“Insanity is doing the same thing, over and over again, but expecting different results,” said Albert Einstein. This describes the Mental Health care system that has existed all over the world and in the present Mental Health Care Bill 2016 that was recently passed.
In regard to the Bill, I don’t want to say much because there are others who can give their expert legal opinion over it. But as someone who has been living with multiple labels because society could never accept me, I see how the Bill and society only speaks of Mental Health as a disease and something that needs to be fixed.
Yesterday, social media had a flood of lay people sharing a news article of the bill with utmost joy, congratulations and a welcome of hope calling the bill progressive and bold. To my dismay some even said they’ve read the bill to have concluded why it is progressive. I honestly wanted to slam my face in my computer screen at that point, because many don’t know what they are even reading and these statements can send out very wrong messages to a world where everything on social media comes across as being the all pervading truth – much like what psychiatrist have sold to the world regarding Mental Illnesses.
Someone’s opinion over a particular state of affair or topic can influence a whole lot of others to buy into it, much like a blind belief or in other words should I call it a social delusion? And this armchair activism makes each individual responsible for what they have to say if they cannot follow up on the consequences it would leave behind to their readers. Much like the same field called Mental Health, where psychiatrists are not being responsible for their actions despite their need to feel importance. Even children can understand the link between responsibility and importance.
But the first part of stigmatization that exists in our social world is when a large group of people share the same ideas and thoughts it is accepted as something valid, when what it really is is a herd mentality. However, when someone like me shares ‘a’ particular idea or thought it is a symptom of a psychiatric disorder only because I am the only one having the belief.
I recently spoke about Stigma and Mental Health at an event in Delhi organized by Youth Ki Awaaz and Doctors Without Borders. It was on a historic day – 6th August 2016 commemorating 15th years of the Erwadi tragedy (6th August 2001) where 28 inmates of a faith-based asylum were burnt to death. Now don’t conclude that just because it’s a faith-based center it is worse than what the Mental Health asylums and institutions offer. On 2nd August 2016 a woman was forcefully injected and in the name of being escorted to an asylum at 11.30 PM the goons punched her and fingered her vagina. Her husband joined hands with a psychiatrist to turn her into another case of ‘mental illness’. This is just ‘one off’ such incidents being shared on social media which doesn’t get noticed much, unlike other cases of sexual assaults. Because in this case the woman is said to have made it up, and society will not believe a word she says.
Society does not and never has believed the ‘crazy’ person if he or she were to share their horror experiences of what is done to them. But society does not believe their own blood and kin to begin with. Society doesn’t want to believe that their family member could think and behave differently. Society rather believes it is part of a disease they can comfort themselves with in order to fix the individual. The same society who will stand for one thing but claim another and find the need to fix others who are different. This is the hypocrisy the bill shares with our society, by giving an advance directive only to have it be challenged and cancelled.
(1) Where a mental health professional or a relative or a care-giver of a person desires not to follow an advance directive while treating a person with mental illness, such mental health professional or the relative or the care-giver of the person shall make an application to the concerned Board to review, alter, modify or cancel the advance directive.”
Sharma of the Human Rights Watch said “India has an opportunity to move away from a system of isolation and abuse and instead build a system of support and independence. The lives of millions of women with psychosocial or intellectual disabilities are at stake.” The highlight over women with psychosocial disabilities point towards the thousand over years of patriarchy that India as a society and culture has only now begun questioning. This is important for us to keep in mind because when a woman comes across as being asexual, hypomanic, or hypersexual – it becomes grounds of diagnosis according to the Psychiatry Bible more formally known as the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM on the other hand carries a lot of weight in India as all psychologists, students, therapist and doctors refer to it. The trouble with the DSM is it is based on Western concepts and constructions of normalcy, what is deviant or abnormal which everyone today seems to refer to while diagnosing anyone including children. In other words, the system is stuck to the medicalization of behavior, thoughts and feelings based on a given set of principles and mechanism that were decided by a group of people sitting at a table in the earlier 1900s. And this pathologizing of human behavior is of serious concern that the Mental Health Care Bill appears to practice.
There is a top-bottom approach that psychiatrists and professionals have in place, where they become the decision makers on who is normal and who is not. That those like me are some lesser beings who ‘need help’ from those who know better. I’m sure these patriarchal and patronizing traits affect their own lives, but they are too blind to see it. These are the very causes of mental health breakdowns and ill health, if people are only willing to see it.
The very word ‘mental illness’ needs to be looked at differently. It calls for an immediate change or we shall turn all children into well behaved robots on psychiatric medications only because society and parents can’t do a better job at parenting. In many national and international discourses and writings, the term ‘psycho-social disabilities’ has replaced persons with mental illness to imply that it is a condition caused by the social influences and pressures which can disable a person. Yet again, whether it is Persons with Mental Illness or Persons with Psycho-social disabilities this becomes a matter of our identity (for life) because psychiatric labelling is very damaging and reduces us to a medical identity.
This medical identity is not the same with persons living with other medical issues such as cancer or diabetes. Therefore, the constant comparisons that society, organizations and even awareness campaigns are engaging in is a problem in itself where those like me are seen as a disorder that needs to be fixed. That there is something fundamentally wrong in the way I think, behave, feel, dream and react when all of these are a part of my identity, like it is with the rest of the population out there who would turn into victims of psychiatric bullying. But society (lay people) are equally at fault here because they too see people like me through the lens of a disorder that needs to be fixed, helped, cured.
The news article speaks of urgent steps to address the lack of infrastructure and shortage of psychiatrists in the country, which is something I’ve heard of all too often. But when asylums and majority of psychiatrist are engaged in such cruel and inhuman exploitations, what are we going to do with more of them coming into the game? How about cleaning and reforming the already present institutions that exist? They need to prove themselves before we blindly agree to them calling shots regarding our body, mind and soul.
The Bill is not progressive and bold, it is built on a power play that has been influenced by 200 years of colonial mindsets and Draconian systems of mental health. Increasing the numbers of psychiatrists and asylums isn’t going to change anything. Have they ever tried to increase to the number of ‘recovered’ people like me? They can’t because they believe that people like me are a ‘chemical imbalance’ that needs to be fixed, when there is yet no clinically significant prove of what chemical is imbalanced.
Social stigma exists within the very system of Mental Health and in society, both feeding into the other. It can only change when both stop viewing people like me as a disease that needs to be fixed. It is because English educated people think they know it all when it comes to understanding about life concepts and the suffering of the mind which places them at a position of decision makers even for those in the rural areas. What they don’t realize is English is a language and not the measure of intelligence or heart.
In fact, it is this very notion of fitting in into social norms and expectations which made me isolate myself and develop schizophrenia. Because I was a different person, society couldn’t understand my ways and hence they needed to put a label on me in order to fix me, so that they can accept my ‘bizarre’ thoughts. They turned me into a disease because there is a market of disease suppliers who can incapacitate me.
The worry here isn’t so much about me, but about all those women who are still forced into asylums who don’t get to read about such Bills and discussions. It is about all those children falling prey to psychiatric and psychological labels because there are professionals equating anger in adolescent boys as early symptoms of depression. Do they not know what puberty is? It is about kids as young as 4 being given diagnosis of ADHD (which has been called a fake disorder) because their parents are lazy at parenting.
How many of you climbed on tables, trees, broke a leg, broke something expensive, kept jumping about and screaming excitedly at random things adults couldn’t understand? Isn’t anger, frustrations, agitation, restlessness, aggression, questioning authority all a part of growing up? This new entrances of ‘symptoms’ have entered everyday discourses because of the rat race we are all living in and we expect our children to keep up with the newly made adult demands. Why are you taking away another child’s childhood by agreeing to psychological text that are fixing everyone?
I find it very difficult to understand that professionals in this field can defend this by saying, “When we explain the symptoms to their parents, it helps the parent understand and accept the kid better.” Isn’t it the parent’s job to understand and accept the child nevertheless? Why do they need a label for it? What kind of a world are we living in to allow this to happen just because it is not you!?
The Mental Health Care Bill allows this to happen since children = minors. They won’t be able to decide on their treatment plans nor give consent.
I am not suggesting that children be given legal rights of the same as someone who is by law considered an adult. I am asking you to think hard about the basis of mental health diagnosis when it concerns children. If a child reacts to force wouldn’t they naturally fight back and get agitated? Or is this another disorder to be fixed? They are going to fall prey to early diagnosis of personality disorders, bipolar and even schizophrenia. Early interventions do not equal early diagnosis or early recovery in psychiatry. Please do a research on the kind of side effects these medications can have on adult bodies including changing the entire hormonal imbalance. To treat children by such failing protocols is a murder to their emotions and natural state of growing.
Furthermore, there are contradictory clauses that can challenge this advance directive removing all agency from the said patient:
9. “The advance directive shall not apply to the emergency treatment given under section 103 to a person who made the advance directive.”
What was earlier called involuntary commitment is simply rephrased into “supported admission” especially where advance directive can be challenged by so many others who think the person should not be given it. “Nothing About Us Without Us” is the motto of UNCRPD but it appears to be easily tweaked by indirect coercion. This Bill is not for me or for my friends who are inside, or for the million women who get incarcerated, or the billion children out there. It is a bill that allows psychiatry to continue their practice using fancier terms.
There are numerous mentions throughout the bill on “the person inflicting serious harm to himself or others…causing serious damage to properties to himself or others…” which suggest that we are dangerous and can be a threat to the welfare of ourselves and others. I am not surprised that society wouldn’t consider this such a big deal, but this becomes grounds for forced treatment and admission when someone else has already implanted the idea that we are violent. How different is this bill than what media has been projecting to the world? Most of us are aggressive towards our care-givers when we aren’t understood. Aren’t all children aggressive (verbal, physical, psychological, spiritual, mental) at some level towards their carers?
There is no need to include the subject of harm here. Even individuals who have diabetes and do not get their food, insulin on time can be seen to be aggressive with anger outburst. Are we having such clauses for them? When I am given a label that brings so much of rejection will I not feel suicidal or inflict harm on myself? Will I not feel such anger towards the world that I might react physically when someone mocks me in public? Do these psychiatrists, politicians, and committee members even know what they are doing by putting in such clauses in the Bill? The fact that such a clause is inserted at numerous sections tells me how insensitive, unknowledgeable, and removed they are in understanding human responses to triggers. On the other hand, with there being so many psychiatrists and psychologists inflicting harm on women and children why are they not treated on the same grounds? Are they not causing serious damage when they misdiagnose, coerce, manipulate, and psyche society into believing we are all just diseases?
People with mental illness are always treated by doctors and policy makers as an element of diagnosis, and not as a person. And likewise, society also views us as a medical concept to be diagnosed much like random people on social media who campaign over mental illness and think they are doing us a favour by spreading awareness of a disease. What they don’t know is they are spreading awareness of a disorder, label and disease that SHOULD be treated instead of spreading awareness of the person behind the label that SHOULD be understood. But I don’t think society has that much common sense to know who the person behind the label is, because the very reason someone gets triggered to experience a mental health condition is because the people around them can’t understand them as a person. You need a label and a disease to understand your loved one?
Each are having to fit in a certain construction that has to be followed furthering the rise of anxiety and depression. To me, anxiety and depression are messages from your consciousness telling you that you are surrounded by a conducive environment and these are responses to it. By simply telling ourselves this, we can begin healing. But everyone is so absorbed by the victimization their label can give them, they won’t work hard enough to change their way of looking at themselves. And with every victim there will come a god complex helper and the circle continues.
My problem with how Mental Health is looked at, spoken about, campaigned, shared, and experienced is still stuck at a disease model that limits our understanding and growth of our experiences. Everyday I see individuals sharing how mental health should be taught in schools and modules must be introduced to kids. That children need to know what schizophrenia, anxiety and depression are so that they can help and understand another person who might be experiencing the same. We are selling the same distorted adults perceptions to children by doing so. That they need to understand another by their label.
When I was introduced as an alien from a different planet to 9th graders, one kid asked “So you are saying you’re from a different planet. What is different on your planet than it is on ours?” I was thrilled at her question. That the child in her exist to see and accept me just the way I am. Something all adults should learn.
Why do people need a label to be understood by another?
Why is it so important that your disorder is understood and not you?
I can only raise these questions to those who have access to technology and who can read this. But what about all the women and children who have been thrown inside institutions?
Why are we advocating for diseases and treatments instead of basic humanity, common sense and acceptance?
My seniors in the field ask important questions as they work at different areas. And I’ve been questioned by others on what I think about those who are inside asylums and institutions. That if someone chooses to be forced for treatment even that becomes a choice. That if someone chooses to give their power away even that becomes a choice. I agree it becomes their choice but maybe because they haven’t been given another way that is less painful and receiving pain is seen as something ‘okay’ in the everydayness of our living…which is the very basis of triggering a mental discomfort.
I can only request everyone to try a different way. In order for any change to happen we must be willing to turn the other cheek and look elsewhere. Most people don’t have the courage for that and most have given up and most don’t want to. We don’t need to tell women, children, men or ourselves that we need a mental illness or ill health to be understood and accepted. I don’t see anything wrong in having to raise our voices, get into an argument or move away for a while in doing so. These are not symptoms of mental illness but natural human reactions when the insides of your soul are screaming and trying to be understood.
That whatever be our differences it is simply a package that comes with our human evolution. It should not be medicalized. It requires a little patience, time, effort and sincere care to empower the other person and make them their own agent of recovery. But this isn’t going to happen easily cause most people think it is about them. The large population of youth who are themselves chasing the Joneses and irrational dreams are a part of the problem and solution as it is with their caregivers. All of them comprise of the same fucked up society. But the future isn’t ours. It belongs to the children. And each one of us become responsible in how we allow and guide their differences into not turning into disorders.
This isn’t something utopian or a far fetched dream. I voice the same every week with 60 children at school and so do their teachers, principal and the very children.
No bill or law has ever given me any right. I have paranoid schizophrenia, got another diagnosis of dissociations and schizoaffective in between, then scar epilepsy, a range of sleep disorders and a list of ‘behavior’ issues as a child. I’ve found ways that have worked over 20 years and I know of others like myself who have done too. The Bill and the medical community will refuse to acknowledge the likes of those of us who have gone beyond the medical model, calling us miracles. But this is also because society themselves don’t accept us and undervalue many of us – including and especially caregivers.
Also read: What does the Mental Health Care Bill means For Persons With Mental Illness?
Featured Image Credit: At the mental hospital in Thane. There are no reliable figures on the number of the mentally ill in India. (Express Photo by Amol Shetge/Archive) | The Indian Express
