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May 07, 2017

India Is Facing a Mental Health Crisis – and Its Education System Is Ill Equipped to Handle It

The taboo surrounding mental health problems and the unwillingness of most colleges to take up the cost of professional counselling make India's youth highly vulnerable.
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The taboo surrounding mental health problems and the unwillingness of most colleges to take up the cost of professional counselling make India’s youth highly vulnerable.

Credit: Victor/ Flickr (CC BY 2.0)

On an April evening in a campus town, a group of college students across various disciplines – sciences and humanities – stepped away from their studies to meet under the stars and share stories through art and readings. All these narratives were on mental health struggles. The tone was of hope, of questioning and seeking help, of building a community. It just may be a significant moment in the history of higher education in this country.

As part of India’s inelegant scramble to match top-class world universities, what has been forgotten is that one of the distinguishing features of those universities is the attention they have paid to issues of student well-being, especially mental health. Anyone who has studied abroad can feel the palpable difference in college healthcare. One may add to this the obvious universal point that a student going for an undergraduate programme experiences a world where she is suddenly separated from parental world views, especially in residential situations. When this happens, there is of course euphoria, but also despair. The morality of the parents may not always speak to the urgencies and pressures of today.

A typical college administration is woefully ill-equipped to deal with this crisis in India. When there are ‘counsellors’ present, they often mimic the voice of one’s least favourite aunt or uncle. Students are often told things like they have “adjustment disorder” or that they should be ashamed of wasting the hard-earned money of their parents or that they are privileged kids so they should not have issues anyway or their issues precede their time in college, so it is the responsibility of their parents. Real issues such as substance abuse or depression are brushed away as typical college blues.

Recently, the WHO ran a major campaign on World Health Day (April 7) titled ‘Depression: Let’s talk’. Depression has become the world’s foremost disability, but what is often unnoticed is that within the subsets, it is the youth that is the most vulnerable. If a student indulges in self-harm, parents and college administrators are quite happy to blame each other, while the young person continues suffering. It is hard for most students to be able to articulate what they are going through – the only legitimate reason seems to be academics, so authorities feel genuinely surprised when a student who performs well takes to self-harm.

Mental health issues often seem more of a taboo than sexuality, though the two are of course not unrelated. Add to this the additional pressures of eating disorders or the past physical or sexual abuse that might resurface, and one is in the face of a veritable storm. Peers and teachers, however well-meaning and trusted, can hardly be expected to deal with this – though one must not forget that the average peer or teacher might indeed give wrong, paternalistic or moralistic advice that could do more harm than good.

While taking nothing away from well-defined political struggles (most evocatively, the Rohith Vemula case), it must be recognised that mental health cannot be reduced to purely abstracted political terms and that every suicide is also singular and leaves behind an enormous and private legacy of grief for the friends, teachers and family. Tragically, as substantive, professional, longer-term counselling is expensive, few colleges – public or private – are willing to take up the cost.

The setting up of a centre at Manipal for confidential and professional psychotherapy, exclusively for students, offers us an opportunity to collectively discuss mental healthcare in our education system. Part of this has to necessarily entail listening to student voices, which are increasingly articulating their needs and encouraging more such interventions in the public realm.

Difficulties that young people face cannot be negotiated entirely in the hospital system or through informal networks. We have to accept that even the most well-meaning parents and family members are not as accessible to their children as they may think. What young people have to negotiate is a very complex emotional ecosystem, that includes pressures of self-image and insecurities of the future, and there are few life skills put in place to adequately cope with deep guilt, shame, fear and worry.

Perhaps it is not our young people who are difficult, as popular wisdom tends to say, but we who are at risk of abysmally failing our young people entirely. What are urgently needed are several such interventions in all higher educational systems in India.

There should be more psychologists trained to handle this particular age group and sensitised to the entire gamut of issues – whether sexuality, substance dependence, anxieties or distressing life events. The therapy files need to be delinked from hospitals, academics and family, and only prioritise the health and privacy of the young person, especially those above 18 years of age. Every crisis is never in isolation, and not be treated as such, but should be an ongoing process. No matter whether we agree with any of this or not, the issue is not going away. We are at the heart of a mental health epidemic among the youth, whose full scope we have scarcely fathomed.

Nikhil Govind is the head of the Manipal Centre for Philosophy and Humanities, Manipal University.

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