Identity Inclusion hosted a webinar on 10 October World Mental Health Day. The webinar title was “Mental health in an Unequal World: How is South Asia Coping?” Researchers and practitioners from – India, Pakistan, Bangladesh, Nepal, and Sri Lanka joined the webinar.
By Asif Tarafdar
Home to almost 2 Billion people, South Asia is one of the fastest-growing regions in the world. Despite attaining economic prosperity over the past decades, the region has some underlying problems that might impede its socio-economic growth in the coming years. Between 150 and 200 million people in the region suffer from mental illness. However, the severity of depression and mental health is often overlooked, leaving millions without treatment and support.
Thankfully, there have been many discussions surrounding mental health in recent years, and numerous organisations in the regions are contributing to facilitating better mental health support and treatment across the region.
Identity Inclusion is a Bangladeshi organisation that works to counter mental health stigma and promote community-based services and inclusion of people with psychosocial disabilities. On 10th October 2021, it organised a webinar focusing on the social determinants of youth mental health in the region.
The participants of the webinar included Dr Syed Shabab Wahid from Bangladesh who is a faculty member at Georgetown University and a postdoctoral scientist at George Washington University (GWU) in Washington DC,Dr Kamal Gautam (MBBS, MD Psych) from Nepal,the Executive Director of Transcultural Psychosocial Organization Nepal. Thiviya Kandiah from Srilanka is a psychologist in Sri Lanka. She has been attached to Shanthi Maargam, Sri Lanka, in promoting the protection and wellbeing of children. Sonal Dhanani from Pakistan is CVE/PVE, neuro-linguistic programming (NLP), art therapy practitioner, and Parindey training and consulting founder. Preeti Khanna from India is a passionate public health professional. She has earned a PhD in nutritional neuroscience. The webinar’s host was Soadekin Rishan, a student of Dhaka University’s International Relations department and currently a volunteer researcher at Identity Inclusion.
Factors Affecting Mental Health
Some critical issues related to mental health came up during the webinar. Some socioeconomic determinants affect the mental health of the youth. Honourable panellists highlighted those socioeconomic determinants that created inequality and discussed how they affect youth mental health across South Asia. They limit a person’s access to mental health facilities. “There are two global meta trends which create inequality, one is the meta trend of urbanisation, and another is the megatrend of climate change. Poverty, climate change, poor access to education, poor living standard limits a person’s access to getting mental health treatment.” Dr Shabab Wahid elaborated.
Research conducted by TPO Nepal indicates that 90% of people with anxiety and depression are deprived of basic mental health facilities. Migration is another factor that affects equality in getting mental health treatment, according to Dr Kamal.
According to Thiviya Kandiah, poverty is highly correlated with increasing suicide rate, substance and alcohol misuse, domestic violence and sexual harassment. Consequently, different segments of the population are vulnerable to varying mental illnesses. Afterwards, Preeti Khanna explained how lack of nutrition leads to mental illness.
Social Media and Mental Health
Shabab Wahid explicated the adverse effects of increased use of social media on adolescents. Increased exposure to social media leads to having unreal expectations among them. They develop a tendency to excessively post on social media and get reactions. Likes and comments on social media are addictive because they affect our brain, similar to taking chemical substances. Likes symbolise a gain in reputation, causing them to compare with their peers constantly. Also, bullying has become increasingly prevalent in our social spaces, and adolescents are the most vulnerable to it.
Bullying in South Asia
The panellists shared their assessments on the rise of bullying and its shifting dynamics in the region. Everyone agreed that bullying has a causal relation with the socio-economic condition and has been catalysed by the pandemic.
“We see mental health disorders as a spectrum with multiple risk factors that can be explained through biopsychosocial models. Child abuse, bullying is common in a low-income country like Nepal. The most dominant social factors are poverty, lack of social support system, lack of employment, family condition etc. People thought that having mental illness meant only having a psychotic illness; that is not true,”
Dr Kamal Gautam
“We have noticed in Srilanka that most pressure comes from domestic violence. The culture bullying is generally accepted in the community. There is a lack of information between generations, which has to be overcome. Schools, families should be more aware of these for their child’s mental health.”
“WHO verified that the primary signs of mental disorders can be identified during adolescence. Early detections can lead to better outcomes during treatment. Subsequently, Micro and Macro environments play a crucial role; access to services, school services, parent’s education, and communication between parents affects the mental well-being of young people. Parents often fail to realise that their children can face numerous issues at school, including difficulty in understanding a particular topic, teacher and bullying by peers. Perhaps, the biggest challenge in identifying mental health issues among children and adolescents in the region is the lack of communication with their parents. Mental health care services must have access to the whole country.
“Digital intrusion catalysed by the pandemic has minimised the space for empathy in our lives. During the lockdowns, our homes practically became workplaces, destroying our work-life balance. It has had a cascading effect on our children’s mental health. The new normal has catalysed digitalisation that paved the way for increased cyberbullying. Mental health is related to those human connections, kindness, empathy, and we have to work on that.”
What is South Asia doing?
The webinar further revealed the current state of the mental health support infrastructure across South Asia, starting with Bangladesh, where lack of awareness and budget constraints contribute to the country’s poor state of mental health support. Similarly, the lack of awareness is also prevalent in Nepal. On top of that, the proximity of help/support centres from residential locations further complicates the situation. At the same time, Srilanka has only six child psychiatrists in the country. In contrast, India has a toll-free hotline providing mental health support. The panellists agreed on the importance of investing more resources to enhance the strength, competency and capacity of the region’s aggregate mental health support infrastructure.
The Way Forward
The session ended with the panellists answering some questions from the audience regarding mental health issues. They highlighted the reasons South Asian parents, in general, keep undermining the need for mental health treatment for their children. The experts suggested creating an advisory group of youth dedicated to helping children seek mental health support. Subsequently, parents should rise above the stigmas and reach out to their children regarding the issue. Most importantly, they emphasised on creating public-private and recruiting lay counsellors to facilitate cost-reduction of therapies related to mental health. Concurrently, the experts also recommended
- More research and collection of evidence (data) reflective of the current mental health scenario of the region.
- A collaborative effort of all the member countries in South Asia to tackle the deteriorating mental health situation.
- Focusing on preventive interventions through all ecological aspects of children and youth in promoting mental health and wellbeing.
Photographs: Courtesy of Identity Inclusion