Mental Health Is Health: The Stigma India Still Has To Confront

India’s conversation around mental health has changed considerably over the past decade, but talking openly about depression, anxiety and other mental health conditions can still be difficult. People may seek help more readily than before, yet stigma remains, particularly around how mental illness is discussed at home, at work and in public.

Dr Nahid Suraiya Islam of the Department of Neuropsychiatry at GNRC says awareness has improved, particularly among younger people, but greater social acceptance is still needed.

“If we compare the present situation with 10 or 15 years ago, mental health awareness has definitely improved,” she says.

She believes the younger generation is more conscious of mental health than previous generations. At the same time, she says mental health problems such as depression and anxiety are increasingly being seen among young people.

Government initiatives, including teleconsultation and Tele-MANAS, have also expanded access to mental health support, according to Dr Islam.

But greater awareness has not eliminated stigma.

The Stigma Has Not Disappeared

Mental illness is still sometimes treated differently from physical illness.

“When people are told that they need to see a psychiatrist or that they have a mental health problem, they can become uncomfortable,” Dr Islam says.

She also points to the way mental illness is sometimes represented in popular culture.

“Mental illness is sometimes trivialised in films, videos and programmes. People make fun of it or undermine its seriousness,” she says.

Such portrayals can contribute to the idea that mental illness is something to laugh about or hide rather than something that requires appropriate care.

Dr Islam argues that mental health should not be separated from general health.

“Mental health is as important as physical health. If a person’s mental health is not good, we cannot say that their overall health is complete,” she says.

She says conditions including depression, anxiety, substance abuse, schizophrenia and bipolar affective disorder should be discussed with greater openness rather than in secrecy or embarrassment.

That does not mean abandoning privacy. Rather, it means recognising mental health conditions as health issues while respecting the confidentiality of individual patients.

The Workplace Problem

The difference between physical and mental illness can become particularly visible in workplaces.

If an employee suffers a heart attack or stroke, taking medical leave is generally understood as necessary. Dr Islam says similar understanding should apply when someone is experiencing a serious mental health condition.

“If a person has depression, or they had bipolar disorder, or some manic relapse has occurred, that should be equally acceptable, whether it is leave or some kind of concession or duty leave,” she says.

She says employees dealing with severe depression, anxiety, schizophrenia relapse, or bipolar disorder can sometimes struggle to obtain the same understanding that people with physical illnesses receive.

“When there is depression or such anxiety, very severe anxiety, or if there was schizophrenia, relapse has happened, or bipolar, during that time it is as if they have to struggle for leave,” she says.

For Dr Islam, this is part of a broader question of workplace culture.

“There is still a lot of room for improvement in workplace mental health in India,” she says.

Confidentiality Cannot Be Ignored

Greater public discussion about mental health also raises questions about how doctors and mental health professionals discuss their patients.

Dr Islam is clear that patient confidentiality remains important.

“We as doctors always maintain confidentiality. If a patient has some problem, obviously we don’t make it public because that is basic ethics,” she says.

That principle, she adds, is not restricted to psychiatry. Patient confidentiality applies across medical specialities.

However, there is a distinction between public education and discussing an identifiable patient’s experience.

Medical professionals may discuss conditions in academic settings, such as conferences and continuing medical education programmes, while maintaining confidentiality.

Dr Islam says she does not support discussing individual patients on social media, even when their identities are supposedly hidden.

“On social media, I personally do not support discussing individual patients. I do not do it, and I do not see a great need for it unless it is within a closed academic group,” she says.

Public Education Is Different From Sharing Patient Stories

Dr Islam does not oppose general mental health education on social media.

Explaining what depression, anxiety, OCD, ADHD, autism, schizophrenia or bipolar disorder may look like can help people understand mental health conditions.

The concern arises when an actual patient’s circumstances become the subject of public discussion.

A patient may recognise their own story even if their name is removed. So may a relative or friend.

“The patient may see it. Their relative or friend may see it. They may recognise the circumstances,” Dr Islam says.

That possibility, she believes, creates an ethical concern around confidentiality.

The distinction is therefore straightforward: educating the public about a condition is different from turning an individual patient’s experience into public content.

The Conversation Needs Both Openness And Responsibility

India has moved forward in its understanding of mental health, but awareness alone cannot remove stigma.

People need to be able to seek help without feeling they have failed or should hide their condition. Workplaces need to recognise that serious mental health problems can affect an employee’s ability to function just as physical illness can. Professionals also need to balance public education with their ethical responsibility to patients.

For Dr Islam, better mental health awareness ultimately means treating mental health as part of health itself.

The conversation, she suggests, should become more open — but never at the cost of a patient’s dignity or confidentiality.

ALSO READ | Dementia Is Not Just About Memory: How Families Can Help