Acknowledging, normalising and addressing mental health amid the information turmoil is the only way forward.
By Nanditha Kalidoss
The last two pandemic years have witnessed a sudden and significant global shift to the online sphere. Sixty-three per cent of the world’s population used the internet in 2021 as per ITU stats with work from home, online classes and an overall increase in access to social media becoming the norm. According to TRAI quarterly services performance indicators report for January to March 2022, India’s internet user base has crossed 82 crore, an increment of 11 crore new internet subscribers compared with 2019.
The unseen negative effects of this shift to cyberspace are two-fold: increased circulation of fake news/misinformation and the impact on mental health. While this is an anticipated outcome of the information explosion, the problem arises when fake news and overconsumption affect mental well-being.
Growing digital penetration and increasing affordability of smartphones is a step toward realising the digital dream but there exists a huge digital literacy divide, which is resulting in the increased proliferation of misinformation. According to Lancet, 1 in 7 Indians was affected by mental disorders of varying severity in 2017. In other words, there already existed an invisible crisis of mental health mired in stigma and taboo even before the pandemic struck. Often in the habit of doom scrolling owing to tailormade content set by algorithms, misinformation finds its way into our feeds and this, in turn, causes paranoia and mental distress. For instance, during the second wave, there was a sharp increase in the Google search for keywords such as anxiety and suicidal.
Given the umbrella term of mental health, it is essential to understand the diversity of the spectrum of mental health. Although in clinical terms, the categories range from mild, moderate and severe under each of the disorders, the onus lies on the state to address some of the common causes, including cyberbullying, body issues, religion and caste-based discrimination, inter-generational and childhood trauma, eating disorders, incarcerations, gender-based violence and financial distress.
Data from the Accidental Deaths and Suicides in India of the National Crime Records Bureau indicates a significant increase in the number of suicidal deaths and the rate of such deaths in recent years. Incidentally, the Mental Healthcare Act, 2017, was adopted during these years. The rise in 2020 and 2021 gives an impression of Covid-induced suicides. It is particularly interesting to note that the trends show men are more likely to commit suicide than women. One of the most pertinent underlying reasons attributed to this strange phenomenon is the lack of willingness of males to seek help and usage of addictive substances.
Bleak Reality
The mental health discourse in India presents a bleak reality. The complexity of the problem is further compounded by a lack of awareness; layered at the intersection of science and traditions fuelled by misinformation and lack of availability, accessibility and affordability of mental healthcare infrastructure. Even traditionally, the media has always portrayed mental illnesses as something enigmatic, ‘abnormal’, often associated with paranormal activities and the cinematic images of electric shocks and asylums.
A recent WHO report states that nearly one billion people suffer from a mental disorder in the world. This crisis is set to translate into socio, economic and emotional costs and have long-term impacts. For instance, as per the World Economic Forum projection of 2021, the cumulative global economic loss associated with mental illness to the world economy between 2011 and 2030 would be $16.3 trillion. To put it in perspective, by 2030, mental health illness could cost the global economy more than cancer or diabetes and in the form of loss of productivity, education, law and order, among others. While the data is suggestive of the apparent and impending waves of mental health issues across the world, India is certainly under-prepared for another battle at this scale.
Given the supply-demand issues, including stigma, skewed doctor-patient ratio and expensive medication, a two-fold strategy is proposed to address the intersection of mental health and misinformation in the current context, improving emotional literacy and media literacy.
It is important to understand the psychological and behavioural aspects of misinformation and its impact on mental health and, therefore, the root cause of the problem must be addressed. The onus lies on the multi-sectoral and multi-stakeholder approach including mental health professionals, healthcare professionals, media and government. Even at the individual level, efforts must be made to educate oneself and their loved ones on the issues.
What can be done
Governments & medical professionals
Like the well-known polio vaccination campaigns, the government must work with medical professionals to undertake massive information, communication and educational material on mental health. The allocation of Rs 713 crore for mental healthcare in the 2020-21 Budget, however insufficient, is a progressive step in acknowledging the crisis. The limited success of the Bellary model or the District Mental Health Program must be taken into consideration where general physicians at PHCs are provided with training and competencies to deal with such challenges. Added to the proposed teleconsultations, essential mental health services and programmes must be provided at State, district and local levels with specific helplines. For long-term success, a feasible and scalable model is a must.
Media
In partnership with expert consultations, the media must focus on identifying and acknowledging mental health issues for all age groups, at-home diagnosis (list of symptoms) and management, when to seek help, among other things. Like Dr Mahinder Watsa’s sex education, print media must have dedicated columns to answer specific concerns of the readers – many publications already cover some of the concerns in the context of the pandemic. Digital and social media platforms must also counter misinformation and promote conversations around mental health by leveraging the platform’s strength, including influencers and reel formats. While several celebrities have been vocal about their mental health experiences, more influential people must come together to champion the cause.
Educational Institutions
The 2022 government survey results on ‘Mental health and well-being of school students’ highlighted the importance of the emotional well-being of students and proposed the need for an overhaul shift in schools’ ethos and practices, including adequately preparing teachers in creating and enabling conditions for students’ emotional well-being. In the context of awareness programmes, it is vital to ‘start early’. Just like how curriculum has dedicated lessons on health, hygiene, nutrition and sanitation, there must be a mental health curriculum as well to create awareness about the importance of emotional and mental well-being. This will also help in de-stigmatising the topic and sensitising children from a young age.
Workplace
Deloitte’s ‘Mental health and well-being in the workplace’ is a significant step in understanding and designing contextual solutions at the workplace. The framework and the suggested solutions include a lifecycle for workplace well-being; providing preventive, proactive and reactive care becomes imperative.
To tackle online misinformation, the way forward is through self-regulation. Given the breadth of the commitments and the heterogeneous range of stakeholders involved, the proposed code of conduct will follow a self-regulatory mechanism similar to that of the Internet & Mobile Association of India, a voluntary code of conduct for fair elections. One of the unseen effects of such large-scale misinformation is the erosion of trust in state’s capacities. However, the antidote to such mistrust is transparency and such a code of conduct to combat the infodemic is a step in that direction.
Like in the case of the European Union, there must be a ‘Code of Practice on Disinformation’ to contain the spread of misinformation, and related to public/mental health issues where scientific facts and sources are available. While labelling misinformation is essential, it is also important to make this more interactive and inform consumers with evidence-based information and credible sources.
Despite the vicarious lives we live in, in the likes of how an invisible virus wreaked havoc across the world, it is important to not repeat the same and be prepared to deal with the impending invisible mental health crisis brewing around the world. Consistent, determined, and tailor-made approach toward acknowledging, normalising and addressing mental health amid the information turmoil is the only way forward.