly limited to urban areas and capital cities. We have poor mental health service penetration in rural areas and a dearth of treatment facilities because of which in rural areas and the poor, in the urban areas go largely undiagnosed even if they are battling a mental health condition. However, thanks to the District Mental Health Programmes, things are changing, where it is implemented.
Mental health treatment takes time and is sometimes not affordable by everyone but there are also many mental health professionals who are being underpaid or charge less for their services due to the lack of investment by the government. The graph is highly skewed. I believe, these things should be regulated but it is only possible when professionals are adequately compensated by their employers or recognised by the government for the service they provide. This control should also be across the board which means it should apply to doctors, pathology labs and hospitals as well, if we want to ensure quality and affordable healthcare both physical and mental, can be accessed by the patients. So ask for that mental health insurance you are due, ask for the enforcement of mental health laws after all, we have all the right to.
Having said all this, I want to express that yes it does make me sad, it is unfortunate that we lost a soul like him. But the hard truth is that we lose such brilliant, young and empathetic souls everyday in this country. Sushant's death is like many of those students, farmers, unemployed young people who could not make it through and I'm sorry that we failed them. I want to take this opportunity and say that I'm sorry we could not make this world a beautiful place for beautiful souls like you.
And we ought to do better, all of us.
Author: Ankur Singh Kapur is a psychologist with a Masters in Clinical Psychology. He has been extensively working with children and adolescents and has provided services at Saksham Child Guidance Clinic and Gangaram Hospital, Delhi. When he is not reading psychology he is usually found in mountains or in the bookstores :')