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How, when, and where to seek mental health care

While browsing social media, you will find many self-help and wellness platforms that provide tips and tools to change your life or promote your mental health. Unfortunately, despite this content economy, many misconceptions remain about mental health. Even those who want to seek support or help can get confused by the terminology related to professionals and medical diagnoses.

On Global Mental Health Day, which falls on October 10,  let's go back to the basics of mental health and mental healthcare to dispel any concerns and answer any of your lingering questions.

The ABC of mental healthcare

Mental healthcare is for everyone, like physical healthcare. "Just like we do a lot of things to live healthily daily, we can do a lot of things to have good mental health regularly as well. So, there is a preventative and a treatment aspect," says clinical psychologist Smriti Joshi, who is associated with the AI-enabled life coach platform Wysa. She adds that it is normal to experience a wide variety of emotions like sadness, anger, and stress. Still, once it starts impacting your everyday work, relationships, focus, and sense of self, it may be time to reach out for help.

Joshi explains the services available for people across the mental health spectrum. First, for those who experience occasional stressors and want to address them, Joshi says they can learn skills to manage them through self-help tools, guides, books, and other mental health resources. Or you can go to a life coach or counsellor for some guidance.

Next in the spectrum are those who are languishing. Joshi explains:"You are not exactly unwell to be diagnosed with something, but you are still in that phase of languishing, where you're not thriving as you would do when you're in the wellness space." It is marked by disruption in emotions, sleep, and appetite, but you are still able to manage to some extent. Finally, the third is the illness phase, where people experience persistent behavioural and mood changes and sleep and appetite issues for at least two to three weeks. It may be marked by other symptoms like hallucination and require psycho-diagnostics, assessment, and treatment.

These mental health conditions and challenges can be a result of genetics, biology, and social and environmental elements.

"Mental health has now been seen as a "bio-psychosocial" viewpoint towards health and also treatment," says Bangalore-based psychiatric social worker Alen Chandy Alexander. Alexander, who works at the National Institute of Mental Health and Neuro-Sciences, analyses how social environments and settings like interpersonal relationships, families, schools, work, and religious institutions affect people's mental health.

In family settings, Alexander explains that mental health problems may arise in family settings due to domestic issues and neglect during parenting. Similarly, marriage may cause distress when two people enter such partnerships without clarity. Finances, dynamics with in-laws, household chores, and responsibilities can be social determinants of anyone's mental health. So are the gendered expectations. Alexander gives the example of men who are expected to be the providers and work and toil hard without outlets to express themselves. It may all come out through high-risk behaviour like substance abuse and gambling. For women, who are expected to keep everything inside and not talk about their issues, their mental health challenges may manifest themselves through unexplained body aches, fainting spells, and other neurological problems.

So, the social environment and resulting social identities need to be considered when it comes to mental health and healthcare.

"The mental health sector has been making inroads to understand that there is a need for an intersectional framework to comprehend better how identities interact and its resulting impact on one's mental health," says mental health practitioner Saransh Bisht, who is associated with inclusive mental health collective, Belongg. These aspects go for a specific need-based approach instead of general mental health solutions for different individuals and communities.

Where to seek mental healthcare or help?

Where do you go if you have a mental health concern and you want to seek help?

Joshi recommends that you go to any mental health professional nearest you instead of losing time. Different kinds of help are available depending on your needs. For example, if you feel you are struggling in your relationships, work, and school, you can go to a counsellor, coach, or consultant psychologist. On the other hand, if you think that it is impacting your everyday life and biological functions and leading to self-harm or suicidal feelings, you can consult a psychiatrist (who has an MD in psychiatry) or a clinical psychologist (who has an MPhil in clinical psychology and registration from the Rehabilitation Council of India). Only they can screen you and diagnose for any mental health conditions like OCD, depression, bipolar disorder, or schizophrenia and provide treatment protocols. Joshi suggests asking any professional for their credentials without hesitation.

As many cannot access or afford private mental healthcare, they can go to public health centres. "If you go to a government-enabled hospital, things would be much more affordable. But over there, what happens is that the infrastructure might be outdated, and then, the flow of the patients will be too heavy," says Alexander. Under the District Mental Health Programme, every district in the country is supposed to have a team of psychiatrists, psychiatric nurses, and social workers for such support. Also, people with psychosocial disabilities can get a Unique Disability Identity Card (UDID) and avail of welfare schemes like transportation and education based on their disability scoring.

With the pandemic, we are now seeing a rise in digital mental healthcare "A lot of innovation happened in the past two years, where professionals felt the need to offer their services via other modalities as well because suddenly the service user and service provider both were badly affected," says Joshi. Many apps and online platforms now provide mental healthcare tools and help you get in touch with professionals. For privacy concerns, Joshi says that people should probe and ask how their data is being used and stored.

Joshi also advocates strongly for community and peer group support outside the clinical setting. "Without it, it would be considered incomplete because ultimately, after treatment support, the person goes back to the community, whether it is at work, their residential area or at a larger level," she says.

For community support, Belongg has been hosting listening circles since 2021 for people from different social identities to come and provide an inclusive listening space to each other. Bisht says that the conversations in such circles do not necessarily stick to any themes and allow people to guide and develop the framework. Therefore, these initiatives can act as additional support for people.

Many professionals and institutions are looking for ways to fill in the gaps and overcome hurdles of the mental health infrastructure, the stigma and hesitation towards reaching out for help, and even the language of care.

Bisht suggests that the new platforms or avenues involve people with lived experiences and those from marginalised communities to make them accessible for persons with disability or trans and queer folks. For instance, "If they [people seeking mental health services] can't speak the language that is prevalent within the sector, they definitely can't access mental health services," says Bisht.

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