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Friday, September 18, 2020

Matters of the Mind: Who is taking care of counsellors?

Several aspects with respect to psychological diagnosis, intervention, prevention, licensing and education need to be made clearer by regularised and centralised guidance. But time and again we find ourselves on our own in this quest.

Written by Dr Shwetambara Sabharwal | Mumbai | August 21, 2020 11:40:51 am
counselling, counseller mental health, healthcare providers mental health, indianexpress.com, indianexpress,There is severe closed mindedness and resistance in sharing truths about suffering, stigmatising seeking help as a lack of strength and endurance. (Source: Getty Images/Thinkstock)

Mental health professionals have powered through the past six months during this world crisis. We have managed panic attacks caused by the pandemic, counselled for both severe anxiety as well as ignorance or resistance towards precautions, and also helped cope with loneliness due to social isolation or separation from families during the mandatory lockdown. We not only found ourselves trying to counsel domestic battles, concerns about online education and how stress will further cut our immunity, but also managed some serious fire-fighting finding suitable medical facilities for patients who needed immediate hospital admission amid the pandemic. Many are also counselling Covid-19 positive cases and their families.

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As I (moving to I; taking full responsibility for any rant that may follow) wake up and prepare for the day ahead, managing home and children, adapting to online counselling, building rapport on phone and giving every bit of educational, psychological, at times social and other critical support, I am aware that there is no council, legal body, government regulatory agency or support centre that stands behind us.

We function with a severely inadequate mental health care infrastructure in the country which has an enormous population, rigid cultural and social stigmas, no awareness, no funding and no one centralised go-to body for support, rules and guidelines.

ALSO READ | Matters of the mind: Swinging from one crisis to the next, there may be chance for a revolution

Of course, we have our batch chats and other self-initiated group chats of highly dedicated and proficient mental health professionals that are our checkpoints for various queries, concerns and connections across the country, when such a need arises. But needless to state that psychologists and counsellors are a highly critical lot of professionals, that are largely neglected, “left on our own” to perform, self-proclaimed flag-bearers of the mental health awareness movement, work under high pressure and exposure to distress, mandatory professionals at every school, college, hospital and corporation at pitiful salaries, all because this brave tribe…cares!

Even though extremely significant, let us put daily life stress aside for a minute. After every crisis, be it Ebola, H1N1, SARS, tsunamis, earthquakes or highly publicised celebrity deaths, people suffer emotionally for months. Some develop mild symptoms, some transient disorders while some need treatment for a significant period of time. These crises leave people, families and lives affected for a very long time. The ones who choose to live it with them are therapists.

In a country that banks on its youth as its fuel for progress, a 150 million people need mental health intervention in a year, 46 percent report chronic stress, one in five people have depression or anxiety disorders, and according to the NCRB report, 2014-2016 recorded 26, 476 deaths by suicide amongst the young (15 to 29 years), 28 a day in the year 2018. The people who live with these numbers are therapists.

I often get asked, “How do you deal with it?” “Doesn’t it affect you?” Yes and no! Yes, so long as I think productively, study and can help with the perceptions, emotions and illness. As far as the problem is concerned, we know we can’t change it for them, and that’s where we know we have to stop.

ALSO READ | Matters of the mind: Response, resilience and recovery — the three-dimensional strategy for mental health

Unfortunately, for some practitioners, passionate employment, stigma with reaching out for help and navigating a profession that suffers fundamental neglect, takes a toll. Dr Hinshaw, author of Breaking the Silence, in which mental health professionals disclose their personal and family experiences of mental illness, said the topic “seems to be out of bounds, with silence remaining the order of the day.”

I don’t see this with an architect who has leakage in his house or a cardiologist who might have a heart problem. An orthopaedic surgeon will proudly share how he saw his knee replacement coming. But judgements over a divorce of a counsellor or a panic attack stay as a dark shadow over their proficiency, often preventing them from seeking support in time.

There is severe closed mindedness and resistance in sharing truths about suffering, stigmatising seeking help as a lack of strength and endurance.

I do understand that a lot of it comes from fear, but sadly the epicentre of the fear is ignorance, not reality. Every now and then we raise our voices, sign petitions and ignite movements. But this needs mobilisation of a nationwide campaign.

My argument and aim is to have guidelines, share knowledge and work towards acceptance that this is a part of our environment, our world, our lives, our families, including those who teach, serve and provide decades worth of critical support and crisis management.

Several aspects with respect to psychological diagnosis, intervention, prevention, licensing and education need to be made clearer by regularised and centralised guidance. But time and again we find ourselves on our own in this quest.

I know I am not asking for too much when I say that the mental health space needs government support, research investment to spur innovation because I guarantee you that India has some of the finest minds and spirited psychologists, help us with concrete opportunities to translate knowledge into practice, construct equipped facilities that provide patients effective treatment and invest in promotion of acceptance and inclusion for people with psychological conditions. These are grievances that impact lives, not only of those we treat, but also our own.

ALSO READ | Matters of the mind: Caution, courage and rationality may be answers to the crisis

This is critical and I hope it draws the attention of the central government. We need policy drafting, regularised licensing, and funding for prevention and research so India can have an honest go at what we know we can achieve, a psychologically healthier developed nation. India, the birthplace of yoga, meditation, Ayurveda and mindfulness practices, deserves better.

Power lies in pre-empting and preventing, both of which need the clutter of ignorance, fear and stigma dusted away, so we can see clearly what lies ahead.

(The author is a Mumbai-based psychologist and psychotherapist)

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