When COVID-19 impacted the world, it seemed very obvious that certain sections of population became more vulnerable and needed immediate, efficient mental health care than before due to the additional number of stressors and yet, they were hardly receiving any. This was even more confusing considering the number of mental health apps that had exponentially propped up, seemingly offering more accessibility and yet there were very less availing it. What seems to be the reason for this disparity?
The Mental Healthcare Act passed in 2017 allowed for agency and dignity of people living with mental health disorders and yet could not solve any institutional or financial obstacles that an individual may face, especially considering the layers of social, psychological and economic discriminations present in India. The law was able to provide psychiatric medicines at a subsidized rate but considering the long hours of transport and waiting required to get it, not to mention consultation charges, it seemed that the law was no further at solving the disparity than before.
In schools and colleges that seek to provide psychology as a subject or at least offer interpersonal counselling, there still seems to be a reluctance to visit the counsellor, to seek personal therapy. “Therapy would force me to look at the places where I had gone wrong, where I had made mistakes so I simply chose not to go despite having the option of going.” says James*, underlying the notion that therapy seems to be an issue in accountability taking and not just accessibility. Other students mention that either they did not think they wanted therapy, or that the therapist they wanted charged way too much. No individual mentions looking for alternative options, pro bono counselling or simply to ask their preferred therapist if they worked at a sliding scale. A small majority of students explain having used psychological techniques on themselves and having found in ineffective, moved on to suppressing the issue to which I would like to call the analogy of a child learning to ride a bicycle for the first time to mind- it is possible, yes to try to ride the bicycle by yourself but in order to prevent falls it is better to have a person standing in the background holding and instructing until you are ready to do it by yourself.
A friend of mine, Natasha*, explains that she uses meditative apps or mental health apps available on Google Play store. A closer look into these apps make me understand that while these apps are doing a good job, it simply isn’t enough. A huge reason for this would be lack of accessibility- apps provide guided meditations or bots to chat with which people with hearing and reading difficulties find hard. The alternative to this would be closed captions/subtitles which the apps do not have. Apps also have excessive widgets, repetitive language and small font size floating around which may distract people who are neurodivergent.
Although apps seem to work fine with root causes or one-dimensional problems, their lack of inclusivity or inability to hold a space for intersectionality seem to narrow their clientele. Apps could also be programmed with DSM-5 or ICD-10 or the latest versions to quickly assess the symptom and severity level of the client chatting with the bot. It would be convenient for apps to be user friendly, to ask for preferred pronouns for each user as well as determine their socioeconomic status and ability to pay for a therapist but such days seem far away.
For Niroop* whose mother was diagnosed with schizophrenia, neighbors asked him to do a ritual to appease the evil spirit that her taken hold of her body. He says “And I remember thinking, what will everyone think of us now ?” Part of our understanding of mental health, no matter our progress is still rooted in our inability to view mental illness as a biological cause instead of a personal cause (“I did something wrong and that is why I have anxiety”) or a social cause (attributing mental illnesses to evil spirits cured by shamans or medicine man).
It seems to still exist that although there is an increasing awareness about mental health, however the awareness ends at just that without a drive forward to taking action. It seems impossible for apps to address the various social and other inequalities faced by an individual but it seems as though it is the first step forward.
*In this article marks names which have been changed to protect the confidentiality of the people I have talked to for this article.
REFERENCES
Bunyi, J., Ringland, K., & Schueller, S. (2021). Accessibility and Digital Mental Health : Considerations for More Accessible and Equitable Mental Health Apps. Frontal Digit Health. doi: https://doi.org/10.3389/fdgth.2021.742196
Varma, A., & Fernandes, T. (2022). Public Mental Health in India Is an Issue of Rights and Accessibility. The Wire. Retrieved 17 January 2022, from https://science.thewire.in/health/public-mental-health-rights-accessibility/.
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