DIGNITY IN MENTAL HEALTH

(WORLD MENTAL HEALTH DAY 2015)

World mental health day, observed on October 10 th of every year looks to raise
awareness of mental health issues around the world and mobilize efforts in support of
the same. Having initially begun in 1992, this annual program that observes a different
theme every year has become the largest educational program of the World Federation
of Mental Health (WFMH).
With this years theme, the WFMH has chosen to target the fundamentally raw,
unapologetic and uglier aspects of mental health conditions ; dignity, or the lack thereof
Dignity has many definitions, none of them precise, yet we recognize it
immediately when we see it, even more so when it is absent. I believe dignity to be a
form of respect or due regards for the feelings, wishes and rights, which every individual
is entitled to. All too often, people with mental illnesses and their families find that dignity
is absent in their dealings with society at large and health care professionals.
In a diverse country like ours, ridden with superstition and varied beliefs, persons
with mental illness are viewed in different ways. Some traditional rural parts of India,
may believe it to be a curse, a source of bad-luck and negative influence on the
community in which case they are despised, discarded and treated with complete
disregard. In other parts, it is considered a blessing or god-send, in which case it is
considered virtuous to help them.
Having said this, we find that discrimination has dissipated in the more
progressive, perhaps educated parts of the country with people crowding the mental
health centers, talking about anxiety, stress and tension. It is peculiar to note that such
ailments are considered if not normal, acceptable at the least, by society at large as
they are often associated with success or hard work. Severe mental disorders, however,
are still viewed with some apprehension, to the extent that they are often hidden. This
acute lack of dignity must be overcome with education of all layers of the society,
starting at home.
Dignity at health care facilities is like treading on thin ice, especially when mental
health is brought into the picture. The more graphic acts such as physically restraining a
patient seem blatantly horrendous, and a clear violation of their basic human rights. In
certain institutes, there is an obvious breach of rights with the lack of decent clothing,
physical abuse and discrimination. More often than not, acts such as disguising
medicine in food, and uttering white lies to placate the patient, thereby compromising

autonomy, is considered customary. This acute lack of dignity is unseen and

misconstrued as an act of good intentions. This years motto aims to dissipate this very
notion.
According to the World Mental Health Survey, the inter-quartile range (IQR:
25(th)-75(th) percentiles) of lifetime DSM-IV disorder prevalence estimates (combining
anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. This is
presumed to be the tip of a gigantic ice berg. Looking at things closer to home, a similar
picture is present, with many patients remaining undiagnosed and many more not
seeking treatment. This can be attributed to the stigma that is still at large.
Patients are expected to be treated with kindness, respect, decency and
compassion at home is expected. Condescending behavior is the major worry and a
direct violation of dignity in mental health.
Rehabilitation facilities are gaining popularity. They must provide a wholesome
recovery to patients without any compromise of their rights, privileges and autonomy on
the whole.
The key to achieving these goals are clear legislations that protect the humanity
of people with mental disorders, thereby preserving their dignity. Thus, this years theme
brings to the forefront an issue of long-standing neglect, aimed to draw the attention of
policy-makers, health care professionals and the families of patients. In the words of
Rabindranath Tagore, Where the mind is without fear and the head is held high
Into that heaven of freedom, My Father, let my country awake

PREETHI RUBINATH
CRRI