When It Comes to Mental Health, India Remains Shockingly Misinformed

Deep stigma around mental health in India contributes to denial and shame, cutting across lines of religion, class, caste and gender.
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Indian journalist Manu Joseph recently wrote a column in which he questions major intellectual advances in history, claiming they were nothing but delusional ideas of schizophrenics. He asks, rhetorically: “What if many things that we call philosophies today had emerged from a mental disorder? What if influencers are influential chiefly because of their mental anomalies? The sane trying to emulate the insane — what if all our tumults arise from this?”

He goes on to explain why he does not believe in empathy or compassion, qualities that are considered fundamental to humanity: “The contemporary world of humanitarian lament, too, contains players who have been diagnosed with a range of mental disorders that makes them highly persuasive narrators. There is a popular belief that their suffering makes them feel more deeply about the problems of others. This is a myth. Empathy is merely a form of self-absorption and self-obsession. The ill create a gloomy world because that is what they see and that is what comforts them.”

Zero Degrees of Empathy

In Joseph’s worldview, not only is empathy a mental disorder, but all those striving to improve conditions for the less fortunate are also mentally ill. In another one of his columns, Joseph implies that environment activist Greta Thunberg’s zeal to change the world is driven by a mental condition, Asperger’s syndrome. “A lot of this extreme altruism is not a consequence of sanity at all,” writes Joseph. “They are doing it because they can’t help it; they are being influenced by their mental health.”

He uses the terms “schizophrenic,” “insane,” “mental disorder,” “mental anomaly” and “paranoia” interchangeably, with no thought given to their specific usage in medical parlance. In his lexicon, these terms are weaponized and deployed as slurs. In his puerile attempts at psychoanalysis, Joseph unwittingly offers us a glimpse into his own psyche.


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“Empathy is our ability to identify what someone else is thinking or feeling, and to respond to their thoughts and feelings with an appropriate emotion,” writes British clinical psychologist Simon Baron-Cohen in his book, “Zero Degrees of Empathy: A New Theory of Human Cruelty.” According to Baron-Cohen, “People who lack empathy see others as mere objects. These are people with borderline personality disorder, antisocial personality disorder and narcissistic personality disorder. They are capable of inflicting physical and psychological harm on others and are unmoved by the plight of those they hurt.”

He could have easily been talking about Manu Joseph. Unfortunately, Joseph’s views are hardly an exception in Indian society.

Scale of the Problem

Mental health should not be treated facetiously under any circumstances, but less so in India, where roughly one in three people seeking medical help could be suffering from depression, meaning that some 23 million may be in need of mental-health care at any given time. India also has one of the highest rates of suicide in the world, losing over 220,000 a year according to World Health Organization data; a student commits suicide every hour in India.

This is not surprising given that suicidal tendencies are directly related to undiagnosed or untreated depression, bipolar disease, post-traumatic stress disorder, anxiety disorder and schizophrenia, all of which thrive and proliferate in both urban and rural India.

The treatment gap for mental health in India is staggering, with barely 5,000 psychiatrists and 2,000 clinical psychologists in a country of 1.3 billion. Psychological care accounts for a miniscule 0.06% of India’s health-care budget. In Bangladesh the number is at 0.44% — not vastly higher, but it’s still better.

“The government needs to make a long-term investment in mental health infrastructure that includes the training and hiring of professionals and promoting research and development efforts,” says Stanford psychiatrist Shaili Jain. “There is no health without mental health so there would be a very tangible return on such an investment — a heathier, more productive and hopeful population. It is vital, that in this modern world, all the well-honed traditions, practices, rituals and social mechanisms that support mental health are not lost,” Jain adds, referring to holistic practices like yoga and Ayurveda.

She suggest that going forward, “On the other end of the spectrum, leveraging the power of 21st century medical technology will play a vital role in addressing the paucity of mental health professionals. Examples are telemedicine, virtual care and smart phone applications.”

Not a Priority

That mental health is not a priority in a country where basic amenities like clean water, power, food, education and housing are sorely lacking is not surprising, but deep stigma also contributes to the denial and shame around the subject, cutting across lines of religion, class, caste and gender.

The what-will-people-say mentality is so widespread that some village programs have attached psychological services to the local temples so that people can seek help in the guise of religious activity to avoid the shame of exposure. This mentality is propagated in no small measure by the insensitive and tone-deaf attitudes toward mental health. For instance, Indian politicians and public personalities often ridicule their opponents by weaponizing terms like “dumb,” “deaf,” “mentally ill,” “retarded,” “bipolar,” “handicapped,” “dyslexic” and “schizophrenic.”  

A survey conducted by The Live, Love, Laugh Foundation revealed shockingly callous and misinformed attitudes toward mental health in India. Sixty percent of respondents agreed with the statement that mentally unhealthy people should “have their own groups” so that healthy people are not “contaminated,” while the same number also believed that lack of self-discipline and willpower was one of the main causes of mental illness. Forty four percent of respondents thought that people suffering from mental illness are always violent, while 41% agreed with the statement that talking to a mentally ill person could lead to deterioration of the mental health of a normal person.

Careless Words

On a personal note, I could summon the courage to write freely about my own childhood trauma only because of my emotional and physical distance from India. I reside in a part of the world where there is no shame in writing about, discussing or seeking help for depression or other issues. In fact, people are applauded for facing their demons and for encouraging others to do the same.

Scores of people who do not have that luxury are forced to stay silent for fear of being shamed and ostracized within their communities. Words have consequences and ought not be thrown around without considering the havoc they may wreak in the lives of those in need of care and empathy. For them, just a few careless words could literally mean the difference between life and death.

“Challenging the taboos surrounding trauma is key. Disclosing a trauma history or symptoms of mental health distress require one to be vulnerable and that is simply not a safe thing to be if it will expose you to discrimination, bias or retaliation,” says Dr. Jain. “If victim-shaming tactics persist, then the silence and denial surrounding trauma will continue. Legal and societal protections for victims [are] non-negotiable.”

The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.

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