What’s on my mind?
Sometimes that is all I need to hear from a friend or a family member. And to that very short, simple question, I may have a long, winding answer that was waiting to be voiced. Then why is it that I don’t ask it of others enough? WHO, in their huge initiative on Mental Health Awareness, talk about the importance of asking that one single question- “What’s on your mind” of our spouses, our kids, our friends and family as we plow through the daily struggles of everyday lives.
Recently, we launched the above podcast on mental health and well-being for ‘adolescents, by adolescents.’
The first episode aimed to understand and establish the merit of having this conversation in the first place with Dr. Kavita Arora, leading Child & Adolescent Psychiatrist, MBBS, MD(Psy) , CCST (Psy, UK) and co-founder of Children First. I feel the need to clearly layout each qualification as the biggest question that bothers us today when consuming information is ‘can I trust this person to be a credible source’.
Towards that end, it is also worth calling out that this launch session was moderated by my wonderful friend Mugdha Kalra, media veteran and BBC 100 Women of 2021 for her work on neurodiversity awareness. My wonderful co-founder and acclaimed young adults/ children’s author Archana Mohan and I are aware that everything on our publishing platform Bookosmia is geared towards young people (under 18s) speaking up. From the second episode onwards, adolescents themselves will be running the podcast from here onwards- reading letters, asking questions, sharing experiences with an experienced counsellor on board.
Why mental health of adolescents?
As Bookosmia (smell of book) is India’s No.1 publishing for under-18s, which really means that we publish the largest number of their poems, essays, stories, book reviews, travel blogs, festival memories, everything under the sun. We are uplifted by the steady stream of cute poems about butterflies and best friends and my -mom-is-the-best, elaborate book reviews, energizing travel blogs but there are a lot of pieces which felt like a piece of their heart, like pages from their diaries. Children spoke of body shaming, bullying, cyber-bullying, of being locked indoors during covid, of waking up to see a pimple on their face, of what they see when they look in the mirror.
We felt something needs to be done. It was now that we realized it has to go beyond just publishing them and provide them a forum. Running on the belief that all young voices need to be heard, outside of the classrooms and report cards and that if they feel heard now at 8, 12, 16, they will grow up to be more confident individuals and engaged citizens.
It is special to have unique insights into children’s minds, having published thousands of them.So, when we started seeing an increasing number of entries on anxiety, depression, low self-worth from our 10+ audience, we were alarmed.As these entries poured in from not just the metros but from remote locations like Kiccha, Saharsa, Goalpara, we realized just publishing their thoughts was not enough. We need to find more and diverse mechanisms to provide support. These submissions from smaller towns, bust the myth that these issues are very ‘first world country’ and at best could be seen amongst the privileged in metros.
WHO’s shocking statistics on mental health issues for kids say 1 in 7 kids in the age of 10-17 years suffer from mental health issues and 50% of all mental health issues start before age 14. In a country like India, these issues are further complicated as openly talking about it is still taboo, making it even more difficult to get help and support to address them in a timely manner. It is time to not dust off the issue. Not label it as trivial or an outcome of ‘over-sensitive’ generation.
Why is mental health so big for this generation?
All of the above made it clear that mental health issues amongst our adolescents are real and need our attention. But did mental health issues not exist earlier? Why such an alarming trend of increase now? Didn’t we all grow up too and felt isolated and anxious at times? Very often we hesitate to ask these questions as they may seem politically incorrect. We have them in our minds but we don’t voice them. But as parents we need to accept that while we are well-meaning, we are not always fully equipped to do the best for our kids. That is when we need an expert to guide us. Mindful of this reality and that these questions abound in many parents’ minds, I posed them to Dr. Kavita Arora. Her response put at ease so many doubts and certainly wiped off any traces of superiority that we as a generation feel in handling stressful situations better than our young ones. Here is a summary of what I gathered from her beautifully articulated and well-rounded take on the subject.
All of us have mental health. It exists for everyone even if not all of us face issues. Many variables and their interaction could be at play as to why we are talking about it now.
Firstly, they were labelled as something else historically. They were not seen as ‘issues’ or ‘illnesses’ that had any remedy or needed treatment. People could be ostracized for being mentally ill. It is obvious that talking about your own issues is difficult given how personal it is to us or the larger social narrative around talking about these things. It is only very recently, 1960s onwards that there is focus on the question- ‘If mental health issues exist, what can be done about it?’
Secondly, there is a lot more increased awareness given the narrowing of the world across borders thanks to the internet. Issues get talked about a lot more, across borders. We hear and identify with issues that people in other locations voice.
Another key consideration is that society itself is evolving. A lot of protective factors on mental health used to come from a sense of community and belonging. What we are losing is a sense of community. The younger population is actively seeking that ‘sense of community’. Building a safe community. Even rolling out this podcast by youngsters is a hopeful step in the same direction- of building a safe community.
And finally, our younger generation is smarter and comfortable in speaking about it. “I have a problem. I need you to listen to it and I will talk about it. I won’t hide it.” We have witnessed that first hand in the writings they submit or the ease with which they run conversations on topics like anxiety and being an introvert.
How are children communicating, “I need help?” to parents/caregivers/therapists?
There is a huge section of 14–25-year-olds who are self-referring, persuading their parents or approaching Dr. Kavita’s Children First Clinic directly in NCR representative of the urban Indian middle-class and upper- class population. However this is not true universally of all demographics.
Children do not say, “I am stressed.” They show you something is wrong. In younger children, where language is not yet the mainstay of communication you can witness this through changes in behaviour, body or withdrawal. There can be unique presentations of what stress or anxiety can look like. Tummy ache, headache, change in appetite, withdrawal from socializing, wanting to be only with friends, increased screen time. When a child has big feelings inside them that they are not able to locate in the context of life, then they will show you in their behaviour or body. As a parent or caregiver, look for any change in the child. Is there something different in their behaviour, in their language, their engagement with you. Listening well to the non-verbal signs of the body and making sure there are spaces to express themselves- through art, through music, through their body especially for the younger one. For older ones who have beautiful access to language, even write poems about it or use dark themes in their art.
Focusing on our health is a key trend that emerged during covid? Is it just a fad or likely to continue?
Dr. Kavita pointed out that to all of us who are 30+, it will mean two years of that life to us- to our identity, economic status, priorities. It is important, yes but a bigger question is to evaluate what these years leave on humans in various life stages. The impact of the last two years will be carried by the ones who will live the next several decades. For those in the developmental stage of puberty to early adulthood where body image, identity and being self-conscious are the biggest points. We will have to stay on our toes about the impact of covid. Till the age of 25, children are still developing a sense of identity and the impact of 2 years of an absolutely different environment on a developing brain will be different from that on a fully developed brain.
Are schools equipped and capable of doing a better job to identify that the child is facing a mental health issue?
Anxiety is normal and universal except when it is excessive, frequent or causing stress. Teachers will pick it up when they spot a change in the child’s behaviour. Good and involved teachers have very good observation and are able to pick it up. The real question is- “What to do when they catch it?” There are varying degrees to which teachers engage- some give a pep talk to the child, some help them navigate out of it, some follow it up with parents . We need to rely on the adults in the caring role but need to build enough collective wisdom to know what to do about it. How to not worsen it?
There is no singular solution as India is too diverse and so is its population. There are children who don’t even have schools so thinking of a universal approach is not possible. But yes, in certain sections, psychology and mental health should be introduced to children. In education the focus is on mental health awareness is from a preventive point of view, of taking care of yourself, looking at well-being and life skills.
But to Dr.Kavita, need of the hour is to look at all the human resource in the country, the collective wisdom it can offer and not necessarily relying on degrees and certifications to qualify mental health providers. There will never be enough psychiatrist for the population of our country and hence the need to look at it as a tiered approach. Creating many community-based spaces, much like this podcast and the publishing platform are essential to first level intervention.
Are we fussing too much over our kids and making them less resilient?
Can one play the devil’s advocate and say that fussing too much over our kids, wanting to protect them at each step hinders them from building resilience inside? What is the balance between self-love and self- improvement?
As pointed out earlier by Dr. Kavita, it is important to remember the context of our growing up years vis-à-vis our children’s. A good example of our times is kids playing in the neighbourhood, on their own, without parental supervision because enough known people and familiar places would be around. With the sense of community shrinking in increasingly unsafe times, it has become imperative for parents to be watching over their children at every step. Children are summoned to come and eat at regular intervals. When they leave home to go to college, they experience hunger for the first time and how to organize food, how to have their clothes washed. If not provided the opportunity to operate independently, how can they demonstrate it? But children are actually very resilient and how they have adapted to COVID is a great example.
What to be keep in mind as the podcast gets rolled out?
It was really heartening to hear Dr.Kavita comment that sharing is generally healing. That she is excited about the sense of community that can be achieved through these podcasts, is vastly encouraging to us. A 14 year old listening to 17 year olds talk about their own moments of anxiety and self- doubt and how they dealt with it will certainly give them confidence that they are not alone in their journey. To a certain extent, it is the tiered approach of collective wisdom which was mentioned earlier. Of course, listening to some else’s experiences can cause a trigger in a few individuals. To mitigate it, all such conversations must be started off with a clear outline of the subject at hand that allows any such individuals to exit, checking in on how people are feeling and providing helpline numbers for anyone needing assistance. As some of our young audience chimed in on how they enjoyed talking with their friends about the issues that affect them on our podcasts, we look forward to handing over the baton to them with hope, excitement and awe of their ease at speaking up. Here is to confident voices and broader smiles for our younger generation!
This article is a creative output of Nidhi Mishra, Archana Mohan and Mugdha Kalra, co-founders of Not That Different movement to understand mental health and embrace neurodiversity. We encourage you to listen to the podcast on audible.com , hubhopper to make the most of this meaningful conversation yourself.