Why many Indians don’t trust mental health advice

A Mumbai student has sought therapy after coming out as a lesbian to her family. “It was a terrible time in my life. My father had disowned me and I was always guilty. I felt I was letting my family down,” Alina told DW, using a pseudonym. The 25-year-old said her search for help has left her crippled, uncertain and with low self-esteem. “My therapist at the time told me that my father only wants what’s good for me, and that I should apologize to him. This made me feel like I should be ashamed of my sexuality.” After a couple of sessions, Alina stopped seeing the therapist.

“I have now fortunately found a supportive queer community and a better therapist,” Alina added. “Many counselors and therapists advertise that they are queer-friendly, but they really aren’t. This is quite dangerous to the mental health of so many people, especially those who come from traditional or restrictive families.”

Same-sex marriage debate in India

As India’s highest court debates same-sex marriage, the Indian Psychiatric Society has extended its support to the cause of equal rights. In 2018, the umbrella body released a statement saying that homosexuality was a variant of normal sexuality and not a disease, adding that members of the LGBTQIA+ community should be treated equally. (Read also | Easy but crucial actions you need to take to build a mentally healthy workplace)

However, some practitioners still hold outdated views when it comes to sexuality.

“Psychic disciplines have historically been based on social norms, and treatments have been used as a way to correct or punish,” says Raj Mariwala, director of the Mariwala Health Initiative. “Women used to be diagnosed with hysteria. There are traces of it even now. The average appears to be cis heterosexual and able-bodied. Discipline has looked no further than making practitioners structurally competent, and there are huge gaps in the care provided,” she said to D.W.

Raise awareness of mental health

According to World Health Organization estimates, 56 million Indians suffer from depression and about 38 million suffer from anxiety disorders. Mental health awareness is on the rise, especially in urban India. A study by UnivDatos Market Insights shows that the mental health industry is expected to grow at an annual rate of 15% for the years 2022-2028.

Sriram, 30, shared her reasons for not having children with her psychiatrist.

“After a few sessions, when the subject came up again, she said I didn’t want children because I was selfish. I didn’t understand how it had affected me at the time. It was only when I went to another therapist that I was able to understand what a terrible experience I had,” she told DW.

“She also dismissed my porn addiction as usual. I wouldn’t recommend her to anyone. She often shared other patients’ stories with me, which meant she shared my stories with others as well,” she said.

“Being single and, or, childless, are choices that therapists should respect, just like any other choice the client makes,” Harini Prasad, a consultant psychologist at Chinmaya Mission Hospital, told DW. “But if he’s a consultant who hasn’t identified his own biases and isn’t taking oversight, judgments can creep into the work.”

“Harmful” advice.

Ritika, a media professional, decided to get tested for attention deficit hyperactivity disorder (ADHD) as an adult. After passing a series of costly and time-consuming behavioral assessment tests assigned to her by a mental health clinic, she got results that did not mention the disorder. She was told that she suffered from generalized anxiety and mild depression, for which she was already in medication and medication.

“I’ve struggled with neurodivergence my entire life and ultimately sought out evaluation when every aspect of my life was being impacted,” Ritika said. “But the psychologist I consulted had no working knowledge of the condition. Also, these tests attempted to analyze me in ways that seemed abusive and hurtful. She said I have difficulty with communication and therefore have difficulty forming lasting relationships. I work in the field I have a strong support system and have been with my partner for a decade. So I don’t know where the rating came from. They could have gotten more just by talking to me. It was not only unnecessary but hurtful too.”

When Ritika questioned that ADHD wasn’t mentioned, she was informed that she “wasn’t qualified” for it. “The whole process has left me furious and invalidated,” she said.

She later sought advice from a professional who had been recommended to her and who had had a much better experience.

“Now I only look for professionals who are personally recommended by someone I trust,” she added.

The Indian Mental Health Care Act, 2017 provides individuals with the right to file complaints for deficiencies in the provision of services.

The Mariwala Health Initiative (MHI) conducts a queer affirmative counseling practice course, through which it has already trained around 500 mental health professionals in India. It lists the names of practitioners who have completed the course on its website. “Being queer, caste-friendly, disability-friendly cannot be confined to one course. Professionals in the field should practice covenant and update regularly and consistently,” she says.

When it comes to “bad therapy,” professionals say people shouldn’t be deterred from seeking help.

“Clients need to trust how they feel around the therapist, counselor, psychiatrist. The same person may not be a good fit for everyone who needs support. Ask for credentials, ask what approaches the counselor uses and what their policy is consent. Most importantly, you the customer should feel respected, your choices are respected, and communication is respectful,” Prasad said.

[If you are suffering from serious emotional strain or suicidal thoughts, do not hesitate to seek professional help. You can find information on where to find such help, no matter where you live in the world, at this website: https://www.befrienders.org/.]