“First aid for Mental health”- 27 May 2018.

It is time we popularised mental health/illness and the role of psychology in dealing with it. Pop psychology was instrumental in popularising psychology (that’s how it gets its name), tremendously among the lay person as the book stores across the globe got flooded by ‘self-improvement’ books by the thousands which was lapped up by the public as well as the soft skills trainers who wanted to teach various types of skills to students and the employees at the work place. The ‘how to do it’ books were selling like hot pizzas everywhere. But this trend unfortunately and surprisingly did not help in removing the stigma attached to mental health/illness in any way for it remained circumscribed to just self-improvement for the normal individual and did not address the problem of mental health in a broad way. People still felt someone experiencing a mental health crisis is from another planet and does not belong to the stream of the ‘normal’ community. Hence many clients approach us with the tag of ‘self-improvement’ whereas what they need is therapy and counselling. This is the impact of the huge stigma that society has created around the mind related problems due to ignorance and stupidity of thought. Therefore, although pop psychology familiarised people with the contribution psychology made to the field of self-improvement, it failed in extending the utility and role of the science of psychology in maintaining and treating mental health/illness.

We attempt here to extend and expand the understanding of psychological disturbances and emotional disturbances by de-stigmatising it and bringing the discussion into the drawing room of humanity. Just as all and sundry have understood many concepts of physical injury and physical health and have been taught first-aid for simple problems of the body,by teachers and parents and guardians, we must teach first-aid for the mind. Every child knows that when he wounds himself he should apply an antiseptic and bandage it. Parents, teachers and guardians should equip themselves with the knowledge and the simple first-aid techniques of mental health to save lives in stress/ distress and also to teach it to their wards. The mind has been neglected too much thus far and we see and hear of the consequences of the neglect. Anyone who is socially aware and well read, would know the terrifying statistics of suicides among the adults and teens where India is leading and recognised worldwide. WHO has already declared depression as the second largest cause of death in the world by 2020 more than a decade ago. What are we doing to our children? Why are we closed minded like the ostrich with its neck into the sands when it comes to mental illness and crisis? When are we going to wake up and work towards removing the stigma and openly talking about depression and fears and anxieties and obsessions? When we diagnose a client with depression, there is a huge gap in the understanding of the malady by the client. Most people react as if depression was the result of a week mind owned by a week person and the result of just negative thoughts. So, the simplistic advices of the general public by the dozen, of ‘think positive’, ‘deep breathe’ and ‘meditate’ just does not work. The depression grows in spite of positive advice and the suicide ensues unfortunately. Then the family wakes up rudely and falls into a state of shock. Where did we go wrong?

Mental first-aid could be defined in three simple steps- the 3 R’s.

The first R is ‘Recognise’- the first step is to learn to recognise the symptoms of emotional distress and crisis. At times the symptoms are subtle and not loud enough to attract attention and sometimes they are significant to attract attention. A simple principle could be to be aware of changes in behaviour in the child or the adult- changes in the patterns of sleep, patterns of food intake, withdrawing from social interaction with family and friends, loss of interest in work and studies, irritation and aggression, rude and violent behaviour, addictions, abnormal speech, abnormal reactions to simple stimuli, being reluctant to bathe and be clean etc. If you notice a difference in behaviour in personal, social or work life it needs to be recognised and addressed before it escalates.

The second R is ‘Respond’. This is the most important step which can save a life and help it restore mental health and well-being. The response of the empathiser /care giver has to be non-judgemental, empathetic, and de-stigmatised. Instead of the usual tirade of general advices and blaming the character and week-ness of the mind, the response should be one of empathy, patience and willingness to listen to the pain. Encouraging the distressed person to open up to them assuring them of confidentiality and ethical behaviour, will go a long way in reducing isolation and stigma and assuring the person of understanding and help. It could encourage and motivate him for the next step.

The third R is “Refer’. The empathiser /care giver should know his/her limitations of offering help and not give further advice that may actually backfire. We know many people would discourage them from going to a psychologist for fear of being exposed and being labelled ‘mental’ as if that was an abuse. Physical illnesses can be a matter of pride for some which is so ridiculous and mind problems are denigrated as if there was a ‘class and status’ to an illness as well. To highlight the point, a person may be proud that he got a pacemaker or a stent in his heart by the best doctor in Mumbai or a kidney transplant done which makes him feel exalted but mentioning a mental disorder like being inflicted and punished by a low-grade disease!

There are mental health experts everywhere (although the numbers are dismal and far below the requirement) who should be consulted and the client should be referred to them immediately. The client needs to be accompanied by a family member or a friend who understands the diagnosis and the plan of treatment and sees him through the rough period. Once the client takes control and charge of his condition and life he could follow up on his own.

Let us remove the stigma and let us talk about depression and emotional crisis with openness. Let us share and care and love those who suffer alone.Remember the three R’s- Recognise, Respond and Refer.

**** We plan to launch a social support group on Depression. Those interested can contact us. We look forward to your brave participation.

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