“Go for morning walks. Jog. Pray. Everything will be alright”, is the advice 26 year-old Yash Kumar* got from his father, when he realised that Yash needed therapy, because of family problems and the ensuing fights at home.
We still get to hear statements like: “you’re crazy”, “you’re mad”, or “oh, you’ve lost your mind”. This stigma runs deep and ruins countless lives all over India, every single day.
According to the WHO (World Health Organization), 7.5% Indians, or over 90 million out of a population of 1.3 billion, suffer from some kind of mental health issue.
India has 0.75 psychiatrists for every 100,000 Indians, which is far less than the desirable three psychiatrists for every 100,000 people.
Many Problems, No Solutions
Seeking help and accessing mental health care in India is difficult. The mental health budget is very less compared to the mental health burden. In most cases, the sheer cost of therapy makes it inaccessible.
And, when an external stressor like poverty becomes the reason for seeking it, the irony of the sad situation is not lost on me. The situation is even worse for people from the marginalised communities in our society, such as gender minorities and people with disabilities.
“When you are from a minority religion or caste, at least your family is with you. They are also facing the same issues. But, when you are a minority within a minority, like when you are the only queer or trans person at home, then even your family is unable to help you,” observed Mumbai-based Sadaf Vidha, researcher and founder of Guftagu Therapy.
“In fact, your family can become one of the first sites of violence. They are more likely to dismiss you, or force you to undergo conversion therapy. You end up facing a lot more,” she added.
A Minority Within A Minority
The WHO states that gender minorities, who constitute roughly 0.3-0.5% (25 million) of the global population, are four times as likely to experience a mental health issue as cisgender people.
People with disabilities too, have a similar story to share. They are always viewed as “different” or out of the ordinary. This is also fuelled by the fact that disabilities are used as mockeries by most Indians, including our politicians.
Indian politics is dotted with such instances, be it when prime minister Narendra Modi joked about dyslexia when trying to indirectly mock a political opponent, in March 2019; or when Priyanka Gandhi Vadra was said to suffer from bipolar disorder by Bharatiya Janata Party member Subramanian Swamy, in January of the same year.
People with disabilities are five times more prone to experiencing mental health issues than their able-bodied counterparts. When perpetual stereotyping, and discrimination is the norm, rather than normalisation and acceptance, it is bound to exacerbate an already existing problem–mental health concerns.
Both queer folks and people with disabilities face discrimination when it comes to employment, because of the social stigma around belonging to a marginalised gender, or the perception that a person with disability won’t be as efficient.
Therapy is expensive, and when you add unemployment to the mix, inaccessibility becomes cyclical.
Are Needs Different Or Are We Ignorant?
Mental health care in India, like most professional spheres, is dominated by cis-heterosexual and non-disabled persons who are not adequately prepped to take on queer clients or clients with disabilities.
“This is not because you need additional training, but because basic training of working with intersectionality is missing. It is we who have made the hierarchy of first learning about heterosexuals, and then doing additional courses. But, this should not be the way the education is structured,” explained Vidha.
“Basic empathy for all and an understanding of intersections should be a part of the basic education. We shouldn’t need additional courses to learn these,” she asserted.
In India today, queer communities are still stigmatised, and thus, heteronormative mental health care can’t help queer people. For instance, cis-het therapists in India remain unaware of the difficulties faced during the coming out process, which differ with age, religion, caste etc.
Non-disabled therapists remain underprepared to understand the personal and environmental barriers that their clients with disabilities could be facing. Thus, most professionals are unable to put aside such biases and deal with their clients.
Catering To Queer And Disabled Folks’ Mental Health Needs
Normalisation and integration of these communities in our society is the key to uprooting these problems. Education needs to assume that everybody is a human being, and teach students in such a way that everybody is catered to.
But, this is still some while away. In the meantime, mental health professionals can create a safe space for queer and disabled persons in many ways. Queer affirmative therapy, which involves acknowledging queer people’s experiences and using correct pronouns and names, can help.
Non-disabled counsellors need to first check their own beliefs and expectations of disabilities. Here, language plays an important role as it reflects the therapist’s own view of disability.
For example, Replacing terms like “normal” with “in majority” or “common” recognizes that there is nothing wrong with being disabled.
Support groups and community mental health needs to be given a boost–everyone should not have to go to a therapist. Everybody is normal, even if they fall outside norms of society.
Everybody is unique too, and cannot be looked at through the same lens. As Kumar puts it: “Everything has a solution. It may be an easy solution or a difficult one. But, there always is one.”
*Name changed to protect privacy
Featured image is for representational purposes only.
Note: The author is a part of the Dec ’21 batch of the Writer’s Training Program.