BHATIA: India and China need to destigmatize mental health, increase access to treatment

I recently watched a Bollywood movie called “Dear Zindagi” with two of my white, American friends. As much as they loved the movie, their first question to me was, “Is mental illness really that stigmatized in India?” A little context: this is a movie that is trying to destigmatize mental illness by showing the struggles of those who suffer from them. This is incredibly rare in Bollywood, and the movie does a great job of showcasing the daily stigma that these people have to face.

To answer my friend’s question — yes, it is. Let’s talk not only about India, but also about China, both of which are major developing economies and together account for about 36 percent of the world’s population. Both countries have millions of people whose depression and other mental illnesses go untreated every year.

In recent years, China’s suicide rate has plummeted. Experts say, however, that this is not due to better mental health overall, but due to urbanization. Rural China accounted for about 79 percent of the suicides in the country from 2009 to 2011 due to poor financial situation, lack of education and easy access to pesticides, which are the most common method used for committing suicide. Since more people have moved away from rural China to the cities, their financial situation has improved, but the main reason behind decreasing suicide is thought to be the lack of easy access to pesticides.

India, on the other hand, has also had very high rural suicide rates with farmers committing suicide due to huge financial burdens. The urban people in these nations are not immune either. Both these nations are known to have very rigorous academic environments, which have led to many student suicide cases.

The social stigma surrounding mental health treatment is a huge reason behind this. In the United States, we still talk about how mental health is stigmatized, but in these countries, the situation is a lot worse. In India, where depression is the one of the most prevalent mental issues, there is an assumption that anyone seeking therapy is “crazy.” China, on the other hand, has huge issues with substance abuse. Like I mentioned earlier, the fact that Bollywood was talking about mental health at all makes “Dear Zindagi” an outlier. This is very true for Chinese cinema as well. Activists have been advocating for more portrayals of mental health in media for ages.

The social stigma and lack of funding for mental health go hand in hand. Less than one percent of India or China’s national health budget go toward mental health. Social stigma makes people reluctant to seek help and mental health practitioners are not seen as a necessity. On the other hand, lack of easily available treatment means that less people get treatment and talk about it, hence reinforcing the stigma. In a situation where both of these countries have limited resources with which to serve very big populations, the focus usually tends to be on more “life-threatening” diseases and not mental health. We have seen though that mental disorders can be just as life threatening and debilitating as any other illness, and need to be taken more seriously.

Another problem with treatment in these nations is the focus on alternate forms of treatment. Both India and China have a rich culture of homemade, plant-based medication that is used to treat various malaises. Ayurveda, acupuncture and homeopathy are quite commonly used in both countries, for religious, financial or traditional reasons. However, it is not known whether they have any significant benefit at all.

It’s surprising how desensitized we are to the fact that millions of people in two of the world’s most populous countries do not even know that they can seek treatment for mental illness. The media, government and medical professionals need to work in collaboration to decrease the stigmatization of mental health and increase access to treatment.

In the meantime, we should do our bit by examining how we talk about mental health. Let’s not stereotype, belittle or underestimate these issues by joking about how many “mental breakdowns” we have had this week or about how “depressed” we are that our favorite TV show got canceled. These are real issues that aren’t as funny for others on the other side of the world.