Psychology and Mental Health in India: An Overview
Picture Credit: Ann Kiernan for The Washington Post
Ever since the genesis of experimental psychology in 1878 in Leipzig, Germany, psychology as a discipline has evolved and emerged as a global phenomenon. Over the years, it has penetrated almost all cultures and societies around the world. In India, psychology as a discipline arrived in the early 20th century and was patronized through the western influence of the time. Our departments and universities are one of the oldest in the region, bearing the hallmark of credibility and importance from the start. 20th century India witnessed the development of large mental care hospitals and post-independence India took a large step in the deinstitutionalization and humanizing of mental health patients and institutes from the erstwhile image of ghostly asylums for lunatics.
But as time progressed, our commitment to the idea of mental health somewhat diminished, and collectively as a nation, we were successful in concealing mental disorders and labeling them as taboo. This is a pitiful reality for a nation that has its history rooted in Ayurvedic traditions, and which has championed the cause of positive well-being way before scientific developments took place in Europe. Not only did Ayurveda address the idea of well-being, but it also emphasized a holistic living pattern, which focused on correct diet, exercise, meditation, and cultivation of the right attitude. Unfortunately, our present dilapidated mental health and social welfare structures are a testament to how far we have fallen from the ancient and modern means.
Presently, the ineptness of the various governments in devoting full-fledged policies at a national level has massively curtailed the growth potential. Even today, in the age of rampant globalization, India does not have a National Psychology Council which, in an ideal situation would regulate and formulate policies for the discipline and its professionals. Only clinical psychology in India is regulated under the Rehabilitation Council of India, leading other important fields of psychology such as sports, forensic, social psychology, and many others to a darker and grim future.
The enactment of the Mental Healthcare Act of 2017 was a welcome move by the Government of India. But as things stand at large, the psychological well-being of our populace remains very elusive and out of reach as a collective goal. This has largely been due to apathy at the policymaking level for decades, and a populace which holds dearer the idea of social standing and acceptance than of individual well being.
With a single counseling/therapy session costing somewhere between 1000-1500 rupees, psychological aid remains out of reach of the poor and the lower-middle class of India. Psychological and psychiatric aid in government hospitals across the towns and cities is next to non-existent, leaving the poor in a mentally vulnerable position, and on the verge of being cast away by society.
Currently, an individual pursuing a clinical psychology course is moved by the idea of money more than that of being an agent of help and change. One of the prime reasons for such an attitude is the lack of social and medical welfare apparatus in our society. At present, mostly the affluent and the upper-middle class, in developing urban spaces can opt for psychological support and help. This has led to the emergence of psychology graduates around the country, who are catering to a particular section of society.
Mental health literacy among varied age groups is at an all-time low. One study found mental health literacy among adolescents to be very low, i.e. depression was identified by only 29.04% and schizophrenia/psychosis was recognized by 1.31%. According to the study, stigma was also noted to be present in help-seeking. Such statistics highlight the alarming illiteracy that is prevalent with regard to mental health.
One can imagine the stereotypes and dogmatic thought process the elderly and the so-called custodians of the society have in place to keep mental health awareness from surfacing.
Educational institutes across the country providing psychology courses, both at the undergraduate and postgraduate levels are devoid of a holistic and practical approach. With most of the courses emphasizing theoretical knowledge and extremely old practical tests, young graduates find themselves in a difficult situation once they complete their courses, as it becomes a compulsory pattern to reskill and reinvent as soon they set out for real-time work. It is imperative for the growth of young mental health professionals and the society at large, that they are provided with relevant skills and techniques via workshops and academic research methods while undergoing their degrees.
All this grand talk of Mental Health Matters and Psychology as a growing discipline looks alluring from the outside, but in reality, our young cadre of professionals has been led astray in this extremely competitive referral-led industry, with little help from the authorities that exist.
Our understanding of any issue is broadened by the amount of individual effort and awareness that has taken place in society. In regards to mental health, there is a very small fraction of awareness measures being taken at the government and the citizen level. The World Health Organization estimates that the burden of mental health problems in India is 2,443 DALYs ( Disability Adjusted Life Years ) per 100,000 population. Such a grave burden is being handled by a very small fraction of the mental health workforce of 0.3 psychiatrists, 0.12 Nurses, 0.07 Psychologists, and 0.07 Social Workers per 100,000 population. But amidst all this, there is still a glimmer of hope.
To evolve as a country on the path of development, India has to develop measures that provide its young population (which comprises more than 50% of the total below the age of 25) with the appropriate skills and structures that can help tackle the mental health crisis that we collectively face.
It is the need of the hour that due importance is given to mental health, and shared responsibility is undertaken both through the government and citizenry. Perhaps it would be much better that students who are genuinely interested in the field of psychology undertake relevant courses and work opportunities with a fresh perspective and dedication, rather than just individuals who have been affected by mental disorders trying to help others and themselves, knowing what it is like to have mental disorder and problems at some point in their lives.
Empathy, Understanding, Awareness, and Accountability are the traits that we need to inculcate to see the field of psychology enhance in 21st century India. Towards a better and kind future.
By Abdullah Kazmi (Guest Writer)
2. Ogorchukwu JM, Sekaran VC, Nair S, Ashok L. Mental health literacy among late adolescents in South India: What they know and what attitudes drive them. Indian J Psychol Med. 2016;38:234–41.