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How inequity triggers mental health issues?

Humane warriors do not just aim to take actions towards social equity (e.g. with our hunger-relief, education, and livelihood post-COVID relief campaigns), but also aim to be a platform to express opinions on systemic issues associated to social inequity. One of them is a lack of access to personal healthcare facilities, including mental health.

One of our warriors, Rhythima Shinde, expresses her experience while working with one of the hunger-relief NGOs, supporting marginalized communities towards better mental health.

Image from Unsplash

Yesterday, while on a call, something which hit me personally, and at the same time, made me realize how systemic this ‘personal’ feeling was. The call was with Ayushi, a member of One-step many smile (OSMS) foundation. Their foundation is doing something amazing - they are helping the complete community to cope with stress during these uncertain COVID-19 lockdown times. They do this through multiple methods including narrative therapy and creating women self-help groups (Mahila Mandal), but I will get into details of them soon.

I talked with Ayushi and got to know about the work of OSMS while working on our hunger-relief and post-COVID relief project (Humane Warriors). We worked together in the region of Ghaziabad for helping around 200 families with monthly ration kit supplies, as they were not able to afford basic supply due to the COVID-lockdown and lost daily wage. She mentioned how they were also including mobile recharge as one of the components of their ‘ration kit’ (additional to food). What OSMS was providing was a basic recharge, which means access to simple phone calls. Now take a pause and imagine how this would look like – a lockdown time, with bare minimum food supply, constant worries, no way to get out of home – and above all this, no way to have a single way to cope with the stress (which we so easily do by calling and cursing that one friend). No hope. No doubt this would accumulate towards a worsened mental health.

Glimpses of our hunger-relief work with OSMS foundation

And then I could see something very clearly - I was too privileged to even realize what this meant. Personally, I knew of many of my friends and family (including myself), who were dealing with a lot of mental stress due to the lockdown and uncertain times, but at least all of us had the privilege of distraction -> we could take zoom calls (unlimited time), and use the unlimited streaming options of movies to series (Netflix, just for starters).

To many of the readers, this would sound as a very ‘first-world’ perspective to a developmental issue. But this is where we need to change our perspective and understand that good mental health is equally important for all. Give a read of these news articles - Suicide of a teenage girl due to lack of access to the internet and online classes, Suicide of migrant labor due to loss of job, no way to reach back to the family during the pandemic. These news articles just represent a tip of the iceberg - as most of this news is never reported, or never brought to limelight when compared to a demise of a Bollywood actor (with potentially the same reason).

Overall, this call made one thing very clear to me – when we are looking at inequity and its various symptoms – something, which we have ignored heavily, is the mental health issues awareness and a divided approach to deal with it, across the society. This in no way means that someone’s stress in society is lesser than another – it just means that someone who is battling even the basic necessities might be having a much harder time to cope with their personal mental (and obviously, physical) health issues. This is already noted by the World Health Organization (WHO). They have identified stress determinants of an entire community, which could be completely different based on their socio-economic condition e.g. with conditions like employment status, social exclusion, gender equity, etc. For example, the marginality and social exclusion of a community (from lack of resources like food to lack of community-ties) can make the members of the community more susceptible to certain diseases.

So what is the solution to this? How do we tackle this problem which lies in the foundation of our societies – especially, for a country like India, where inequity lies in every sphere – from social (gender, caste, etc.) to economic (income, regions, etc.) spaces? Something, which OSMS is doing, is taking some simple steps of measures with a community-as-whole approach for community mental health development. What they envision is to develop strength of entire community, e.g. (1) by supporting with their basic resources (e.g. what we did together with the hunger relief project) to relieve the stress, but also (2) by questioning which are the further stress determinants of the entire community -which need to be taken care of. One example which Ayushi gave me was how they do frequent check-in calls with the community members, just asking them questions like ‘how are they doing’ (isn’t it simple? Like the way you do with your friend who is in distress). These are not meant to be any form of diagnosis calls – but just a show-of-support towards the community.

Image from Unsplash

The larger goals of OSMS include developing a sense of strength and solidarity towards each other within the community so that there would be a sense of equity and belongingness amongst themselves. They have already started seeing the effects of these measures – where they have examples of community members trying to support those in maximum needs, over their own personal needs. The introduction of narrative therapy has helped community members to start looking at their set of personal skills over their problems and potentially develop better/ new identities to deal with their stress. The same targets have been achieved by Mahila Mandal or women self-help groups where women share their issues and also resources, within the community. OSMS envisions building a larger framework out of this and developing community leaders via training of the members.

The work of OSMS definitely sounds like hope for communities that we easily tend to forget. However, these are just the first steps towards tackling one of the symptoms of our systemic economic inequity. Unfortunately, those who face these issues, have either no access, no means, and in worst cases, no personal will (or just plain feeling of embarrassment, due to their situations) to share their stress. So let’s take more steps towards sharing within community, without judgments of where they come from or of their current situations – to move towards an empathetic and humane society.

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