Research Critique 2
Lecture with Dr. Attur
One of the lectures I have listened to so far has been from Dr. Ram Attur. He is a Psychiatric Doctor, and his lecture addressed mental health in India. He has a clinical practice treating children, and he likes to collaborate with schools to help with primary prevention of mental illnesses. We discussed the definition of mental health, which is being in a healthy state. It does not mean the absence of disorders though. Being mentally healthy does not mean that you never feel depressed or anxious for example, but it means that you are still able to be productive and able to cope with day to day activities in a healthy way. There is no way to not have stress at all. Dr. Attur’s target population is children and adolescents. In his collaboration with schools, he implements a preventative program to help children build resilience.
Dr. Attur showed us this statement on the screen: Mental health issues are rare in children and adolescents. He asked if we thought it was true or false based on our own prior knowledge and assumptions. This was false, as mental health issues start to occur within children and adolescents. Dr. Attur gave us the statistic that 50% of disorders start within adolescents who are 15-18 years old. This shows how crucial it is for parents and teachers to be aware of this and try to identify children who have mental health issues. If they can identify if their child may be having an issue, they can help them to treat their problem sooner, rather than it becoming a bigger mental health issue for them later on. Patel, Flisher, Hetrick, and McGorry (2007) stated that youth from 12-24 years of age is when most mental disorders begin, but they are often detected later in life. Dr. Attur shared with us that there is a higher prevalence of emotional issues with females, but this is true only before a female begins her teenage years as an adolescent. There is a higher prevalence of behavioral issues with males, but this is also only true within males before going into adolescence. With helping to identify disorders, it is important to understand that there are internalizing and externalizing disorders. Internalizing disorders are issues that other people may not being able to see or identify because they are happening inside the person, usually emotionally and mentally. The person may not show that they are having a problem. Some examples of internalizing disorders are anxiety and depression. On the other hand, externalizing disorders are ones that other people can see. These disorders are behavioral, and some examples are Conduct Disorder, Attention Deficit Hyperactivity Disorder, and Enuresis (bed-wetting). These are issues that show outside of the person because they are behaviors that a person exhibits. Therefore, externalizing disorders can be easier to notice.
Another statement shown by Dr. Attur was: Suicide is caused by mental disorders. This is not true. Mental disorders can be a cause but not always. The topic of suicide is a cause of great concern as India has the 2nd highest suicide rate for adolescents who are 14-25 years old. Some factors that contribute to suicide are social factors. In India, there is a certain time of the year where young students take tests and entrance exams. There is a parental and family pressure for academic achievement, and suicide occurs during this critical time of exams for young people.
Dr. Attur shared with us more information about the history of mental health status in India. Legislation has been recently changing with the recent passing of a mental health act bill in 2016. Mental illness is closely interlinked with India’s religious belief system. There is also a stigma in Indian culture that visiting a mental health professional is a sign of weakness. In India, there is a lack of resources to provide treatment to those suffering with mental disorders. There are 0-3 Psychiatrists per 100,000 people, and 1 in 10 people are left untreated. Only 0.06% of the health budget is spent on mental health in India. There are not enough psychiatric social workers, clinical psychologists, psychiatrists, and psychiatric nurses available than what is needed. For example, the required number of clinical psychologists is 17,250, but there are only 898 available. Some challenges of mental health care involve awareness and reducing the stigma and having more resources to deliver care and treatment. Some opportunities that can be addressed for people is yoga and complementary medicines.
The key issues to be addressed are awareness, more availability of resources, and preventing adolescent suicide. As I mentioned above, there is a lack of mental health awareness and availability of treatment. Adolescent suicide is a problem to be addressed in India and even in other countries as well. Patel et. al. (2007) stated that suicide is the leading cause of death in young people in India and China. Young people are at a heightened risk for suicide. Patel et. al.(2007) has stated the issue of mental health in young people as a global public health challenge. There is a strong correlation between poor mental health and other health and developmental issues, such as lower educational achievements, substance use and abuse, violence, and reproductive and sexual health (Patel et. al. 2007). This shows that maybe if children have a poor mental health, they will not do as well on their exams. So, some interventions to promote mental health may help with reducing the health and developmental issues. Students can even perform better on their exams if they are in a healthy state of mind. Dr. Attur told us about a public awareness video developed to show adolescents to help children from becoming depressed and attempting suicide around the results time. The video is titled, “You first, marks second,” and I think this video is a great way to spread mental health awareness and also to help young students with reframing their mindset so that they do not get so depressed if they did not score well on their exams.
There are some values unique to India that influence the issue of adolescent suicide. There is parental and societal pressure placed on children to perform well academically. These values, like I mentioned above, are some factors that contribute to suicide. In India, there is also a stigma about receiving mental health treatment. It is important to understand the unique Indian values and belief systems in order to effectively help with the issue. With adolescent suicide, I cannot help to prevent it unless I first find out some factors that are linked with suicide, such as high societal pressure to achieve. If I can learn more about the Indian values and how it influences the issue, it can help me work on culturally appropriate treatment and actions to help with solving this issue.
These issues of adolescent suicide and mental health awareness are applicable to actual field experiences. So far, we have gone on a field experience to Odinadi, a place for sex trafficking victims to rehabilitate. The co-founder of Odinadi, Stanley, spoke to us about what the process of rehabilitation is like for the children and women. He said that it is very important to provide them with hope and listen to them. It is important for them to see that they have support and people who care about them. This field experience relates to mental health awareness by communicating with the woman and providing them counseling. It is important to build trust when working with the community. Odinadi helps to provide more awareness, treatment, and suicide prevention. Stanley mentioned that some women feel like they have no hope and want to commit suicide. The content discussed in the lecture showed me that it is important to provide more awareness and education within the community on mental health topics in order to help reduce the stigma. The information in the lecture showed me that I have to be culturally sensitive to the community and understand what some of the issues are and factors that relate to them.
To address these issues, I think my role is to learn more about the Indian culture, their values, and belief system. This will help me try to understand more from their perspective, and not my own. I can talk more with people from the community to learn more about what they need the most. This helps me see what I can do to help. Once I learn and understand more, I can try to come up with ideas and ways I could help. I can use research to help inform my understanding and research based treatment for the community. Around the world there is a lack of interventions to prevent mental disorders and promote mental health. More research is needed to improve the interventions offered as most mental health needs in young people are unmet (Patel et. al., 2007). Patel et. al., (2007) stated that the key challenges to addressing mental health are a deficit of mental health professional and the stigma associated with mental disorder. Research is needed in this area to reduce the stigma in mental health, create more awareness, and educate children in order to promote a positive mental health. Dr. Attur mentioned that opportunities to be addressed could be yoga and complementary medicines. Tells, Singh, Bhardwaj, Kumar, & Balkrishna (2013) conducted a study using a randomized control trial to look for effects of yoga or physical exercise on school children’s physical fitness, cognitive performance, self-esteem, and teacher-rated behavior and performance. Tells et. al. (2013) found that yoga and physical exercise are useful programs to add into schools. Because of these findings, I think research definitely needs to be addressed in India specifically regarding programs that could increase mental health awareness in schools, using education and some holistic approaches, such as yoga and mindfulness.
References
Patel, V. Flisher, A. J., Hetrick, S., & McGorry, P. (2007). Mental health of young people: A global public health challenge. Lancet, 369, 1302-1303.
Telles, S., Singh, N., Bhardwaj, A. K., Kumar, A., & Balkrishna, A. (2013). Effect of yoga or physical exercise on physical, cognitive, and emotional measures in children: A randomized controlled trial. Child and Adolescent Psychiatry and Mental Health, 7 (37), 1-16.