Mental Health is Political. It is High Time Therapists Acknowledge This.

We are publishing a series of stories to coincide with World Mental Health Day on Saturday, Oct. 10. It raises awareness about the importance of mental health and advocates against social stigmas. These are challenging and stressful times. According to the World Health Organization, half of all mental illnesses begin by the age of 14 but most cases go undetected and untreated. Let’s make the world a kinder and happier place for all to live in.

I still remember the first time a psychologist very senior to me in age and experience gave me a long lecture about staying neutral as a therapist after I’d asked for his opinion on discussing politics with clients. By staying “neutral”, he advised not to take a stand on issues like bigotry, prejudice, violence, governance, etc. “It doesn’t make sense to take sides,” he concluded.

For him, this was a “teaching moment” granted to a grad student who was studying to become a psychotherapist. For me, it was a spark of confusion that led me to question this neutral stance and eventually advocate against it.

This neutrality persists in the mental health systems in India: a country where systemic oppression, policy failures, socio-economic crisis, and violence projected on several identities (such as those of caste, class, gender, etc.) affect both, individuals and community mental health.

“Mental health cannot be isolated from the social and political constructs we live in,” says Devika Mehta, a practising psychotherapist based in Mumbai. “It threads into factors which go beyond biology. The social injustices that we witness and live with embed themselves in our bodies. Fragmentation, dissociation, trauma are all results of this embeddedness which leaves a long-lasting impact on our ability to live through these experiences and the ways we garner resources against them.”

“Mental health professionals, as practitioners of science, are supposed to have a cold, disinterested ethic, disentangled from socio-economic and political fractions,” says Anjendra Targe, a practising psychiatrist based out of Pune. “That’s how we are told we should practise medicine (and/or psychology): unaffected by the happenings of the world around the patient who comes to us. The irony of this ethic begins with the fact that we belong to the very world from which the people’s problems emerge,  and it doesn’t require much effort if we only listen to what our patients have to say.”

What Targe is emphasising is that all psychological issues can be traced to systemic issues. “It could be an economic strain resulting from an economic downturn, a young person struggling to open up about their sexuality in a heteronormative environment, a woman with depression living in a demographic where the state’s elected representatives make derogatory and misogynistic remarks against women time and again. How then, can the professional just stick to a disinterested approach, when the “symptoms” are at least in part, echoes and fragments of the collective symptoms of whatever that ails the society on the socio-political levels?”

But what does it mean to “take a stand”? As a mental health professional, it is to first acknowledge that the mental health discourse covers each and every identity affected by marginalisation, oppression, policy failures, decisions, judgments, governance. “The effort it takes for us professionals to help someone place their trust in the mental health system should be enough to remind us about the responsibility we have towards their social and political context,” Targe adds.

By taking a stand, psychotherapists can also affirm a political responsibility towards the society—what they do in their clinics, what and how they speak to their clients and their families, the language they use and the care they devise represent not merely an occupational persona but an unconditional mindset into which people coming from different backgrounds can place their trust.

We are surviving in a time of chronic inequality stemming from decisions taken by those in positions of extreme power, and with these decisions come the vicissitudes of our mental pain. In such times, a stand against systemic abuse taken by someone who works for the mental wellbeing of people conveys solidarity, allyship and the message that we understand or at least are willing to understand where all this is coming from.

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