Wednesday, May 15, 2013

Indians Don't Understand Mental Health Issues

One thing I remember distinctly about my time in Amritsar is how a friend's husband owned a mental health clinic. It was in the most heavily traveled part of town and part of a well-known Indian national health system. He was UK educated and a good businessman (he owned 3 other businesses that were thriving in Amritsar and 1 in the UK). So what was surprising? The fact that he had to shut it down after a few months because he couldn't get enough clients to make the business profitable.

It was then that I started looking around me and I noticed that mental illness was not treated the same in India as it was in the US. In some cases I discovered people thought they could force the mental health issues out of a person. As in maybe they could beat them, lock them away in a room or starve them to cure the issue. In other cases I noticed that the issue was completely ignored and was written off as the persons "nature" or "habit."

If someone had a mental health issue it was more acceptable for them to drink to the point of becoming an alcoholic rather than see a doctor. Another woman found it more acceptable to drink poisonous chemicals and try to kill herself than to seek help outside of the home. While these may be some extreme examples that may or may not happen everyday, they are evidence of how Indians view mental health. These issues are simply dealt with at home and hidden from society.

In the US some people still try to hide their mental health issues from society but overall it's become widely acceptable to seek out medical assistance. The way I heard it as a child is: Why not seek help for your mental issues from a doctor when you clearly seek help for any other medical issues. The brain is a part of the body just like your liver is. I've adhered to that principal my whole life. Mental health is just as important as physical health.

We are rapidly seeking more understanding of mental health issues here in the US. This started long before the Columbine shooting and the Susan Smith drownings but those cases only emphasized the need to recognize and treat mental health issues. As such, Americans are more open to asking for help when they are depressed, suffer from anxiety or other lesser life-disrupting disorders.

From what I see, most Indians in general disapprove or shy away from any sort of diagnosis of mental health issues. This includes senility (which I know is a medical disorder) as the person ages and begins to forget things, act irrationally, etc. Indians are very dismissive of these issues and very quick to cover them up.

Before anyone gets their panties in a twist, I am not saying Indians are wrong for this. It's simply a difference in culture and understanding between the US and India. Most things in India are kept at home, done at home, and center around the home and the family and outsiders are not let in easily -whether they would understand or not.

When it comes to interacting with those with mental health issues, some Indians try to use insults to get a person to act 'normal' again. Others talk down about the person as if the mental illness was not the problem but instead their moral character were. I've even noticed one Indian who spread the bad moral character thoughts to the entire family because one member had mental health issues that were not understood - thus the whole family must be bad.

It all leaves me wondering just how Indians would deal with someone who had schizophrenia or bipolar disorder, or even ADHD (which again I know is medical and not mental). In the US many decades ago, these people used to be considered 'demon possessed' under Christian thinking. I wonder if religion in India causes some to have similar views.

Have you had experience with Indians who had mental health issues?
How did you address them?
How did you see other Indians address them?


  1. In a city like Delhi, there are many psychiatrists (most of whom have been educated and have practiced abroad) and psychologists, so it's not so much of an issue here. It also depends on the education level of the family (and when I say this, I usually mean families in which both men and women are equally educated with equally successful careers).

    However, there is a massive stigma associated with mental issues all over Asia (not just India). It's seen as a weakness, an embarrassment, and sometimes, a major personality flaw.

  2. There is definitely a stigma associated with mental issues in India. Many such issues are attributed to ghosts or spells. However, in cities and towns people do have an understanding that something abnormal needs medical help. At the same time, they seek divine help if they do not get good results. Schools in cities have integrated learning which accommodate children with disabilities. There is better understanding for special children and people with disabilities in cities.

    Our society looks for perfection in everything as perfection means social respect. Good grades, good job, perfect health etc. Anything less than than brings shame to the family.

  3. GoriNiqabiWife.blogspot.comMay 15, 2013 at 12:00 PM

    When I saw the title of this post, I just had to read it.
    It's actually really sad that Indian's deny any mental health issues and refuse to seek help or accept they have problems. My Pakistani husband says the same thing goes on in Pakistan... if someone has any kind of mental issue people deny it and just have the "get over it" mentality. Or as you said they could just get it "beaten out of them". It's crazy. I have heard countless stories of Pakistani women committing suicide at an alarming rate. Many of the women are probably depressed and have no where to seek help. Depression and anxiety are totally ignored over there, leaving the people with no where to turn for help or even confirmation that they are mentally ill.

  4. It's interesting that you notice the education level affects how they view mental health issues. I am not sure of the education level of the people mentioned in my posts but now I think I might try to discover it. It makes sense that those with less education tend to be less understanding of many things.

  5. This is a good point. I have heard of some seeking spiritual/divine intervention for anything not seen as normal - this includes perfectly normal behavior that the parents don't like.

  6. The stigma in the US seems to be more personal (as in 'there's nothing wrong with me') as opposed to in India, whole families dismiss the issue. This could be attributed to the differences in culture as well. I do hope that craziness isn't contagious - otherwise I'm screwed. :P

  7. And that may just have been a tasteless joke at the end of my comment. Oops.

  8. You make a good point, many people don't have any way to seek out help. Some may also feel like that getting help would bring shame on the house (they don't want anyone to know about the problem).

    Similar issues occurred in the US decades ago. Mental patients were locked away and horrible things done to them in the name of getting the demons out or forcing conformity. It's very sad to think about this kind of suffering.

    I noticed in India that when a person is 'sad' then people try to gather around them and do things to cheer them up. They will keep up this behavior until the person looks happy again and keep repeating it as if it fixes the problem. It does temporarily but then the cheering up stops and the person is sad again. They have no understanding of the concept of chemical depressions or medical issues that cause imbalances and subsequently mental issues that are treatable. People are expected to just keep pretending life is great, etc.

    The issues facing women are very difficult to hear about in both countries. It doesn't have to be this way but no one realizes that. They're too scared (it seems) to adapt to modern medicines and treatments and I personally feel like their standards of living are nothing like ours and that makes a difference too. We seek happiness and peace in much different ways than they do and we are also satiated differently in life. I think their view of happiness may also complicate how they view mental health issues as well.

  9. There are a lot of professions in the US you can't work in now if you are taking even relatively common psychiatric meds like antidepressants.
    And a lot of health insurances don't cover 'mental health treatment'.

  10. Ugh. That's just effed up. I haven't yet seen a policy that didn't cover mental health issues be offered to me. It's just ridiculous people would not cover it nor allow those with depression to work. I swear there's still more than a few executives here who need to be smacked!

  11. I'm not sure that this is an either/or situation. Mental health issues are not entirely about a biologically dysfunction that only a course of chemical intervention can correct (the American way). It also does have a situational and social context where family support can be critical (the non-American way). E.g., refereed research articles show that outcomes for schizophrenia in low- and middle-income countries are better than elsewhere because schizophrenics are not institutionalized and isolated. And a recent article showed how French counselors treat ADHD not with drugs but with intervention in the social context (i.e. school). A combination of drugs and social support gets good results.

  12. Interesting point. Social support is critical in just about any setting. I've seen many programs in the US where schizoprhenia patients are not isolated. In Florida they are taught how to live on their own, pay bills, manage treatment options, etc. and the state helps them. Those I know in Virginia are not institutionalized either unless in extreme circumstances. Virginia seems to be moving away from institutions as a whole (at least in the areas I am aware of) but there is no real state support like I saw in Florida. ADHD can be treated much better without medicines at all in most cases and I am a firm believer that parents should seek out alternative methods of treatment such as diet. ADHD medicines are scary. I also think that Americans are too quick to come up with new mental health disorders that warrant medicines. It's like every time you turn around there is some new disorder people are being labeled with that should not be a disorder at all IMO.