Report | Let’s Talk Mental Health | The Indian Millennials Podcast

One Future Collective, on the occasion of World Mental Health Day, spoke to The Indian Millennials podcast on the topic of Mental Health. Vandita Morarka, Founder and CEO of One Future Collective (henceforth: OFC) and Shruti Venkatesh, Program Director at the Queer Resource Center at OFC spoke on the importance of mental health in India and its various aspects. Following is the transcribed interview of the podcast:

Rohit: Let me just start by asking, what does mental health mean to you? 

Vandita: It’s interesting that you start with that because we often forget about what mental health means to each of us. It’s important to start recognising that mental health doesn’t have to be a definitive concept that is set in stone. More and more for me, mental health is like physical health. Some days I have a cold, and some days I have a more severe physical illness which means I can’t leave my bed. I have some good days and some bad days. Of course, mental health too has variations such as clinical aspects to it. It could be mood based, hormonal, or brought upon by circumstances around me. As long as we understand mental health as an evolving, fluid state of being, and keep at its core the element of resilience, the ability to come back to the state that I want to be at mentally, I think that’s what good and healthy mental health is.

Rohit: In my experience this topic is extremely stigmatised and comes with a lot of myths. Can you help me bust a few myths about this topic?

Shruti: One of the myths I would like to address is especially because I came across it recently and it really got me thinking as to how frequently this is happening and how often people believe in such a myth. A few days ago I was part of this conversation where this person was explaining to her father that of late her anxiety has been acting up and she hasn’t been doing so well mentally and she’s not able to get out of bed on most days. What really intrigued me is that her father seemed extremely stunned at hearing this and he was under the impression that her past issues have not really been showing up. Just because she was cheerful in front of him he assumed that his daughter’s been doing okay. It’s really important that family members and caregivers and even friends take the extra effort to actively check up on their people and not assume they must be doing okay because people with mental illnesses usually mould their behaviour around people, especially those close to them so you never really know what goes on, so their outward behaviour may not always mirror how their mental state truly might be. Even if we look at stories of family members who have lost their people to suicide, they’ll be able to tell you they never expected this and the loss came as a shocker. It’s really important to take that conscious, active effort into not assuming how the person is really doing. It’s definitely one of the most prevalent myths.

Rohit: Do you think there’s still a sense of taboo and stigma in people actually accepting that they possibly need to go and see a therapist to get better from a mental health perspective? We stay in a society where sometimes people are looked down upon when people say they are not keeping well from a mental perspective and there is a stigma attached to going and seeing a therapist. Quite a few young adults can afford therapy and many cannot, but the ones who can also think twice before going and seeing a therapist just to get better from a mental perspective. Mental well-being is looked down upon, what’s your take on this?

Shruti: Here I would like to address another myth. A lot of people believe that if their mental health is not restricting their life in some way or acting as a blocker in their life, or it hasn’t come to a point where it is affecting the people around them or if their psychological symptoms are not manifesting physiologically then it’s not important for them to go out and get the help they require, or go to their therapist or go back to their psychiatrist and re-up their medicines. They feel that they need to be in a really dangerous spot for them to actually go out and take therapy, or take any sort of mental health support or even speak about it, like you said, to their loved ones and that’s really unfortunate. Because of this stigma around seeking out the care that you need to overcome the condition, which can start of as mild signs and symptoms, and actually goes on to worsen and that puts them at risk of multiple major mental illnesses and self destructive behaviours and other harmful things that harm them and the people around them. You are very correct when you say that the stigma is what stops people from getting the attention and care they deserve.

Rohit: Since this is the Indian Millennials Podcast, and also by virtue of you guys being in this space and seeing some sort of development happen in this particular space, do you see patterned change that basically tells you that the Indian millennial generation is more cognisant to what they need from a mental health perspective? Is it true to even assume that the millennial generation is more inclined towards taking care of their mental health more than what maybe the previous generations were?

Shruti: I definitely think so because there’s so much progress – there’s the internet, there’s technology, psychology is now considered a really important subject so mental health definitely is getting a lot more attention than earlier but unfortunately I have to say that one of the patterns I do notice in a lot of Indian millennials is that they go for a first time experience with a therapist or a psychologist or any mental health professional and somehow they don’t really want to go back to it and that just stops the possibilities of them exploring their mental health and taking that into utmost importance. There can be many reasons for this. Some of the immediate ones that come to mind are they are either not able to connect to somebody they feel are not familiar to them or the idea of therapy in itself that is opening up and speaking about things that make you uncomfortable and addressing traumas – they are probably really averse to that idea. The stigma of going back and having regular therapy sessions and being labelled as someone who takes therapy often – a lot of people want to runaway from that idea because of how society treats that idea. I have to say that there is a lot of change in the thought process and mentality when it comes to mental health and therapy and I do believe there is a long way to go.

Rohit: Shruti, you have been a mental health advocate yourself. From your experience what are the few suggestions you could give to our listeners on how they could actually take care of their mental health and what are the red flags people should look for if they need any therapy? In my experience not many people are aware of what’s happening, that’s why I’m asking you.

Shruti: I think that’s extremely subjective – red flags can be different for everybody but one thing I must mention is that there is this misconception that we need to have a major mental illness or you need to have a very strong diagnosis or a very complicated psychological disorder to take your mental health seriously, which is very incorrect. If you are feeling that your mental health is poor or relatively poor, or you feel some sort of deterioration then you definitely have to go out and seek the support that you require because you never really know where this can lead you to. If there is help available then you should for sure be taking it and its important to speak about this to your friends and family because you never really know if people are going through the same thing. I think that’s really important.

Rohit: Perfect. I think in coming to the entire initiative of OFC, you are doing a lot of good work in different spaces, especially mental health, and queer rights and so on. Vandita, this question is to you: what made you start to take this initiative? You are lawyer by qualification and from being a lawyer to doing something so interesting in the social space – what is your ‘why’ behind what you are doing?

Vandita: I think it started way back for me when I was 17 or 18. I started something with a group of friends called SSRI and we got together about 120-150 young volunteers to take up small projects in different communities in Bombay and it seems like such a small initiative but we were able to drive a lot of impact and this was the first time I was able to see for myself the power of young people in action for themselves in communities that they occupy. That’s what drove me to starting OFC. I took some time getting experience in different organisations but the core idea behind OFC remains that how do we get people to care and how do we get them to care enough to act on what they care about. In terms of being a lawyer, we also run a feminist justice legal center so I haven’t left that pathway behind but interestingly we weaved in the legal aid we provide as well,  very strongly with mental health aspects to ensure that its more holistic because justice cant just mean legal justice. The why for me stems from my experiences with the community I worked with. I remember once, there was a classroom and we asked the kids what they wanted to be when they grow up and everyone gives you these answers of a doctor, an engineer and this really small boy, about 8 or 10 years old, told me “why are you asking us these questions – don’t ask us questions we know won’t be a reality”. I think that really is where OFC comes from – how do we take on this responsibility to create this change, how do we create an environment for people that are healthy financially, mentally, physically and increasingly we find mental health to be a strong aspect of this. I suffered from depression for the longest time – I think 2 and a half to 3 years – I still do. I don’t think its something that’s ended, it comes and goes in phases. I have a lot of close friends who have gone through different phases of mental health and what it made me realise is, how little we talk about it, how little community care is available for those people who are going through something like this and the immense stigma that exists around this, the lack of information. All of that led us to making sure that mental health is an integral part of OFC – not just externally but internally as well. We make sure everyone on the team has access to pro-bono mental healthcare because the nature of our work is such that we are constantly exposed to stories of trauma. We ensure that even a small workshop we do we have a counselor on call, if not physically present because we don’t know when we will trigger someone by some conversation. Whatever warnings we give there may be a point when it’s not enough and we want to make sure that’s embedded in every aspect of what we do. This is the more clinical side of it but even in general we focus a lot on self care and well-being and ensuring that people don’t just incorporate rest as just one Sunday a week where you take time off but how can we make sure rest is a part of everyday life and how can mental well-being become a part of everyday life. I think for most of us on the team it comes from a space of having gone through experiences that were adverse at some point in our lives. Maybe years back as well when we were kids and it’s all come together quite beautifully now to create this.

Rohit: That’s really awesome to hear. What are the kind of initiatives that you have taken in this space of mental health and awareness. With the number of NGOs that are coming up doing a lot of different things in the space of mental health do you see a brighter future? Do you see if India will not be called the most depressed country in the world? Do you see that happening in the near future?

Vandita: The thing is I don’t see that happening in my lifetime and maybe that’s a pessimistic thought to have but I don’t think NGOs, governments and all of this can fix the mental healthcare crisis that we are going through. I think it’s more of a cultural and larger problem that we are facing. Of course new initiatives are really helping. I find so much hope in the fact that even young people like college kids and school kids are starting conversations about mental health. We are always thinking formally in terms of organizations and maybe like a government body doing something? But it’s beautiful to have your own peers create a space where you can talk about your mental health. It doesn’t always have to be about professional support. A lot of times it’s just about having someone who will listen to you. To see this flourish so much and to see this across the country – of course it’s a lot more —than it is in other places. But it’s starting out and gives me immense hope. Internally at OFC, we run multiple projects so we do certificate courses in different aspects of mental health, say an introductory course or a families and mental health course. We have done that earlier last year and this year with the department of psychiatry at Sion hospital. We also do a lot of workshops where people just talk about self care, we give people actionable tips to practice self care. To big communities that can care for each other and of course we don’t talk about this as much because we have limited capacity as a not for profit but we provide pro bono mental health support to people who reach out to us or at a subsidized rate as far as possible. We never want access to therapy or good care to be blocked by the fact that someone can afford to pay for it and someone cannot.

Rohit: There’s one more thing that I have noticed – mental healthcare is kind of expensive and very few people can afford it. There is this bill that was passed in the parliament – the mental health bill – is the access at a policy level restricted? Is there something that needs to be changed or is it just a huge social problem that we are facing right now?

Vandita: The Mental Healthcare Act came in 2017. I don’t think it’s more of a policy issue right now I think it’s more of a problem of implementation. Government hospitals provide some of the best mental health care that I know of. A lot of leading psychiatrists and counselors work at these hospitals. For example, Sion hospital in Bombay has a brilliant psychiatric ward. — all you need to do is get a 10 rupee paper made but the problem with something like that is that you have to wait long hours because there are a lot of people lining up for service – for access to service over there. The problem is more that we don’t have enough professionals to deal with the crisis that is currently happening, which is also probably because we did not foresee this crisis? I feel like in a couple of years this might be better because we’ll be better equipped to deal with it but we didn’t plan for it beforehand, which is why we don’t have enough professionals now that can actively deal with this. Additionally we don’t necessarily have the correct regulatory mechanisms. We have multiple mechanisms for different types of mental health professionals like a psychiatrist a counselor. There’s no one proper certifying body or regulatory authority which would make this an easier process. If we can improve that if we can create a system where more professionals are not only training but also joining the field actively in India that would definitely help. Second, we would have to look at solutions that are realistically achievable right now which would creating a pipeline of community mental health workers which I know some NGOs are doing so brilliantly in villages and small towns in India where you train general social workers, lawyers, persons who already deal with frontline operations for a lot of not for profits to also change. They are trained on how to give mental health care, helped by educators and teachers so if we just do that at the current operational level we have it would definitely help in reducing some portion of the burden we have currently.

Rohit: Since there are a lot of people who would be interested in starting such initiatives or want to volunteer in such initiatives which deal with mental health, what would be your suggestion as a person who’s been been there and done it – maybe a three step formula on how they can start something or take initiative.

Vandita: That’s interesting because I haven’t personally reflected on this much. I don’t know if I have a three step guide to it but I would recommend that before you start something, it’s very important to question the intention behind what you’re starting, because one, there are already such wonderful organisations that exist and such great work that’s happened, so it would make more sense to join them rather than starting something. So intent becomes of great value here. Second, educate yourself. I don’t necessarily think it’s important to gatekeeper and say that only mental health professionals should be doing work around mental health and mental well being. But then there are aspects of mental healthcare that require a professional who’s been trained. You wouldn’t go for a heart surgery to a lawyer right? You do need mental health professionals who have medical and clinical training to be able to deal with it. So you have to assess what level of intervention you want to be at and then equip yourself with the skill. So if you want to be giving direct therapy, then you need to go get yourself a degree in that, be qualified enough to practice. I find that a lot of times people who work with — communities don’t see the need to get the training. No one in an urban setting would pay you 2000 rupees an hour for therapy if you didn’t have professional qualifications. But the same people think it’s okay to like go to a village and deliver such therapy sessions or counseling sessions for like  pro-bono rates or whatever, but without the qualifications required. I think step one would be identifying why you are doing what you are doing; step two would be getting your knowledge base in place, making sure you have the skills or you build a team that has the skills if you don’t have the skills; then third would also be identifying the target population you want to work with because mental health is very varied so either you identify in terms of if you want to work with young people or senior citizens or children, or you look at it in terms of these are the sort of mental health issues that I want to work with. Do you want to advocate for policy, do you want at the school level and so on. Once you have that in place each project will take its own trajectory.

Rohit: That makes a lot of sense. For a person like me, I happen to have zero experience from a professional aspect in mental health. I feel that sometimes just having these sort of conversations helps. It helps me to help somebody else so maybe just talk to people and being kind and being open to hearing a few thoughts and understanding if a person is in trouble, does he/she need help and just by kind of pushing them and motivating them to just get help will go a long way — this is what I feel. Just a simple conversation needs to keep happening and that’s when things will happen organically. We have reached a stage where our generation is having more conversations about this and that’s a good sign though there’s a lot more that can be done and I must really, really commend what you guys are doing at OFC. Coming back to Shruti, you’re fairly young as a millennial and you have been a mental advocate for a long time. I can sense so much passion in the work you are doing. What is your vibe in what you are doing?

Shruti: I must say that when I started of it was quite a juvenile thing, I was just very fascinated and interested in the subject of psychology. That led me to exploring fields of mental health and that’s when I realised the power and impact it can have to better the lives of people and to help them  by taking their mental health into consideration. These are just surface level points, we hear about having to speak more about mental health, we hear about depression and about awareness but we don’t really address other issues or attempt to tackle them. I lifted the rug when I understood that there are much more complex problems that we need to face right now when it comes to the mental health crisis in India and just like you and Vandita mentioned, it’s about the accessibility to mental health care and via my own personal experiences as well, I understood the issue. There was a point where I was unable to afford mental health care or go to therapy sessions and I desperately needed it but I wasn’t able to prioritise that. I would consider us the more privileged set of the lot but it really makes you think of the people in the country who require immediate mental health care but they don’t have access or are not able to afford it. Making time to pay attention to mental health care or allocating resources to it sometimes becomes a cost. These need to be thought about. When we speak of mental health care it shouldn’t be only the privileged people who have access to it, everyone should be able to get that. That’s what started driving me and I kind of shaped everything I want to do around the communities that are facing a lot of inequalities and injustice right now.

Rohit: Can you throw some light on the work that you have done with the Queer Resource Center at your NGO and also the inequalities prevailing today and how that impacts from a mental health perspectives?

Shruti: OFC has been a fantastic platform for me to really channel my work and energy and reaching out to the community that I think I can help in my capacity and just really working towards our cause. The Queer Resource Center is a queer youth led center by OFC and all our work is designed around serving the LBGTQ community and mainly about awareness and creating resources for people to understand the different types of problems and discriminations the LBGTQ community faces and all the consquences queer people have to go through just because of how they are treated by society. One of the aspects is definitely mental health. If you consider the queer community, the circumstances they have in India from low acceptance to family risks and the general exclusion they face in terms of health care and housing and even workplace and schools and colleges, it just puts them at so much more risk. Major mental illnesses are depression, anxiety, PTSD, the suicide rates are so high – we keep hearing of the discrimination faced by young lesbians and transgender youth, it’s not surprising at all that they become a high risk community for poor mental health. What’s worse is that when your situation is like this, you need to have enough care and support from the community and health care sector and from society to tackle such issues but then again there’s a gap there as well. There are many barriers to health care that the community faces and there is discrimination even within the health care sector where so many people don’t want to treat people who are part of the queer community, trans people are outright rejected from attaining the help they need. Its really sad but that’s the scenario. We need to consider these intersections and how everybody is affected by it and how different people have different sorts of problems. For example, the LBGTQ community has skyrocketing depression and anxiety rates and the reason for that is extremely different – there is so much homophobia and internalised homophobia and that has a direct impact on their mental health. So many are kicked out of their houses and have to do everything on their own and obviously they can’t afford mental health care because they have to make a living and survive. Mental health care doesn’t become a priority for them. We need to really look at these things when we speak about mental health and not just the surface level things. That’s kind of what we’re aiming at.

Rohit:What you just said about the community and the kind of things they lack, do you also agree that it’s not just one community but a lot of people have limited access to mental health care and that’s a problem India is facing as a whole and there are some sort of initiatives that have been taken but there is a problem. How can anybody address it, what would your suggestions be?

Shruti: It is definitely not the LBGTQ community only of course and different minorities face similar issues. The root of the problem is the inequality and lack of access. I spoke about the LBGTQ community because that’s what QRC does but I think it’s important to get to the root of the problem when we speak of mental health care and not just look at the surface but the people who are able to afford it who are living like Vandita mentioned – people in rural communities have no way to attain mental health care and they don’t even have the accurate information on how to deal with it. I really think it’s important to understand the different layers and issues of the mental health crisis in India.

Rohit: Since we have been speaking on a very serious topic, I would like to ask you both a fun question: How is it like to work for an NGO? Obviously it’s a fulfilling life but how is your day like in a NGO?

Shruti: I think it’s just brilliant. I would like to focus specifically on OFC right now because it’s a brilliant organisation, I cannot say enough about Vandita. I think I speak on behalf of almost every team member out here, I have never really come across an organisation with whom I can share values to this extent. The best thing is it really gives you an outlet and a platform to do the things that you really want to do and set out to do when you were really young and had no idea how you can reach out to these communities. It really bridges that gap. To use the word fulfilling – I really resonate with that, personally and professionally, when you know that you’re trying to give everything you have to serve the people that really require help and you are able to apply yourself in a way to give back to the community and to the society in a way furthering the progress in however little capacity that you can. I think it’s excellent to work in this sector and especially with OFC.

Vandita: Thank you so much Shruti for saying that. For me, OFC is special because I have a team here that I count as more than just my team, they are my people. It makes it easier to work in a place where people don’t just have your back personally but also professionally. That’s the work culture we try to build. Apart from that, it’s great to feel like you’re working towards causes that you believe in. Change can sometimes take time in being visible so that can also be easily frustrating. I think I speak for most non profits when I say that our days don’t have a schedule, we don’t know what work will come up or what time work will end. We try to be very mindful but the nature of the work is human centric. I think that’s a key difference for me. However, I want to say that this isn’t the only way for people to give back or to make change around them. There are private companies that probably create, in technical terms, more impact than OFC does every day by providing livelihood, jobs. Everything each person does is important, what they find important for themselves is necessary to keep doing but I would urge people to find some time to volunteer or take up causes within organisations they are already situated in because its a fulfilling feeling, it helps you sleep better.

Rohit: I think you’ve perfectly said it, “ it helps you sleep better.” Before we wrap this up, a few mental health tips to inculcate in daily routines to have a better mental well being from both of you, from your personal and professional experience?

Vandita: I don’t know if there are generic tips we can give everyone but I do think taking time for yourself and making sure rest is a part of everyday life and not something you should do once a month or once a week. I think that’s a good first step to ensuring your health, physically and mentally, and learning to recognise patterns and trends in your moods and behaviour, just logging that in helps. I find journaling very helpful but don’t find unstructured journaling helpful. I’m someone who finds specific questions to answer or a specific way to think while journaling useful. So find what works for you but do try to incorporate something everyday which you’re doing just for yourself. I also feel that apart from you, there’s an onus on your community to be there for you and more and more we need to learn for our mental health and that of others to be active listeners and the ability to hold space for others without necessarily giving them solutions or advice. The ability to just be there and listen to someone and be around for them – you may not be able to solve all their problems but you’re there in whatever capacity you feel you can show up, I think that’s a great way to show other people’s mental health as well.

Shruti: I would just like to add one thing to what Vandita has said that when you are in a profession where you are serving the community and are facing hearing stories on discrimination and struggles and prejudice, it can have a direct impact on your mental health as well, whether you’re an activist, lawyer, mental health professionals. It’s important we are taking into consideration our own mental health and making that a priority as well and not just ignore it when we try to help other people. When we address our own issues it will help serve our community better and cope with issues that come up in such a field. Its natural because they are faced everyday but it’s also extremely important.

Rohit: I think the takeaway from this conversation for me has been that to really make a change you need to volunteer and find a cause and that’s when you meet like minded people and the more like-minded people you meet the better you feel and that kind of makes it easier to heal. The healing process begins there if you are facing any mental health issues. 

Featured image source: Kaiser Health News