Mumbai still shirks the shrink

In a city moving at breakneck speed, it is time to let go of old perceptions of sanity. There are many triggers for mental disorders which can turn into illnesses that often play out unscreamed, and untreated. On World Health Day, Humaira Ansari and Namita Handa analyse an oft-ignored problem.

Since society gets jittery with that which is not the norm, it turns on the aberrant, expecting him, or her, to lie low and invisible. That is why mental illnesses have always been dealt with behind closed doors, sometimes all alone, if they are dealt with at all. A clinically depressed parent, a bipolar child, a paranoid schizophrenic neighbour, an obsessive compulsive colleague — sometimes we can never see the behavioural patterns and if we do, we brush it all under the carpet, calling them tragic character flaws, when the truth is that serious mental disorders worsen with age, if not treated.

Then one day we hear of an incident like the Andheri shootout, where a middle-aged man shot his teenaged neighbour in a fit of rage over trifling repair work. Psychiatrists ventured that “Maroliya was a disturbed man whose malaise went untreated”.

Mental health is not as rare as a freak shootout. It confronts everyone at some point or another, first-hand or indirectly. Last year, a World Health Organisation report put the number of people suffering from schizophrenia at 1.6% of the global population.
Ours is a culture that sanctions aggression that can provide triggers for dormant disorders to surface. Ours is also a culture of silence.

Malini Shah, senior counsellor, Aavishkar Centre, says, “Mumbai’s mental health barometer is shifting from being bad to worse.” While the stigma attached to seeking assistance for disorders like stress, depression and anxiety is slowly waning, those suffering from serious personality and psychotic disorders like schizophrenia, bipolar disorder, obsessive compulsive personality disorder and borderline personality disorder, often don’t acknowledge their mental condition. Even if they do, they dare not let the fact out in the open for fear of ridicule and alienation.

Gurudatt Kundapurkar, vice-president of Pune-based Schizophrenia Awareness Association, says we need to grow out of the mindset that ‘if he is taking psychological help, he is mad’. “And this thinking is prevalent across all sections of society,” he says.

Maybe that’s what led 19-year-old engineering student Amit Pandey* to a tantrik when he started hearing his dead grandfather’s voice in the night calling him a failure. He could never have imagined that it was all in his head. His condition consistently deteriorated. Finally, the student met a psychologist only to learn that he was a schizophrenic. During his treatment, Pandey confessed that he didn’t eat food at his hostel, fearing that his competitive classmates may have poisoned it.

Thara Srinivasan, director of the Schizophrenia Research Foundation, an NGO that has been conducting research in the area of mental health for the last 25 years, feels that mental health is seriously ignored, right from funding to a well-in-place mental health policy. “In countries like India, infectious diseases take priority in policy-making and understandably so, but it’s important to focus on mental health issues as well,” she says.

Even the law has managed to change little in a social space directed by attitudes. While a recent high court judgment stated that no person can be terminated from service if he develops a mental ailment, experts say there are still many who are forced to quit their jobs because of their condition. “Several patients have been asked to leave their jobs, despite the fact that their condition is not so severe that they discontinue working,” says psychiatrist Harish Shetty. This not only aggravates matters but in cases where there are no support systems in place, patients also end up committing suicide, he adds.

Experts point out that there has been a steady increase in cases of anxiety, stress and depression over all ages and professions. “These are like the most common mental health disorders. But if left untreated, they can manifest into more complicated mental health conditions,” says Shah.

The factors that have taken a toll on the city’s mental health, experts believe, are vast and varied: traffic jams, unfavourable infrastructure, increased cost of living, higher aspirations, relationship turmoil, over-population and increased dependence on technology. “We are leading such a fast-paced life that we want to live a century in a decade. Obviously, the bubble will burst with the rise in pressure,” says Shetty.