When it comes to mental health, it is hard for most of us to reach out and seek help and I’ve always wondered why. While growing up in Kerala, I have come across many friends who would travel far away from where they live, just to go see a therapist. They would be asked to keep their mental health a secret and not let anyone know that they were consulting a mental health professional. I was also exposed to this same stigma surrounding mental health, negative labels like ‘mental’, ‘crazy’ thrown around, and people kept referring to their distress as a ‘passing phase’. This made me wonder why we acted like this and what I could do.
As I looked for answers, I turned to research for some reliable information. I came across what we now call the barriers to professional help seeking. I realised that despite mental health disorders being so common amongst all of us, there exists a huge gap in the number of people actually using mental health services to help themselves. In fact, studies showed that only 5 in 100 individuals with common mental health disorders, like mood disorders, anxiety and substance use, sought treatment in India. The percentage of people in India that actually reach out for professional help are as low as 12% showed another study, which was alarming to me! Especially because this meant that those of us with more problems, are often less likely to seek help. And I kept wondering why.
So I set out to find; why we wait for so long before we approach a therapist for help or in other cases not approach a therapist at all. During my research, I came across various barriers in our thinking, attitudes, the stereotypes around that prevent you and me from seeking professional help. The most common one was lack of awareness about mental health and how to seek this help. We don’t know when we should actually approach a therapist, it’s not like we get a fever with mental health problems. The next issue was that there was no support for us because people surrounding us don’t feel that it is a problem to be addressed. Or in other cases, there is no one to help us reach out to a professional. Then comes the infamous fear about societal reactions and last, we had doubts about therapists and mental health treatment itself. Some individuals even shared that they prefer to get support from family or friends, or show self-reliance!
When you get a flu, you go to a physician. Why not go to the mental health professional when you experience emotional concerns?
Reading this, I delved deeper and spoke to 2 kinds of people- first group were of people who were distressed and seeking help and the second group were those who were distressed but not taking any professional help. The results showed that fear about societal consequences which roughly translates to “what will people think about me?” was the most common. Then came the doubts about usefulness of therapy and finally self-reliance i.e. “I’m strong enough to do this by myself” seemed to be the most important self- perceived barriers. Situational difficulties, such as issues with affordability, accessibility to services and time constraints, were also shared to be high in these groups. And now my childhood experiences started making more sense.
I imagine such stigma makes it even more difficult for our parents to understand what we might be going through and why we want to try out therapy.
I then wondered what I could do to tackle these concerns, and me and my team turned to technology. Starting from the beginning of this decade, we learnt that many studies have reported that young adults show an increased inclination to use online mediums when they experienced higher levels of distress and so we thought this is where we also need to be if we want to help these young adults. Moreover, this helped in cutting across various situational barriers like affordability, accessibility issues, and low effort on part of the one battling mental health concerns. It is important to point out here, that these interventions are not a substitute for face-to-face session with a mental health professional. But we found this to be a “game-changer” in helping you take the first step to the doorstep of a mental health professional.
Since then, the technology interventions developed have included various components to improve mental health literacy, de-stigmatisation, and have also been instrumental in providing necessary information to promote help seeking. Moreover, they help in symptom identification and provide you with relevant self-help strategies. On exploring further, we found that many such platforms have significantly reduced stigma related to mental illness and also improved mental health literacy. Much of the interventions being developed now target to bring out a change in your attitude so you’re better able to seek help. I believe that we will have to wait and see the effects of these emerging game-changers in help seeking in the coming years.
Till then, all I’d like to say is that we all grew up learning these attitudes towards our mental health but we can now unlearn them, especially if we are looking for support. So if you are someone who is distressed or have a close friend or loved one who is in need, yet are hesitant to seek help from a mental health professional, I urge you to understand these are barriers that might be between you and the right kind of help. These are the stories we grew up hearing that makes us not take care of our mental health.
But I would like to urge you take a small step towards exploring scientific ways to help yourself, explore genuine internet or mobile based applications and consider therapy.
I understand that this might not be a substitute for the help that you receive from trained mental health professionals but the only hope is, it can be very helpful in answering the “what”, “why”, “where” and “how” questions related to mental health that you might be dealing with. Mental health concerns are treatable, so let’s together make a positive difference in your mental health- one step at a time!
Jemimah A. Johnson is a Research Officer in Department of Clinical Psychology, NIMHANS. She's interested in teaching and researching on mental health and is currently working on ways to promote mental health, and how we can use technology and humour to do the same. She tells us she loves using humour to make people smile and is learning ukulele in these lockdown days!