According to the World Health Organisation, India has the highest suicide rate in the South-East Asia region. And while conversations about the importance of mental health awareness have definitely started to open up, it wouldn't be inaccurate to say that we still have a long way to go. After the tragic death of actor Sushant Singh Rajput, who was found hanging in his apartment last month, celebrities, fans and well-wishers took to social media to encourage people to 'reach out' and 'seek help'.
It's easy to tell someone to get professional help for their mental illness--and though it is certainly prudent advice--we are still ill-informed about how inaccessible mental health care in India is. Keeping aside the fact that going to a therapist or a psychiatrist is still largely a 'taboo' in our society, the more alarming aspect is that the majority of our population cannot afford it.
To shed light on this subject, twitter user Karnika Kohli shared exactly what it is like to 'seek help' for mental health issues and the myriad of challenges that come along with it.
I HAVE SPENT Rs 1,61,800 SO FAR TRYING TO TAKE CARE OF MY MENTAL HEALTH.— Karnika (@KarnikaKohli) July 21, 2020
TW: anxiety, depression
Now that I have your attention with all that clickbait and all caps yelling, read this #thread.
TL; DR: WE NEED A BETTER HEALTHCARE SYSTEM!
That's not an extra zero accidentally added to the figure. This is the actual amount of money she has spent on trying to improve her mental health. She points out how she is extremely privileged and financially secure, and yet it is expensive for her.
I am a straight, upper caste, middle class, cishet woman - putting this out there in the beginning just so that you have context.— Karnika (@KarnikaKohli) July 21, 2020
I am privileged enough to be able to afford healthcare but it is still a LOT. (3/n)
You don't buy the first shoe in the store, right? You gotta try many to find one that's the perfect size and fit for you. Well, finding the therapist is something like that. Only a lot less enjoyable.
Ok, let's talk some numbers.— Karnika (@KarnikaKohli) July 21, 2020
I have been in therapy for 1 year and 11 months. I have dealt with anxiety pretty much all my life. (4/n)
I started seeing a therapist in 2018 after spending big part of a solo vacation in tears, not knowing why I was crying or feeling anxious.— Karnika (@KarnikaKohli) July 21, 2020
First major anxiety attack happened at a hostel in Khajuraho. (Beautiful place btw. Do check it out) (5/n)
1. Finding a therapist is not easy— Karnika (@KarnikaKohli) July 21, 2020
2. Not necessary the first (or second or third) one you find will be a good fit for you.
It's not as simple as going to a doctor, taking prescribed medication and feeling better instantly. Therapy can take weeks or months to be effective.
3. You don't see 'results' for like months. Therapy is like a marathon. You have to keep doing the work. In my case, it took almost 9 months before I realised that growth for me was being able to recognise some of my triggers. (7/n)— Karnika (@KarnikaKohli) July 21, 2020
4. Going from one therapist to another is too damn exhausting because you don't get to TL;DR your life there. You have to start from scratch every single time. Thankfully I didn't have to do that and got lucky the first time itself. (8/n)— Karnika (@KarnikaKohli) July 21, 2020
For therapy to be effective, you'll need to go at least once a week. That's four sessions a month. Let's do the math:
Let's talk money now. Most therapists in a city like Delhi charge between 1000 rs to anywhere up to 4000 rs for an hour-long session.— Karnika (@KarnikaKohli) July 21, 2020
When I started, my therapist used to charge 2000 rs/session. 4 sessions in a month for a year = 4 x 12 x 2000 = Rs 96,000
After that I took a break for 8-9 months and when I went back in August 2019, the cost/session was Rs 2200. This time I decided to do two sessions/month. So till now (my most recent session was yesterday), I have spent -- 2 x 12 x 2200 = Rs 52,800— Karnika (@KarnikaKohli) July 21, 2020
Total amount spent in therapy so far = Rs 1,48,800— Karnika (@KarnikaKohli) July 21, 2020
(damn! this is the first time I've calculated this.)
Btw, this doesn't include the cost incurred to travel to the therapist's clinic and back.
I got diagnosed with anxiety about a decade ago. When I started going to therapy, I realised that it came with a side of mild depression and OCD. Mental illnesses are complicated!
My very special friend anxiety usually brings another friend to the party every now and then. That friend is insomnia. I have gone weeks without sleep. Like I can't sleep for more than 2-3 hours/day. At the same time my appetite decided this party wasn't cool enough for it.(13/n)— Karnika (@KarnikaKohli) July 21, 2020
So, now I can't sleep or eat. And I LOVE food. I love to cook and I love to eat. So this was really messed up. Just thinking about food made me nauseaus.— Karnika (@KarnikaKohli) July 21, 2020
It got a lot worse few months ago. There were other things too that I am not getting into right now. (14/n)
I figured I need to do something at least about the sleep. So I went to a general physician. (I am too much of a fattu to try to get pills without a prescription)— Karnika (@KarnikaKohli) July 21, 2020
TBH I just wanted sleeping pills. Something that would let me sleep for at least 5-6 hours/day. (15/n)
For some people, therapy is enough. However, for a lot of cases, medication is also prescribed in addition to therapy to treat the physical symptoms. There's absolutely NO shame in taking medication--you wouldn't think twice before popping paracetamol for your fever, would you? But the unfortunate part is, you're paying for two treatments now.
The GP was concerned and asked me to go to a psychiatrist.— Karnika (@KarnikaKohli) July 21, 2020
Now finding one during the lockdown was super fun. But a few friends told me about someone who is known to be pretty much the best. (and they were right.) (16/n)
Now, let's talk money again. I booked an online consultation. Cost/consultation: Rs 3500.— Karnika (@KarnikaKohli) July 21, 2020
He asked me to get tests done. Cost of that: Rs 6500.
And then a follow up after two weeks: Rs 3000.
Another followup scheduled after three weeks. (17/n)
So far, I have spent Rs 13000 on this (apart from therapy). Thankfully the meds are cheap.Don't get me wrong. It is really helping (A LOT) and the psychiatrist is really fucking good. Again completely worth it. can't stress enuf on how grateful I am that I can afford it. (18/n)— Karnika (@KarnikaKohli) July 21, 2020
And of course there are cheaper options available out there but I wanted to go to someone who came with good recommendations because this shit is scary. like so scary. not gonna get into the stigma attached to pills.— Karnika (@KarnikaKohli) July 21, 2020
So in total I have spent Rs 1,61,800 so far on mental health.
Talking about mental health is easy. Seeking treatment will make you feel better, but it will also mentally and financially exhaust you. How is this fair?
OK so the point of this thread is not to get sympathy or make you feel bad for me. I am just fine and I am taking care of myself.— Karnika (@KarnikaKohli) July 21, 2020
The point is to highlight how badly we need a good healthcare system that supports people who deal with mental health-related issues.
Most insurance policies don't cover visits to a therapist. If you can find one that does, please share link. I am serious. I am looking for one.— Karnika (@KarnikaKohli) July 21, 2020
I can't stress enough on the fact that I can only afford to take care of mental health because of my immense privilege.— Karnika (@KarnikaKohli) July 21, 2020
I am a straight, upper caste, middle class, cishet woman. Just in case you couldn't see the amount of privilege I am sitting with. (23/n)
For anyone who doesn't fit in these brackets, just finding a therapist who won't be an asshole alone is a big task. I am not gonna speak for anyone. But if you tag me, I will RT and try to amplify your stories.— Karnika (@KarnikaKohli) July 21, 2020
It's hard enough to struggle with a mental illness. Why should it be equally hard to seek treatment for it?
WE NEED A BETTER HEALTHCARE SYSTEM (like now).— Karnika (@KarnikaKohli) July 21, 2020
Please share and tag your elected officials.
So the next time you notice someone struggling, think twice before putting up the token 'please seek help' story on your Instagram. You need to do more. Reach out to the person, and ask them what they need. Ask them how you can help--be it financially or to find a mental health professional they can afford. And raise the topic of inaccessible mental health with your local government.
And then maybe someday, somehow, every human being in India will be able to afford mental health care when they need it.
Featured Image: Pexels