You suffer a slight bruise, a mild fever or even a bout of sneezing and the world rallies around you. Advice arrives from all quarters. Everybody turns a doctor and starts recommending plethora of medicines, diets, new lifestyle, et al.But dare you be seen talking to yourself then the same folks will run a mile away from you. You will be dubbed mad, who would bite, kill or maim the world around. As in many Western movies, you will become a present and real danger to mankind.
That is how our society discriminates between physical and mental illnesses. Few are willing to accept that even mental ailments more often than not have physical, chemical and organic origins.
Medical anthropologists Kohrt and Harper assert that Nepali culture believes in division between the mind and the body, and that a greater degree of stigma is attached to illnesses of the mind.
Apparently, there is a sense of awe and vicarious thrill in imagining that a person has been overpowered and driven 'mad' by a gang of evil spirits, ghosts and witches. And that being the case how can friends and relatives shoulder the responsibility of bringing the 'crazy' back to sanity? After all, how can mere mortals fight demons? How convenient!
But it is this inconvenient perception of life that we need to address on the occasion of World Health Day today. Mental ill health is widespread not only in Nepal and other low and middle income countries but even in the so called advanced world. The contributing and precipitating factors do vary from region to region, but there is considerable similarity in general social response to mental troubles.
There is a strong social stigma attached to mental ill health, and people with mental health problems experience discrimination in all aspects of their lives including family, friends and employers. A UK survey revealed that stigma and discrimination make matters worse for nine out of 10 persons challenged by mental problems.
Why is this so? Because most of us have stereotyped views about mental illness and how it affects people. Those afflicted with mental ill health are viewed as violent and dangerous. Ironically, the mentally ill are more at risk of being harmed or of harming themselves than of harming others.
Psychotherapy experts feel that the media too has played an adverse role in exacerbating the situation. News reports often link mental illness with violence. They portray people with mental health problems as dangerous, criminal, evil or very disabled and unable to live normal and fulfilling lives.
According to Patricia R. Owen, PhD, a professor in the Department of Psychology at St. Mary's University in San Antonio, Texas, most cinematic depictions of schizophrenia promote misinformation about symptoms, causes and treatment. Analyzing English-language movies released between 1990 and 2010 that depicted at least one character with schizophrenia, Dr. Owen found that most schizophrenic characters displayed violent behavior, one-third of these violent characters engaged in homicidal behavior and a quarter committed suicides.
"I was also surprised by the high suicide rate shown and the number that showed people with schizophrenia as supernatural or having supernatural abilities, which I didn't expect at all. And I didn't expect that there would be so much reference to medications as treatment," said Dr. Owen.
She observed that movies like The Soloist, Canvas, and Some Voices offered a realistic and sympathetic representation of the disorder. She also suggested Clean, Shaven—but as a teaching tool and not for the general public.
On another plane, a WHO cross-country study has highlighted the yawning gap between demand and access to mental health care. Low income restricts access to much needed medical care. This is particularly true for Nepal where low socio-economic status is the norm. Poverty can be pulverizing for most but all the more for the mentally ill from the underprivileged social segment.
No wonder traditional faith healers rule the roost. They also tend to draw people away from modern mental health care. If things continue as they are then one out of four people in Nepal will be affected by mental illness. In fact, some studies claim that over a quarter of Nepali population is already challenged by one or the other medical disorder.
Yet only 0.14 per cent of the country's health expenditure is allocated for mental health. There is an acute shortage of qualified psychiatrists, psychotherapists and counselors. According to INGO reports, of the 60 Nepali psychiatrists, half have chosen to practice abroad. The policy framework on this front is too weak and needs urgent updating and upgrade.
The decade-long Maoist war left deep scars on the Nepali psyche. Political uncertainty thereafter did no good. The devastation unleashed by the April 2015 earthquake compounded people's post trauma stress disorders. Substance abuse that is drug addiction too is adding to the growing number of mentally ill persons. Large-scale migration of Nepali youth, mainly males, is weakening family ties and badly impacting mental well being of all concerned.
The rapid erosion of personal social interaction following the phenomenal growth of communication gadgets and media too has taken its toll. In today's rat race, we talk through machines. We talk to machines. Unfortunately, machines do not talk to us. They do not empathize with us like fellow beings. They do not feel our pain and growing loneliness. We are losing our minds and mental ailments by different names tend to besiege us.
Schizophrenia, organic disorders, bipolar disorder, anxious depression, pure depression, generalized anxiety, panic disorder, obsessive-compulsive disorder, phobias, distress, eating disorder, chronic fatigue, bereavement and adjustment disorders are becoming the order of the day.
It's time to set our heads right and our house in order. It's never too late.
The author is the Founder of Basant Chaudhary Foundation, poet, writer and social enthusiast
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