Mental health is widely misunderstood unlike the very straightforward physical health. It is defined by the WHO as "... a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community." As we can see, these are all qualities required for a fulfilling, dignified life - instrinsic to our basic constitutional Right to Life. In fact, it is fundamental to all our other aspects of health - including physical, social and economic. It is a shame therefore that something so basic to our overall well-being is ignored, misunderstood and even stigmatized.
Mental health is associated immediately with mental illness; depression, suicide, anxiety is what comes first to the mind when we think of mental health. It is also ridiculed; jokes where we make fun of each other by calling someone 'mental' are common. Because it is so less understood, there is a lot of shame and stigma attached to it. It is unfortunate that like every other aspect of our lives, something as basic as health is also divided along gender lines, making certain kinds of health (physical) accessible while other kinds (sexual, reproductive, mental) are to be ashamed of and completely ignored. Access to mental healthcare is even more divided - along gender, caste, class and religious lines - where all these prejudices create obstacles in accessing good quality, dignified and essential mental health services such as counselling, therapy and psychiatric medicines. Mental health care providers are anyway very scarce - there are 0.3 psychiatrists, 0.12 nurses and 0.07 social workers per 100000 population in India according to a 2011 WHO report. Horror stories of how clients are treated in government mental health insitutions show a complete violation of human rights. The recent Mental Health Care Act, 2017, passed by the Indian parliament is a welcome step in this regard. The Act takes into account all the prejudices attached to mental health in India and asserts that accessible, affordable, dignified, non-discriminatory, client-centred, community-based mental health services must be provided by the government. Proper implementation of the Act will truly be a success for mental health in the country.
Anubhuti works with youth and this is the population most in need of care and support. In India, this age group struggles the most with mental health issues - we are reporting the largest number of adolescent suicide deaths in the world. A 2015 WHO study says that between 30 and 40 people per 100,000 Indians aged between 15 and 29 kill themselves. An estimated 11-31 million youth suffer from reported mental health problems in India. The WHO states, "Determinants of mental health and mental disorders include not only individual attributes... but also social, cultural, economic, political and environmental factors such as national policies, social protection, living standards, working conditions and community social supports." As we all know, in India, it is our gender, caste, class, etc. that determine these factors - and therefore our mental well-being too. Families and communities too are not supportive of mental health needs of their youth, especially if they are girls and women.
Anubhuti has therefore started a mental health program with awareness, counselling and referral services which are rights-based, non-discriminatory and community-led. This program is taking mental health into communities - where there is little understanding and acceptance of the subject, lot of superstitions surrounding it, and very little access to public or private health care. As part of this program, Anubhuti has come up with the unique concept of the 'Mann Mela - A Mental Health Fair' where games, songs, quiz, discussions, etc. are used to take the concept of mental health to college and community youth in a fun, accessible way. Such fairs are used by activisits in India to explain science, gender, etc. but a Mental Health Fair is perhaps the first of its kind in the entire country.
Our very first Mann Mela was conducted on 7th September 2018, at Mahila Sangh College for young women in Vile Parle (East) Mumbai, with over 120 participants. There were a few unique approaches that this event adopted:
- Youth leaders, who had been trained before-hand, led almost all the stalls in the fair. As peers and belonging to similar vulnerable backgrounds, they connected with the participants with the kind of empathy that is difficult to be seen even in seasoned social workers and activists.
- Mental health was approached from the perspective of well-being instead of from the perspective of disorders. It was therefore easy to understand and accept.
- Gender, caste and other social vulnerabilities of the participants were kept in mind because causes of mental disorders as well as access to mental healthcare are closely tied to social discrimination.
- Rights-based, client-centred approach.
The module had been created after lot of study and based on years of experience of working with youth by expert trainer Deepa Pawar. There were stalls like Rings, Snakes & Ladders, Quiz, Hit the Target, Masks, Laughter stall, etc. Each of these elaborated upon one important aspect of mental health and together, all the stalls functioned as one holistic unit. The immediate impact of our first such event can be seen from the documented feedback:
Of the young men and women who had been handling the stalls:
- "After today I am quite clear that mental health is very important to be discussed about. I can now organise a workshop on the subject."
- "I managed to connect emotions with examples of mental health issues. Few young women did start crying and shared their experiences of facing violence, abuse, loneliness, ridicule..."
- "One girl shared how she is dominated because of her minority religion. Lot of girls repeated how their major problem is they are not allowed to take their own decisions."
- "We discussed on my stall how we cannot judge each other by our facial expressions - like those always smiling or extroverted are given more opportunities in class by the teacher and this is a form of discrimination."
- "One girl said she feels like she just not good enough as the other girls.. I never thought there would be so much sharing and girls would break down with their experiences.. I told them that there is no weakness in crying, it felt that they perhaps don't have much space to cry about these matters. I am happy that we could provide this safe space for them to express. Many girls came to me even after the fair to talk and ask for help. I have referred few of them for further counselling."
- "I was motivating the girls who were sharing the discrimination they face - that the fight is yours, the problem is yours and the power to fight is also yours. You can surely do it."
Of the participants:
- This kind of event should happen every month so that those who missed out today can also experience it and we too need this space regulary.
- I felt very free, could share and express.
- This is the first such fair I have seen, the first time I have laughed so much and really felt happy for a while.
- I feel lonely sometimes, there is not so much support from home. I can now identify lot of negative emotions like sadness, fear which trouble me and can start working on them.
- We could share our personal problems and they (youth leaders on the stalls) gave us practical solutions to work on those problems. I feel like I will personally benefit from those ideas.
- We were asked certain questions which we found difficult to answer but we did answer them. And it was not limited to only answering, but we started thinking about those things. There are lot of emotions like rage, loneliness.. and even when we try to share these things we are mostly ignored which increases the 'low' feeling. This was a space where we were being taken very seriously and this gave the opportunity to take ourselves and our emotions seriously.
Few of the young women have approached Anubhuti with cases of religious discrimination, sexual abuse and so on, whom we are providing counselling. We are also working in collaboration with the college for a more supportive environment for young female students.
We wish to replicate this event in many more educational institutions and communities and require financial support for the same. Request you to please get in touch - firstname.lastname@example.org if you wish to support.