Young People and Mental Health in Changing World

World Mental Health Day 2018

Adolescence is a crucial phase of a life in which a child transitions into an adult. It is a tumultuous period of rapid changes, uncertainty, identity formation, restlessness and curiosity. At the same time it is a very exciting time of self explorations, socialisation and adventures etc. The growing demands of modern times, changing values and expectations, shifting relationships, the shrinking space to explore oneself and rapid physical and mental changes put adolescents in the state of perplexity and may not be able to comprehend the changes properly. This may lead to the experience of stress from mild to severe. Seeking out avenues to channel out their frustrations and stress, they can develop unhealthy coping of stress which can lead to risky behaviours such as the use of drugs, alcohol, aggression, apathy towards others and even to suicide as well. The stress for some of them becomes too much to handle due to which they might develop mental health problems. In this
context, World Health Organization is celebrating this year’s World Mental Health Day on October 10, with the theme ‘Young People and Mental Health in a Changing World’.

Adolescent’s mental health status in Global Scenario

According to World Health Organization , 1 in 6 people are aged 10-19 years whereas mental health conditions account for 16% of the global burden of disease and injury in people aged 10-19 years. Depression is regarded as one of the leading causes of illness and disability among adolescents and suicide is said to be the third leading causes of death in 15-19 years olds globally. Half of all mental health conditions start by 14 years of age and three quarters by mid-20s but most cases are undetected or untreated due to stigma and lack of awareness in such issues. The consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead lives in adulthood with good well- being and full potentiality.

Scenario in Nepal

According to the report of Central Bureau of Statistics (2014), the population of adolescents make about a quarter of total population which stands at about 6.4 million. There are several issues that concern Nepali adolescents such as child marriage, child labour, migration, maternal mortality rate, sexual exploitation, trafficking, HIV AIDS , mental health etc . Adolescents in Nepal have huge risks of developing mental illness but the facilities of the treatment haven’t been focused on adolescents mental health solely. WHO ( 2006) reported that among 18 outpatient mental health facilities available in the country none of the health facilities are meant for children and adolescents only. But , in 2015, Kanti Children’s Hospital has opened a child and adolescent mental health outpatient ward to provide psychiatric treatment and psycho social counselling to children under 18 years. The rate of incidence of suicide among adolescents is alarmingly increasing every year. It has been found that suicide rate among adolescents jumped from 5% in 2005 AD to 15.7% in 2009 AD (Mishra, Shrestha, Poudyal, & Mishra, 2013) .

Dealing with Adolescent’s Issues

Having a mental health issue in the early age of life is not choice or conscious decision, it can be due to environmental or biological reasons. Though we might not control the happening of the mental health condition to a young people but we for sure can prevent its happening or at least deal with the issue in such a way that every mentally ill can live their life with dignity. Firstly and majorly, starting with conversation on such issues will be a help while dealing with adolescent’s mental issues, it will not only help to bring awareness but help adolescent to acknowledge and speak up in the initial phase will help in early detection and treatment. Likewise, making educational institutions, family and community aware and empower to deal with such issues will be another way to help young people live their with full potentially and productivity in this changing world.

References:

Central Bureau of Statistics . (2014). Population monograph of Nepal, Volume II.

Mishra, N., Shrestha, D., Poudyal, R., & Mishra, P. (2013). Retrospective Study of Suicide Among Children and Young Adults. J. Nepal Paediatr. Soc, 33(2), 110–116.

WHO. (2006). WHO-AIMS report on mental health system in Nepal. Kathmandu,Nepal. Retrieved from http://www.who.int/mental_health/evidence/nepal_who_aims_report.pdf

(The article was featured in Republica- https://myrepublica.nagariknetwork.com/news/young-people-and-mental-health-in-changing-world/ )

Mental Health at Workplace

-Sujan Shrestha and Kripa Sigdel

break_from_work

In today’s busy world human life has been reduced to mere mechanistic ritual of making a livelihood. Every adult’s life is subsumed by the conundrums of their work which after some times have the greater likelihood of being monotonous. Being in the constant pressure of workload, deadlines, pleasing the boss, yearning for extra buck and recognition among colleagues can be deterrent for our mental health. In this context, to make us all aware of the work related stress and its impact in our mental health World Health Organization (WHO) has decided to celebrate this year’s world mental health day, October 10,  with the theme ‘ mental health in workplace’

Any work is better than no work?

Undoubtedly, it’s good for our overall wellbeing for us to be employed rather than staying idle. But, at the same time, negative working environment can be the potential stressor in life threatening our mental health. The recent study conducted by Chandola and Zhang (2017) in the UK revealed a quiet insightful finding. The study was done between the population who were re-employed in poor quality jobs and those who were unemployed. They found out that the population who were unemployed had lesser biomarkers of stress than those who were reemployed in bad working condition. This research has elicited the crucial understanding that any sort of job may not necessarily be better than no job. We need to focus on qualitative aspect of job rather than a job itself.

Cost of mental health problems

Negative working condition is very stressful for employees. This stress results from many sources. Some of the chief sources are: workload, inflexible work schedules, poorly managed shift works, intrapersonal conflict, low participation in decision making, job insecurity, poor pay, low social relationship, conflict with supervisors and managers, bullying and harassment etc. All these factors can lead to mental health problems such as burnout, anxiety, depression , substance abuse and some may even resort to suicide. All these have downward effect on the productivity of the job.  As per WHO, depression and anxiety have been attributed for costing global economy US$ 1 trillion each year in lost productivity.

One of the glaring evidence in Nepali context has been the news of suicide of those who went for foreign employment in Middle east countries, Korea and Japan. The report, “When the Safety of Nepal Migrant Workers Fails” published by International Labor Organization (ILO) in 2016, attributes suicide as being responsible for  about 10 % of all the deaths in foreign employment. The report compiled the number of deaths from the year 2008 -2015. Out of many reasons we can speculate negative working condition, work related stress and job dissatisfaction having contributory causal role to the suicide .

People with mental health problems have been suffering doubly. On top of their detrimental condition they have to bear the brunt of social stigma. They are seen as unfit for work. First of all we shouldn’t conceive ‘mental health problem’  constituting complete derangement of mental state and being out of reality only as demonstrated by the derogratory terms such  as ‘bahula’  and ‘pagal’. Infact majority of the people have mental health problems not exhibiting the symptoms of psychosis and they appear to be functioning well professionally. Due to the fear of stigma many people keep mum about their conditions in the workplace which will ultimately worsen their conditions

Protecting rights

Nepal is a signatory of The UN Convention on the Rights of Persons with Disabilities (CRPD). Article 27 of The UN CRPD provides a legally-binding global framework for promoting the rights of people with disabilities (including psychosocial disabilities). Similarly The Constitution of Nepal, 2015 enshrines the fundamental rights of all Nepali citizens regardless of disabilities. But still there are provisions in the law which debar the people with mental health problems from taking official responsibilities assuming the mental and cognitive incapacitation. The legal provision is vague in stating the mental state that constitutes mental and cognitive incapacitation but has sweeping generalization that puts all the mental health conditions in one basket. The government should amend the flawed laws which cast out the persons with psycho-social disability from workplace.

Majority of workplaces in Nepal do not have an insurance scheme for the health of their workers let alone for mental health. The attitude of co-workers and manager are not favourable to the employees who are facing mental health difficulties. There’s a need for understanding of such problems which can happen to anybody at anytime and not make it as a taboo. An environment of safety and security should be created for the employees who are facing mental health problems.

Nepal has recently introduced The Sexual Harassment at Workplace Prevention Act, 2015 which aims at preventing sexual harassment in the workplace, protecting the victims and punishing the culprit with the fine upto Rs. 50000 and six month imprisonment. Such laws should be introduced to prevent other forms of workplace harassment such as bullying. The organization should have non-discriminatory policies for their employees and have punitive provisions for the harassment and bullying and protection for vulnerable employee.

What needs to be done?

An organization can start with hiring a industrial psychologist or counsellor who can provide regular counselling services for the employee. Any employees can be benefitted by such facilities regardless of their mental condition and can be effective shield against any mental health problems. The management should be sensitive enough to understand the problem and accordingly design the job flexibly for employee with mental health problems and have supportive and confidential communication.

In terms of working condition we might be surprised to know that workers value more intrinsic motivations such as good relationship with supervisor, praise, respect, recognition than extrinsic motivation such as pay rise, bonus, good physical setting etc. This has been proven by famous study known as ‘Hawthorne Studies’ which compared the workers in different working conditions and  found productivity to be increased when the supervisor – worker relationship was good  than when physical conditions such as lighting, pay , breaks were increased. Therefore, good management and worker relation can improve the productivity and at the same time make positive working condition.

Employees should be aware of their own self care for one’s own physical and mental health. Regular physical exercise, plentiful rest, sleep and hydration are simple yet very effective for good mental health. Employees self care can be complimented by the organization by making good and flexible job designs and motivating the staff. One simple exercise of periodic group supervision in which members perform some rituals such as mindfulness exercises, share their highs and ups in work and personal life can have therapeutic effect.

While we are busy in making a living let’s take break sometimes to live a life!

(The article was published on October 10, 2017 in Republica. Here is the link of the article in the paper – mentalhealth in workplace )

Psychbigyaan Kurakani 1 – Dignity in Mental Health (October)

Psychbigyaan Kurakani  is a monthly discourse on the topic exclusively of Psychology and mental health.  It is an innovative interactive session between the experts and the participants. As Psychbigyaan team, we expect it to to create the awareness and interest especially in the mental health and psychology. We hope to clarify the doubts and stigmas regarding mental health through seasoned interaction and discussion.

As, our first Psychbiygaan Kurakani, (october) we are discussing on the ”Dignity in Mental Health” the theme of mental health day 2015. The interaction was held on October 5, 2015 at American Space , Teku. Program started with a song by a person with mental problem which shows they are capable of doing everything if they are treated properly and in a dignified way. Then the interactive session began.  The program was hosted by Ms. Kripa Sigdel and moderated by Sujan Shrestha. The guests for the interaction were Matrika Devkota, founder and chairperson of Koshish Nepal; Nir Prakash Giri, chairperson of Nepal Mental Health Foundation and Bishal Dahal, Human Resource Counsellor of National Federation of Disabilities Nepal. Down below is the video of the interaction session:

 

Interaction on “Dignity in Mental Health” held

kurakani

Psychbigyaan Network Nepal in association with American Space, Teku organized an interaction program on the topic “Dignity in Mental Health” on Monday, October 5 at FNCCI building, Teku. The interaction program was held to celebrate the World Mental Health Awareness Week. The interaction program was held amidst 30 participants with three distinguished guest speakers. The guests were Matrika Devkota, the founder and chairperson of Koshis Nepal ; Nir Prakash Gir, chairman of Nepal Mental Health Foundation and Bishal Dahal, the human resource counselor of National Federation of Disabled Nepal.

An hour and half long interaction was focussed on the overall situation of Mental Health of Nepal. Matrika Devkota stressed on government policy for the inclusive policy in Mental Health. Nir Prakash Giri opined that the negative societal mind set, stigmatization and discrimination as the major barriers for the acquiring dignity in Mental Health. Bishal Dhakal said that the understanding and proper care from family are very essential for the betterment of mentally ill people.

group pic

The program was updated live in twitter and the participants asked the questions to the guests after the floor was opened. The event was followed by short snacks and socialization and some light moments with the participants. The video of the entire session will be uploaded on Ocober 10, on the occasion of World Mental Health day. Stay tuned.

Here is the link to the video of our first Psyvhbigyaan Kurakani :

http://www.psychbigyaan.com/kurakani/psychbigyaan-kurakani-1/