Strap: The undue emphasis on the role of family/community in dealing with mental health crisis in individuals has had severe ramifications
“But I don’t want to go among mad people,” Alice remarked. “Oh, you can’t help that,” said the Cat: “we’re all mad here. I’m mad. You’re mad.”
The Cheshire Cat of Alice in Wonderland acknowledged this phantasmagorical reality long before something even remotely resembling a neuro-policy was being talked about in India. Now that the Economic Survey of India 2024-25 has declared that “Mental Health of Youth Will Drive Future Economy”, maybe it will be taken seriously. Or perhaps, we’ll just shove it under the carpet after it has generated appropriate sights and sounds, rather ironically, on social media.
Whatever we choose to do as a nation as we advance needs to be informed by the fact that it has taken an epidemic, a crisis even to acknowledge that we are collectively being ruined by neglecting mental health. Sample this. Even the pre-Covid Global Burden of Disease Study (2019) confirmed that mental disorders accounted for five of the top 10 causes of disability. Mental disorders like depression, anxiety, psychosis, and drug addiction are, collectively, the second largest cause of deaths globally.
Let alone the everyday darkness that comes with psychiatric disorders, life expectancy is reduced by 15 to 20 years owing to suicide and co-morbidities. Unfortunately, these statistics haven’t meant very much, and mental health issues have been either getting fetishised by the attention economy or blindsided in the name of pride and propriety.
While the Indian government has finally acknowledged that “hostile work cultures and excessive hours spent working at the desk can adversely affect mental well-being and ultimately put the brakes on the pace of economic growth”, will the industry leaders campaigning for long work hours and weeks change their attitudes? Or will it become one of those things that look good only on paper but are rarely implemented in spirit? Like increased participation of women in the workforce. There are hardly any reactions from industry leaders and observers on the survey findings.
The emphasis that the survey lays on family and school level interventions is also problematic. Psychiatric experts across the world have been saying, ad nauseam, that mental health discourse needs to steer away from the one-size-fits-all approach. Kay Redfield Jamison, a doyen in the world of psychiatry and author of several lay books on the subject, has been on a mission of sorts to draw attention to the biological roots and the treatability of mental disorders. In her 1999 book, Night Falls Fast: Understanding Suicide, Jamison used numbers to demonstrate how suicide was a vast global public health crisis, which can be dealt with through preventive and curative clinical action matched with psychosocial maintenance.
The undue emphasis on the role of family/community in dealing with mental health crisis in individuals has had severe ramifications. Jamison notes in her book how, in a misguided attempt to prioritise civil liberties over lives, patients dealing with psychiatric disorders were left without any institutional care in the United States. “We have released the severely mentally ill onto our streets, and they have come to make up a third to a half of our country’s homeless. They disturb the well who share their streets and perplex city managers. They make us uncomfortable, but not so uncomfortable that we protect or house, insure or tend or heal them.” The “crazies” of the New York City subways and streets have had to find their own means to survive. Or not.
There is only so much we can blame social media for. Some time ago, a Hampshire family chose to reveal that an online suicide group encouraged their 17-year-old son to drink poison, which led to his death in 2024. Both good and bad faith actors on social media can indeed exacerbate the feeling of despair around one’s life — often deviously through eliciting comparisons — and aggressively encourage ending it, like in the Hampshire case. However, can spending more time with family, which can be equally judgmental and emotionally damaging, be prevention or cure for psychiatric disorders?
A 2023 policy brief prepared for Baker Institute by various stakeholders in Europe can act as a starting point. Underscoring the importance of precision psychiatry, the brief recommends “multidisciplinary research between academia, industry, health economists, regulatory agencies, patient associations, policy entrepreneurs, ethicists, and philosophers” to “find the right treatment for the right patient”. This is what the government needs to encourage instead of merely pontificating, rather dangerously and irresponsibly, that “returning to our roots may allow us to reach further for the skies in terms of mental health”.
Nishtha Gautam is an author, academic and journalist. The views expressed are personal
