Mental Health - From Stigma to Priority

...one day he decides to end it all. At midnight, he walks on a deserted bridge. His eyes stare at the ground and his legs seem to move on their own accord, pulling him wherever they want him to go. He stops and holds the cold metal railings of the bridge and looks down at the deep river.

  The next day his name resonates in every street. 'He's missing'... 'he's gone'. The sirens blare. A body is pulled out of the river...

  For the next few weeks, everyone in that small town seemed to have the 'complete knowledge' about what had happened. Everyone, whether they were related to him or not, had a sure opinion of what had happened. Everyone talked about the, hushed, suicide for a few weeks.

Then? People carried on.

The World Health Organization (WHO) has defined 'health' as, 'a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity'.

To make sure our health is intact, we take a series of measures such as going for annual physical check-ups, consulting physicians and taking necessary medications, even when we don't have any serious issues. However, somewhere in our preoccupation of keeping our body up-to-date, we have forgotten or undermined the importance of our mental health.

NOT ALL WOUNDS ARE VISIBLE

World Mental Health Day is observed every year on the 10th of October. So, what is mental health?

Mental health encompasses our psychological well-being. It's about how we perceive the world around us, our intelligence, decision making, feelings, emotions, thoughts and behaviours.

Our mental health is influenced by how we react and deal with daily stressors and our reactions are influenced by our previous experiences.

Also, our mental health can have a huge impact on our physical health. For instance, a person who might have worked hard and given their best for their job but still hasn't been recognised or appreciated might get intensely frustrated and it may lead to severe headache or stomach ache. Frustration is a psychological reaction, however, it has a physiological impact as well.

If such frustration, sadness, fear, perception of loneliness, persists for a long period of time, it may lead to mental illnesses. According to the National Alliance on Mental Illness, U.S., 'A mental illness is a condition that affects a person's thinking, feeling, behaviour or mood. These conditions deeply impact day-to-day living and may also affect the ability to relate to others.'

In the Middle Ages, mental illnesses were regarded as the curse of gods or the possession of devils. Although such notions persist even today, we now have scientific evidence to prove that etiology of mental illnesses range from traumatic experiences to genetic predisposition. Also, the severity of mental illnesses vary, just like how different physical ailments have different degrees or stages.

The most common mental health disorders include depression, post-traumatic stress disorder (PTSD), bipolar disorder and schizophrenia. Depression and bipolar disorder are mood disorders. PTSD comes under trauma- and stressor-related disorders. Schizophrenia is a psychotic disorder. In severe cases, these disorders may also lead to suicidal ideation or attempts. Thus, there are many categories and levels of mental illnesses.

Usually, the names of the above mentioned mental disorders and others are used loosely or as a 'joke'. People who are sad might state that they are 'depressed'. Many call people who are organised, 'OCD' (Obsessive-Compulsive Disorder - 'Oh, she's so OCD!'). Such usage of clinical terms is incorrect and must be addressed. Mental disorders have diagnostic criteria which are strictly followed before stating that a person has depression or any other disorder. The two main diagnostic tools used for identifying and classifying disorders are the Diagnostic Statistical Manual (DSM) issued by the American Psychological Association (APA) and the International Classification of Diseases (ICD) issued by the World Health Organization (WHO). Both DSM and ICD categorise disorders and have stated criteria for diagnosis of every disorder. For instance, for a person to be diagnosed with PTSD, 'symptoms like flashbacks (reliving the trauma over and over, including physical symptoms like a racing heart or sweating), bad dreams, frightening thoughts, must last more than a month and be severe enough to interfere with relationships or work' (National Institute of Mental Health, U.S.).

Speaking about mental health conditions is a 'taboo'- a deep-rooted stigma.

Whenever anyone expresses their willingness to approach a psychologist or psychiatrist for therapy, the general comment is that the person is 'mad' or 'crazy' and can never be 'normal'. This stigma makes it difficult for people to seek proper treatment for their psychological problems.

Stigma arises out of preconceived notions, misconceptions, lack of awareness and empathy, and conservatism. Many still believe mental health conditions can be cured by religious rites or black magic and consider taking psychiatric help as the last resort.

Overcoming such obstacles at a macro level takes decades. What can we do as individuals to turn things around, to make mental health a priority?

STIGMA TO PRIORITY

To destigmatize, it is important to gain knowledge about mental health. Our mind is highly profound, but we don't necessarily have to delve into its complexities to understand mental health.

Educational institutions must impart knowledge regarding our psychological self and how to manage it. Organisations should take into consideration 'mental health leaves', which allow individuals to avail a day off if they are not in a position mentally to deal with the day's work. We, as individuals, can read, listen and observe new findings by professionals, spread awareness and become mental health advocates. We must learn to recognise armchair psychologists (pseudo-psychologists) who, unlike professionals with licence and doctoral degrees, have minimal or no knowledge regarding psychological aspects and might increase the myths surrounding mental health.

We all have gone through some rough times in our lives. The common thought we get during those tough times is that we are alone in our troubles. But, only when we speak out do we realise that many others have also been down the same treacherous roads. We need to 'unmute ourselves'- have more discussions regarding mental health, put in more efforts to understand and empathise with others.

At a macro level, we notice governments and health care organisations implementing new laws, making amendments in our understanding of psychological problems, conducting research, spreading awareness and allotting resources for mental health care. However, according to a recent WHO report, the percentage of government health budgets spent on mental health is still hovering around 2%. A study published in the Indian Journal of Psychiatry stated that there are only 0.75 psychiatrists per 1,00,000 people in India, which is much lower than the suggested level of at least three psychiatrists per 1,00,000 people. Such deficit in actions lead to lack of necessary psychological intervention and accessibility.

MIND MATTERS

The journey from stigma to priority is still long and arduous. However, we can give our best for uplifting mental health care. Firstly, we can observe ourselves, introspect, and check our own mental health. Am I feeling more stressed out than usual? Are my thoughts more negative these days? Do I get exhausted way too soon? We must ask such questions to ourselves on a regular basis because unlike physical ailments which have tangible symptoms, mental health issues need more careful and closer observations.

Secondly, we need to stop reacting adversely towards people seeking therapy from mental health professionals. Just like we go in for an annual physical checkup, we should also go in for an annual psychological checkup. Lastly, we need to help the people around us. Humans are social animals- we need each other. Let us check in on each other's health - both physical and mental. Let us listen and understand more than condemn and advice. Let us start acknowledging from now the importance of our psychological self. For, there's no health without mental health.

References:

World Health Organization. (n.d.). World Mental Health Day. https://www.who.int/campaigns/world-mental-health-day

World Health Organization. (n.d.). Constitution of the World Health Organization. https://www.who.int/about/governance/constitution

National Institute of Mental Health. (n.d.). Mental illness statistics. https://www.nimh.nih.gov/health/statistics/mental-illness

psychiatry.org. (n.d.). Diagnostic and Statistical Manual of Mental Disorders (DSM). https://www.psychiatry.org/psychiatrists/practice/dsm

World Health Organization. (n.d.). International Classification of Diseases (ICD). https://www.who.int/standards/classifications/classification-of-diseases

mayoclinic.org. (n.d.). Obsessive-compulsive disorder (OCD): Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432

mayoclinic.org. (n.d.). Post-traumatic stress disorder (PTSD): Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

cdc.gov. (n.d.). Mental health stigma. https://www.cdc.gov/mental-health/stigma/index.html

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37–70. https://doi.org/10.1177/1529100614531398

World Health Organization. (2025, September 2). Over a billion people living with mental health conditions: Services require urgent scale-up. https://www.who.int/news/item/02-09-2025-over-a-billion-people-living-with-mental-health-conditions-services-require-urgent-scale-up