What Corporate Policy?: Mental Healthcare in India

Fact #1: According to estimates made by World Health Organisation, mental health is going to cost the Indian economy losses to the amount of 1 trillion dollars between 2012 and 2030.

In 2019, I launched my own legal consultancy business. I organised my working hours, set aside some capital, set up my socials, put up a neat business page online and learnt how to operate the new printer. I networked with Non-Profits, advocates, activists, journalists, writers and welfare organisations. I listened to women, talked to women and worked with women. I created a directory and established a client-base. Just to make it clear, this was not my life plan. No woman in her 20s wants to be self-employed and work from home.

Fact #2: According to a report by the Wall Street Journal, Indian millennials spend 52 hours per week at work; much higher than their global competition.

After three years of stalking, sexual harassment, institutional betrayal, intimidation and threats, I found myself at breaking point. I had graduated with a degree in law and a diploma in counselling but in the months that followed, I was busy filing a complaint with the police, gathering evidence, lining up witnesses and giving my statement to the Court. I was diagnosed with Depression and Anxiety; I was under treatment for IBS; I was entirely dependant on antacids and anti-anxiety pills. To be honest, I was completely incapacitated by the age of 25. What was really hard was that I’d lost four precious years of my life and I was not in a state to do anything anymore. How would I get a job?

I chose to share my story on social media where it quickly caught on and became an inspiring tale of suicide prevention. Yes, I’d become suicidal; but I’d also fought against the tidal wave and when it receded, I was standing alone at the shore, trying to stand on my own two feet.

I knew that if I accepted the offers I was getting from Non-Profits and law firms, it would quickly become clear that I was mentally and physically ill. They’d say I should take leave and come back when I was feeling better. Then I’d be laid off, because I was, after all, unemployable. It wouldn’t matter that I was the first Indian woman to publish online workshops on gender-based violence or to come up with a safety plan for domestic violence victims or to start a WhatsApp helpline for women having mental health crises- I’d walk out, my self-worth in tatters, confirming something I already knew: I was worthless.

Swetha Dandapani, a writer at Huffpost India conducted a series of interviews with women suffering from a range of psychological conditions: depression, anxiety, panic attacks, schizophrenia and personality disorders. All of the women were grappling with the reality of their mental illnesses but they were also facing identical issues at work: lack of awareness, no empathy, bullying, stigma and no breaks for self-care.

Would it be fair to let someone like me be abused at work for having a mental illness?

No.

Would it be fair to expect a company to create a safe space for me to work?

Yes.

Fact #3: 1 in 5 employees in the Indian corporate sector, suffer from depression.

According to a study conducted in 2015 by the Associated Chambers of Commerce, 42.5% of the workforce in the private sector suffers from depression and anxiety, overtaking obesity, high blood pressure and diabetes as leading health issues.

At Cosmos Institute of Mental Health and Behavioural Sciences (New Delhi), there’s been a threefold increase in the number of young, professional, working men and women complaining of headaches, insomnia, chest pains, fatigue and burnout. These are psychosomatic symptoms of chronic stress. The greatest challenge is juggling your work life and your home life and not getting enough time to strike a balance. There’s no manual on it, right?

Industries like IT, entertainment, goods and services, manufacturing, finance and business start ups have some of the most stressful work environments. It isn’t surprising when you think about all those big projects, late night conferences, inventories, audits, deadlines, promotional events, incessant phone calls, training courses, site visits, client meetings, promotions, consultations, hiring and firing and the dynamics between employees. It’s exhausting to navigate workplace stress and there’s no time to figure it out.

Fact #4: When Live Love Laugh Foundation did a survey on how Indians perceive mental health, the results were alarming: 87% people showed some awareness of illnesses such as Depression, OCD and Alzheimer’s but half of those who took the survey used derogatory terms like ‘mad’ ‘retard’ and ‘crazy’ to describe mentally ill people. Only 17% admitted that they knew someone who had a mental illness and only 2% admitted that they were suffering from a mental illness.

My job is to advise clients on how to handle issues relating to family law, women’s rights and child welfare. Counselling clients on their choices is a part of this service. So let me break it down for you. How viable are your options to manage your mental health in the workplace?

a) Let’s say you decide to take a break from work. You’re extremely stressed out and want to find better ways to handle your workload without compromising your health. Sanchana Krishnan, a 25 year old editor at an education start-up, was diagnosed with Bipolar Disorder in 2013 and was going through a difficult period trying to find ways around her condition. Her psychiatric medication often caused dizzy spells and she once fainted at work. When asked about it later by a colleague, she tried opening up to him. She was told that everyone has mental health issues but they should never talk about it. So how can you take a break if you can’t talk about why you need one?

b) Now let’s say you have a mental illness but you have a job you love. What is that like? Reshma Valliappan, a Pune-based artist, had worked as a marketing researcher, bartender and book manager, until someone let it slip that she was a schizophrenic. After that, her work life was sheer misery, filled with taunts and sexual advances. The fear of losing out on the companionship of her co-workers and potential opportunities was too much to bear. If your privacy was violated and your mental illness was found out, you’d be bullied and become subject to shearing. Like breaking off from the machine because you’re a malfunctioning part. So how do you work if you’re seen as a liability?

c) Let’s try this: You don’t talk about it at work. So you try to bring your A-game every day no matter how hard it is to get up in the morning. Unemployment is high, competition is fierce and there are bills to be paid. You have to work but you can’t jeopardise it by talking about your mental health issues so you act like you’re absolutely fine. You follow the same hours, you achieve your goals and you socialise as much as you can. It’s easier to pretend that you’re healthy than admit that you’re not. But a recent study has concluded that people who succumb to societal pressures to always look happy, actually have the worst symptoms of Depression. So, that doesn’t work out so well for you in the end.

d) Here’s your last option. You apply for sick leave. When Moumita Mazumdar, a 30 year old marketing professional was diagnosed with Clinical Depression, therapy and medication helped stabilise her condition. But she still needed days off. She could not ask for sick leave, however, because her employer required her to submit a medical certificate for every leave. If you were granted sick leave and gave a medical certificate declaring that you were diagnosed with Depression, there would be consequences. You might be asked to say you had the ‘Flu’ instead. The company may take discriminatory actions such as taking you off crucial projects, reducing your responsibilities, redistributing clients, denying you promotion or even firing you.

Fact #5: In 2016, a Bangalore-based employee assistance programme provider conducted a study which found that 80% of the respondents showed signs of anxiety and 55% showed signs of depression. The study also found that the risk of suicide had jumped from 2 people in 10 employees from 2008 to 8 people in 10 employees in 2016.

Fact #6: India has a Mental Healthcare Act.

The Act decriminalises suicide and provides for every citizen access to mental healthcare services which must be affordable and accessible. Any person with a mental illness has the right to live with dignity, to be treated humanely and in the same manner that a person with a physical illness would be treated. They also have the right to confidentiality, personal contact, medical records, communication and legal aid. A mentally ill person can complain against lack of care, ill-treatment and poor services.

Fact #7: Companies in India have started granting mental health leave to employees.

I spoke to a member of Connecting, a Non-Governmental Organisation in Pune that runs a 24/7 Suicide Prevention helpline. The spokesperson laid out an action plan for me: What are the logistics of having access to mental healthcare in the workplace?

  1. While it should be mandatory to offer mental health leave to employees, a more holistic approach should be taken to ensure their mental well-being.
  2. Psychologists should be on call keeping in mind the appropriate ratio to employees to provide round-the-clock counselling. A distress helpline would be advisable which employees can dial into whenever they’re stressed out. If it’s not viable to run an internal helpline, one can be outsourced to any NGO in the city which can take over.
  3. Mental health leave should be available to employees who are suffering from a mental health condition as diagnosed by a professional or for employees who are going through a stressful time at work or have been through grief, trauma or loss in their personal lives. A system to monitor mental health leave days for employees should be set up by assigning supervisors.
  4. Stress-busters should be introduced such as mindfulness and yoga classes, therapeutic massages, short walks, an open-door policy, bright aesthetics, flexible schedules, communication workshops, unplugging electronics, healthy snacks, flash mobs, bringing in puppies, high-standard technology, ping-pong tables, board games, outdoor team activities such as camps and hikes and mental health awareness campaigns.
  5. It comes down to the employers to ensure that the working environment is a safe space for employees to share how they feel, be treated with respect, have a discussion on mental health and fight the stigma associated with it. It is vital that companies understand that this is economically beneficial for them, as by maintaining the well-being of their staff, they are encouraging productivity, efficiency, innovation and ultimately, capitalising on their profits and cutting their losses.

The in-house psychologist for SheForShe, a WhatsApp support group and online helpline for women’s mental health which I started in 2019 after my own nervous breakdown, talks about the urgent need to create safe spaces for people to talk about their mental health issues:

I think everyone has the right to a safe space to talk about their feelings. That sense of community is so vital to our well-being. As mental health professionals we study something called the Diathesis model which is all about nature vs nurture. Someone may have a natural tendency towards a mental illness and there may be triggers in their environment. At this point, what they need is a strong support group which will help them fight these internal and external forces, as in the push-and-pull and keep their balance. What we need is for everyone to know that they are not alone.

Debjani chatterjee, psychologist

{Does your company offer mental health leave? Get in touch and we’ll spread the word!}

{Do you have a helpline that offers counselling to people in need? Let us know!}