First of all, I would like to congratulate you on your bold decision to disclose your struggle with depression and your commitment to educate the public about mental health issues in 2015. After the news about your struggle with depression surfaced in the media, I thought a lot about how to communicate my words of appreciation to you. I also spent a lot of time thinking about the potential positive impact of your commitment to educate the public about mental health, to humanise the issue, and improve the most neglected lives on earth, particularly in South Asian countries. This letter is the result of all that thinking.

Unfounded discrimination

I have always firmly believed that mental health is not as complex to deal with as it is often made out to be. People who suffer and recover from mental health problems are people like you and me. They could also be our mothers, brothers, fathers, friends or neighbours. I am convinced, contrary to popular belief, that people who suffer from mental illness have the drive to improve their lives and address their problems. But there are multiple layers of discrimination attached to mental illness, which is painful even to imagine, and which play an extremely negative role in encouraging people to seek help.  

Once labeled as ‘mentally ill’ in the eyes of the community and even at times family, people lose membership in vital social organisations like ‘my family’ or ‘our community’. People are demoralised and demonised. They are no longer recognised as human, social and legal entities. In developing countries, the status of women struggling with mental health problems is particularly worrying.  Their family members and/or spouses abandon them and they often fall victim to physical and emotional assault and rape.

For the cause

Unfortunately, there is no single dedicated international agency to speak out about these issues. Human rights groups, development agencies, donors, and governments do not bother to recognise this problem. I have yet to understand how and why the discrimination associated with mental illness is still justified in our societies across sectors. We must work to eradicate the shame and discrimination attached to mental illness before we expect any major change in the field of mental health. I am sure your exposure and influence, if used to further the cause, will set a milestone in this direction.

The Bollywood film industry has already shown how films can be used to increase public knowledge and draw public attention and sympathy towards complex human developmental issues like autism and intellectual disability. The Aamir Khan-starrer movie Tare Jameen Par is probably the best example of this. However, more generally speaking, mental health-related problems are mostly projected negatively in films and mass media—whether it’s Bollywood or elsewhere. I am confident that in the Bollywood film industry, this can be rectified under your leadership.

Every day, millions of people suffer and recover from mental health-related problems around the world. But their experiences are never discussed in public. We only see the worst cases and form a public opinion on that basis. The worst-case scenarios are largely the source of public knowledge on mental health. Society and nations are ill-informed about mental health issues. So it is now time to narrate positive mental health stories filled with hope and optimism. Your story can be that beginning.

In developing countries, including India, people who suffer from mental health problems cannot access basic healthcare services and mental health support. The main reason is that public health services are denied for those who are labeled as having mental health problems. Can you even imagine that health segregation to such an extent exists in this day and age? Sadly, this is the reality for millions of people struggling with mental health problems. Because of this public health apartheid, the life expectancy of people with such conditions is 25 to 30 years shorter than that of the general public.

In the SDGs

I strongly believe that we can redefine images of mental health in developing countries, and the drive to change it must come from within. You have the full potential to lead this drive. The year 2015 is an important one in many ways. It marks the end of the Millennium Development Goals (MDGs) and the beginning of finalising agendas for the Sustainable Development Goals (SDGs). The MDGs completely undermined mental health issues. Now the makers of the SDGs are likely to repeat same trend when it comes to mental health. We must not let the SDGs bypass mental health in 2015.

Deepika, I imagine you have drawn much insight from your own personal experience, which you will reflect on to inform the public about mental health. I really look forward to your charismatic leadership in promoting mental health education and advocacy in developing countries. As a result, I hope we will be able to humanise mental health and related services for all.

Yours Sincerely,

Jagannath

Lamichhane is principal coordinator, Movement for Global Mental Health