“I was engulfed. Completely. I felt like I was being pushed towards an abyss; I was slowly shrouded by darkness. All these people around me and no one can see through the happy façade I put up every day? Why can’t they see the monster that’s hunting me down? Is it all just in my head, like I am told so often? Or am I just another victim of the unknown?” – Anonymous
This is how someone suffering from a mental illness could feel. Unlike a lot of other physical health issues with visible symptoms, mental health problems are not very apparent and obvious in the same ways. This is one of the reasons why they are often ignored or not taken seriously enough. People suffering from mental illnesses are often subjected to negligence as well as mockery. This has led to the stigmatization of the issue and people tend to either completely ignore it or prefer to keep it to themselves. In some parts of the world, mental health issues are not even considered a medical ailment. Especially in developing countries, mental illnesses are so commonly misunderstood that they are associated with supernatural activities and phenomena rather than with medicine and science.
If we talk about the South Asian region, and more specifically the subcontinent, there are harrowing accounts of how patients with mental health problems are dealt with. They are often denied proper treatment, shunned by their own family members and their problems are overseen and misinterpreted as rage, jealousy, mood swings etc. One of the most prominent reasons why mental health issues are dealt in this way are the stereotypes and prejudices surrounding them. There is a lack of proper knowledge and understanding regarding mental health in South Asia. Mental illnesses are not widely recognized as a medical issue. Not only this, mental issues are often thought to be a result of paranormal activities and unnatural happenings. This lack of knowledge is usually due to lack of awareness regarding this issue and the lack of education related to mental health.
A large population in the subcontinent as well as in the South Asia, generally, is living below the poverty line – while the other parts of the population are divided into middle-class and the upper-class. Like many other socioeconomic matters, mental health issues and the way they are dealt in this region are also affected by this segregation in the population. Mental health is often thought to be a rich people’s problem – someone who can afford the “luxury” of indulging into an illness that affects their mind and behavior. This is a common misconception and a very hazardous one too, as it puts the health and life of a person suffering from mental illnesses at risk.
The societies in the West are working on mental health issues and trying to de-stigmatize them, they have more resources and access to medical facilities to combat this issue; however, there is a terrifying silence about mental health problems in the South Asian region. The attitude towards mental illnesses in this region is not only due to lack of resources or education but also due to the centuries-old perceptions and prejudices ingrained in the minds of the masses. An interesting supplement on this topic is the study conducted by two doctors at the University of Missouri, who discussed the reluctance of South Asian residing in the USA towards health issues. According to Dr Khosla, one of the doctors on the panel, “In South Asian culture, it is common for patients not to report their pain to avoid burdening others or being seen as weak.”
This mindset is very common in working and lower-middle class families and one of the reasons why people do not want to seek complex treatments and medications for a condition that is not too apparent and physically and visibly affecting them. Those suffering from mental issues do not want to cause any problems to those around them or they do not want to be seen as weak and vulnerable; it basically has a lot to do with the prejudices put into the minds of the masses and the buildup of their ego. The prejudices that portray people who have health issues to be weak and vulnerable coerces the sufferers to avoid speaking about their problems and their egos come in the way of their treatment.
So there are a lot of reasons why people often dismiss mental health problems. One of them is that these problems are not accepted in the first place. People see them as an “inconvenience” and “glitches” in the lives of the patients and their families, so they are not even ready to accept if something of this sort even exists. However, another important reason and a more common and serious one is the apparent association – drawn by common people – between mental issues and money. “Yeh therapists aur psychiatrists ke kharchay sirf paisay walay puray kar sakte hain (Only the ones with money can afford physiatrists and therapists)”; this is a common thought amongst masses in the South Asian region, particularly the subcontinent.
This misconception is not baseless, though. Medical care for mental health can be expensive for some and therefore, ones who are already living in dire conditions are left with no choice but to live with their disturbed mental conditions, rather than getting a treatment for it. There is a scarcity of hospitals and trained staff and psychiatrists which makes it harder for common people to access these facilities. According to the World Health Organization, in Pakistan, for a population of over 180 million people, there are only 400 psychiatrists and 5 psychiatric hospitals. This is an alarming ratio considering that approximately 50 million Pakistanis suffer from some kind of common mental health issue.
The disturbing negligence of mental health issues by the government and the society as whole in the South Asian region has given rise to the common misconceptions that mental health problems are only a rich people problem.
However, though due to unfortunate circumstances the scarcely available mental health facilities and treatments are accessible only to the ones who are rich and can afford them, these mental conditions do not discriminate. In fact, in general implications, people living in dire lifestyle conditions are more prone to these problems than those living in relatively better settings – socially and economically. This means that mental health issues are an issue not just for the elite class and can affect the working class as well, even if they do not accpet them.
The negligence regarding mental health issues is quite prevalent in all of the South Asia, particularly in the sub-continental region, Bangladesh, Afghanistan etc. In India, at least 5% of the population lives with some kind of mental health problem. This means over 50 million people. These statistics are in close relationship with the rate of suicides, cardiovascular health and several days of productivity lost. However, the way these issues are dealt is just another sorry story. A wide majority of patients suffering from mental health problems are left uncared for and untreated while the ones with less severe problems are not provided proper medical facilities as well.
Mental health problems are a grave issue that needs serious and immediate attention. This issue cannot be dealt on just an individual and personal level and requires the engagement and attention of the masses and above all, the government. The government and other official departments also need to understand the phenomena of mental health issues and deal with them accordingly. In a recent turn of events, a Pakistani supreme court ruled out schizophrenia as a mental disorder, allowing the man suffering from it to be executed. This proved to be a new low for the country and also added to the already existing misconceptions regarding mental health.
Therefore, to enable reasonable treatment and to create awareness regarding mental health issues so that they are not seen as an upper-class issue, it is absolutely necessary that the government takes the matter seriously. The government needs to introduce proper mental health care units for everyone and campaign actively to bring this matter to public knowledge and aware the masses.