For South Asians, stigma and systemic barriers stand in the way of mental healthcare

For South Asians, stigma and systemic barriers stand in the way of mental healthcare

Actor Sushant Singh Rajput’s death has once again shed light on mental health among South Asians.

Actor Sushant Singh Rajput, whose death has sparked renewed conversations around mental health inside and outside Bollywood. (Screenshot: Film Companion)
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Sushant Singh Rajput’s fans were shocked to learn in June that the 34-year-old had died by suicide. Rajput, who delighted movie goers with his performances in movies like “MS Dhoni: The Untold Story” and “Chhichhore,” was reportedly diagnosed with clinical depression six months prior to taking his own life.

News of his death has sparked renewed conversations around mental health among the rest of the country’s film fraternity. “As a person who has had a lived experience with mental illness, I cannot stress enough about the importance of reaching out,” actress Deepika Padukone wrote on Instagram.

Rajput’s celebrity aside, his struggle with mental health is hardly unique for Indian and South Asian communities.

“One of the major barriers we have as a community is a sense of denial; we believe we don’t have problems like this and that this only affects Americans,” said New Jersey-based psychiatrist Dr. Vasudev Makhija, founder and president of the South Asian Mental Health Initiative and Network (SAMHIN). “But nothing can be further from the truth.”

Over 450 million people around the globe suffer from some mental health illness or the other, according to the World Health Organization (WHO), an estimated one-fifth of whom live in South Asia, home to a quarter of the globe’s population, where the subject of mental health is often surrounded by stigma and discussing mental health may be seen as taboo. This is true, too, among South Asians living in North America, whom studies have found less likely to seek help from mental health professionals.

“There’s a lack of a safe space for women, men, binary, non-binary individuals to come out and talk about mental health. It’s seen as a very bold move when someone talks about mental health,” said Ronisha Bhattacharya, a 31-year-old, from Gurgaon, who suffers from multiple mental health issues. “The ecosystem in itself is so cruel and uninviting and not discussion-friendly, so you move on.”

Bhattacharya, who was diagnosed with PTSD, high functioning depression and chronic anxiety, had gone most of her adult life without a diagnosis before seeking professional help at 28.

“For a 9 to 5 person to manage a mental health issue without a therapist is crazy. I don’t know how I managed all those years, but I can never go back to that life,” said Bhattacharya.

“The main two reasons that stopped me from getting help much earlier, one was access and the second thing was my peer system where not everyone had a mental health issue. Ten years back or even five years back, people in India were not ready for this conversation,” she added, referring to the “walk it off” approach sometimes taken by Indian and South Asian communities.

But Makhija says changing attitudes toward mental healthcare is just one part of the problem.

“In the U.S. especially, immigrants tend to have a greater difficulty in navigating the mental health system and this can be a major challenge for families. They need to be made aware of the local resources and ways to navigate the mental health system,” Makhija said.

For many immigrants, finding culturally competent doctors who speak languages besides English presents the biggest barrier. SAMHIN has worked to combat this problem by creating an online directory that specifically lists South Asian providers who speak different languages.

Additionally, lack of access to affordable treatment also often deters those in low- and middle-income brackets.

“A good therapist comes at a price and the deeper your trauma, the more sessions you need. So cost was a huge deterrent for me initially,” Bhattacharya said.

A session with a psychologist may cost anywhere between $75 to over $100 in the U.S. As the number of sessions increases, these costs can quickly add up. On average, people in the U.S. spent $71 billion to treat depressive disorders alone in 2016, according to the American Psychological Association.

Despite the prohibitive costs and stigma associated with mental illnesses, the silver lining may be that attitudes are slowly shifting as awareness increases. At outreach fairs, SAMHIN used to find it difficult to attract people’s attention and have them approach a SAMHIN table. Many feared being seen talking to a mental health awareness team, said Makhija. Now, he’s witnessing a slight shift in that attitude.

“Now things seem to be changing. People are a bit less reluctant to come to our table to learn about mental illness and have a dialogue. But we still have a long way to go.” he added.

by Lakshmi Sivadas

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