Re-Imagining Mental Health of Youth- Prof. Vikram Patel @ IMPRI #WebPolicyTalk

Simi Mehta, Anshula Mehta

The Mental Health of India’s Youth is a pertinent concern. Whether we have personally experienced the challenges or seen a close loved one carrying the burden of a Mental Health Issue. IMPRI, Impact and Policy Research Institute organized a special lecture with Prof Vikram Patel chaired by Prof Prabha Chandra on Re-Imagining Mental Health of Youth.

Prof Vikram Patel, the Professor, Department of Global Health and Population, Harvard TH Chan School of Public Health, USA; Co-Founder and Member of Managing Committee, Sangath, India, delivered a lecture on the mental health of India’s youth, the burden of mental health disorders and how to address them most efficiently, organized by IMPRI Impact and Policy Research Institute.

In his presentation, Prof Patel began by highlighting that India is the home of the largest youth demographic. Young people are the foundation of not just the economy, but also the society. Their health and wellbeing, thus, is of critical importance not just for them as individuals but also for the country’s national interest. This issue is most seriously manifested in the common occurrence of Youth Suicide. Usually, the victims include students from top universities who seem to have lost hope for their future. 

How to motivate this section of the population to access health services because they are physically healthy? The services need to ensure that they create and cater to the existing demand. There is also a need to co-create this space with the youth of the country. Pandemic has risen the concerns even further, digital divide due to electronic mode used for education, the absence of social gatherings, and the lack of employment.

Suicide: A leading Challenge to Mental Health in India

According to NCRB data of 2014, there are 60,000 youth deaths every year. More recent data of 2018, shows a year-on-year increase in young people suicides. India, by all means, is the epicenter of global suicide.ICMR Data shows that between 1990 and 2016, the total proportion of male suicides shot up from a fifth to a quarter, and for females, it shot up to suicide being the reason for more than a third of female deaths. The global proportion during the same time has not seen a great change and continues to remain constant. 

Suicide is the leading cause of death among young Indians for a decade. Despite this data, no suicide prevention program has been implemented in India, especially for young people. Given that suicide is a global phenomenon, it is important to understand why it is such a prevalent cause of death to come up with a solution. 

One of the prevalent reasons for high suicide rates in India includes growing gaps between aspirations regarding sexuality and occupations and social norms and expectations. Other reasons include adverse childhood experiences, violence, substance use, discrimination, peer influences, and comparisons on social media. 

Understanding the Problem

Recognizing the new field of science on teenagers and their unique mental and emotional conditions, Professor Patel further expanded on the psyche of young people during his presentation. He said that “youth is biologically and evolutionary ‘primed’ to take risks and behave impulsively”. This idea challenging the traditional medical sciences understanding where the mind was thought to stop its changes in early childhood. 

This is risk-taking is an essential advantage of this phase of life because it’s a transition from being dependent on parents to becoming autonomous. Instead of blaming young people for being mischievous, it is important to realize that risk-taking and impulsivity is a positive aspect of a person’s childhood and adolescence.  However, if a child’s environment is not conducive to this, then one can end up with risky behavior.

One of the prevalent reasons for high suicide rates in India includes growing gaps between aspirations regarding sexuality and occupations and social norms and expectations. Other reasons include adverse childhood experiences, violence, substance use, discrimination, peer influences, and comparisons on social media. All risk-taking behavior has common behaviors, patterns, determinants that define the risk. 

The COVID-19 World: Youth Thrown under the Bus?

A fundamental aspect of being a young person is the need for interpersonal experiences which has been a challenge during the pandemic. Ironically, the youth are the least affected by the virus itself and they have had to deal with the burden of the containment policies even though they are least vulnerable to the actual virus. The lack of interpersonal contact will hamper and stunt their growth. In a group that traditionally does not seek help, the lack of interpersonal contact could exacerbate this issue. 

It’s been observed that the younger you are, the worse is your mental health. This is paradoxical because for the longest time it was said elderly people would have worse mental health because of the virus when in reality, it is the opposite. Older people have weathered this pandemic much better than younger people have. 

Key Concerns 

Professor Patel highlighted three important initiatives that could help with improving the youth’s mental health which included the World Bank’s disease control priorities program with a focus on mental health; the Lancet Commission on global mental health and sustainable development and; the Lancet Commission of adolescent health and well being. 

The important message was unified throughout these programs that promoting youth’s mental health is everyone’s business. Mental health is affected not because of biology but the world that we live in. Thus, in the world of home, social, and educational institutions need to promote a healthy environment for children to strive in.

Some challenges that prevent the youth from addressing their mental health issues include narrow binary biomedical framing of mental health, lack of tailoring to the needs of the disadvantaged youth, lack of attention to mental health programs to social determinants, lack of skilled providers, and reluctance to seek help from professionals.

There is a need for a structured response where the ministry realizes that its framing of mental health is narrow, binary, and focussed only on the biomedical component. Its policies are not tailored to the needs of disadvantaged youth. The challenges become difficult to cater to given that this group is resistant to seek help and when they do there is a shortage of educated and trained specialists. 

Re-Imagining Mental Health

Thus, it is imperative to reimagine youth mental health which can be done in many ways. Firstly, there is a need to look beyond narrowly defined and diagnosed mental illness offering a range of interventions with a focus on the “base of the pyramid” through task-sharing of psychosocial interventions. 

Secondly, it is important to balance individual clinical interventions with social and cultural determinants across the life course. Thirdly, it’s important to have digital tools for the workforce, health systems, and affected persons. Lastly, we need to ensure that youth is at the center of all decisions, from what matters to how it needs to be addressed.

The guiding principles of action include providing young people with information, restoring hope that things will get better, enhancing their agency so they’re empowered, and respecting their dignity and rights, and always focus on the science of what works. An interesting organization pointed out was ‘Mann Mela’ is a museum for youth to share mental health stories. It becomes a platform to emulate healthy practices in a particular age group. 

Acknowledgment: Sajili Oberoi is a Research Intern at IMPRI Impact and Policy Research Institute, New Delhi and Marketing and Communications Lead at BrainGain Global, New Delhi

Youtube Video of “The Mental Health of India’s Youth”.

Picture Curtesy: Voices of Youth