2022: When mental health invited action, but work needed on shedding shame

Insurance regulator intervened, India Inc stepped up but the road to awareness and acceptance remains long

Priya Hiranandani–Vandrevala, co-founder of Vandrevala Foundation, feels shame was why many in India wouldn't call her foundation's free teletherapy helpline. So she set up a WhatsApp helpline last year, and 2022 has seen 50 per cent of all consultations shifting to the messaging app.

Sports icon Virat Kohli understands that "we don't want to be looked at as mentally weak". 

"Trust me, faking to be strong is far worse than admitting to be weak," Kohli told broadcaster Star Sports in August after taking a break from cricket.

That was the year for mental health in a nutshell. The conversations around it rose, firms ramped up initiatives to help employees do self-care, and many people started therapy — as evidenced by some counsellors who said their slots were full for the year.

But the lived reality of many is still shrouded in shame, as Indians exhibit the highest prevalence of mental health illnesses globally, according to the World Health Organisation.

"We find women (18-35 years) have the fear of not getting a partner or losing status in social circles. This is less true of men. They are more worried that being labelled as a person with mental illness may affect them in their job," says Hiranandani-Vandrevala, whose Mumbai-headquartered foundation engages with about 15,000 calls a month across 11 Indian languages.

A lack of awareness also perpetuates misgivings about seeking help.

"People don’t know what therapy is. They assume it is either useless or will work like magic or that it is for weak people. If they knew what it is, there would be less scope for such misinformation," says Divija Bhasin, founder and psychologist at The Friendly Couch, a New Delhi-based mental health organisation.

There's also the social environment.

“Almost 20-30 per cent of our workforce is in tier 2 or 3 towns. Sitting in Mumbai we can talk for hours about mental health. But imagine if I have to orient a manager based out of Satara (Maharashtra) about mental health,” says Sudakshina Bhattacharya, chief human resource officer, HDFC ERGO. “First, I will have to explain to him what psychological safety means. A challenging opportunity for us is to spread awareness about mental health among our workforce that’s in Bharat.”

Also, as the bulk of material on mental health is in English, it prevents many from accessing it.

Creating space in vernacular languages for mental health is critical, say experts.

Actor and mental health advocate Deepika Padukone’s LiveLoveLaugh (LLL) foundation is working towards this. In August, LLL launched its rural mental health programme in Tamil Nadu's Thiruvallur district, after Karnataka and Odisha. “We use street plays and wall writings at primary healthcare centres to build awareness,” says Anisha Padukone, chief executive officer, LLL. “Often, once families get a better understanding of the topic and see a gradual improvement in the condition of the person, the stigma towards mental illness and accepting treatment reduces.”

For those who fight the stigma and decide to seek help, the price of therapy can act as a barrier. One therapy session costs anywhere from Rs 800 to over Rs 4,000 for a 50-minute session, and most people see their therapist once a week.

What can help is wider insurance coverage. This year, the Insurance Regulatory and Development Authority of India mandated that starting November 1 every health policy must cover mental health. 

It is a much-needed intervention. Some issues, however, remain. To claim health insurance, one needs to be admitted to hospital for at least 24 hours, which excludes the vast majority that seeks mental health interventions but doesn't need to be admitted. So, experts suggest checking the policy document for details and call for including visits to psychiatrists and therapists in the policy.

Sanjay Datta, chief-underwriting, reinsurance and claims, ICICI Lombard, says while people have availed of the services, there's still a long way to go in utilisation.

"The lack of credible data, non-disclosure about mental health ailments, and lack of awareness are some of the challenges that we face," he says.

Some firms, meanwhile, are doing their bit. At HUL, mental health expenses are covered for managers under the OPD (outpatient department) coverage via insurance. For other staff and for other health expenses, including mental health, that are not covered by insurance are paid for through the HUL self-fund.

At L’Oréal India, the insurance covers OPD consultations, therapy sessions, and hospitalisation arising out of mental health issues under the group mediclaim policy, says Roshni Wadhwa, director-human resources. 

The older generation

A New Year goal for many mental health advocacy groups is getting the older generation comfortable with discussing the maladies of the mind.

Currently, it’s largely young people who are receptive to the idea of talking about mental health, says Aanya Wig, a TEDx speaker and co-founder of Her Haq, a youth-led organisation working for women empowerment.

"Virat Kohli spoke about mental health, but there was also Kapil Dev who said there’s no such thing,” she says, adding, “Now, Dev is followed by people who are much older" and they continue to believe in the kind of ideas espoused by their icon. 

It often boils down to shame -- but it doesn't have to. 

“We must put in all our energy to drop the shame,” says Bhattacharya from HDFC ERGO, adding, “Mental health can be positive. It doesn't have to be about being treated. It can simply be that I want to figure out my life better.”

Mind Matters

• IRDAI mandated that every health policy must cover mental health

• HUL: Mental health expenses for managers covered under OPD via insurance. For others, paid for through HUL self-fund

• L’Oréal India: Insurance covers OPD consultations, therapy sessions, hospitalisation under group mediclaim policy