However, while we try to bridge the distance, we should ensure we do it right—with long-term, systemic and structural change rather than short-term interventions.
The pandemic brought us a silver lining with the mainstreaming of the mental-health conversation. There has been an increase in funding for the cause from private philanthropists and foundations, many of whom traditionally supported education, healthcare and poverty alleviation.
However, my experience at Mariwala Health Initiative (MHI) tells me that we have barely scratched the surface. Mental health is an urgent, widespread and systemic challenge.
Piecemeal and inequitable interventions are grossly insufficient to address it. To make a meaningful dent, we need to revisit and fine-tune our approach and priorities.
For one, most funding is currently directed to mental healthcare institutions in urban areas. This care does not reach remote and marginalized communities such as indigenous or rural groups, Dalit communities, women, the LGBTQIA+ community, and people with disabilities.
These groups face unique stressors, higher rates of mental health distress and greater barriers to accessing care. What exacerbates the issue is our current approach of seeing mental healthcare as a top-down service, focusing on diagnosis, and institutional as well as clinical solutions.
While we do need to address the gap between the demand and supply of mental health professionals, we tend to overlook the role that peer support networks and community-driven interventions can play.
MHI has partnered with almost 70 non-profit organizations that work on mental health at the grassroots with marginalized communities. Their programmes are designed within the local, cultural and social context.
Philanthropists can spend efficiently by funding development and capacity-building for such peer and community programmes, which are tailored to the unique needs of the community. India has found proven success in training community members to respond to common mental distress in villages.
Another way to make mental healthcare more accessible to underserved communities is to invest in its integration with primary healthcare systems.
As part of an ongoing collaboration with the Chhattisgarh State Health Resource Centre, MHI designed a curriculum on mental health and suicide prevention and shared it with 120 master trainers across Chhattisgarh.
The trainers pass on these skills and tools to front-line healthcare workers. Similar work is being done in Kerala with the Kerala State Health Resource Centre for mental healthcare and suicide prevention with the LGBTQIA+ community. This approach can ensure that mental healthcare is seen as part of general healthcare and stigmatization is reduced.
However, while building capacity, it is crucial to also build it right. Mental healthcare should be framed as a human right, focusing on accessibility and non-discrimination. Practitioners and social workers should be trained to incorporate a psycho-social and intersectional lens.
They should be equipped to acknowledge that a person’s identity–gender, race, caste, religion, sexuality, disability, class and age—results in unique experiences and hence mental health outcomes.
For example, MHI’s Queer Affirmative Counselling Practice (QACP) is designed to help mental health practitioners incorporate a queer-affirmative lens to their counselling, thereby ensuring that their practice becomes a safe space for people who have lived experiences that vary from the ‘norm.’
Community or peer interventions based on identity or geography are often small-scale grassroot efforts. Scaling a single such model is not effective because mental healthcare cannot afford a one-size-fits-all approach.
Secondly, mental health interventions often lack the immediate and measurable outcomes that philanthropists have come to expect from education or healthcare. We must be open to investing in approaches beyond impact numbers.
Creating comprehensive and integrated programmes that address personalized and localized needs calls for large-scale collaboration. Philanthropists need to work not just with one another, but also with governments, corporations, non-profits, academic institutions and community leaders.
It is crucial to pool our resources and expertise and create knowledge-sharing platforms that help different stakeholders—practitioners, researchers, policymakers and philanthropists—share their insights, learnings and best practices.
We need to pull together to push for policy and cultural shifts that embrace a rights-based approach and an inclusive framework that encourages multiple voices, perspectives and narratives. Simply spreading awareness about mental health is not going to cut it. We need to change its narrative.
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