Multiple-Stories Matter!

When you make an image, an idea, a perception or a conclusion about someone or something, how often that is overruled by a Single Story? And If I say ‘Single story could be merely an outlet of your single perception, single experience with someone or something or a single story you have heard and seen about it’, will you believe me?

Most of the time, before my first lecture in any class, I am regarded as a student myself and the journey of my identity as a teacher only begins once I start lecturing or start my introduction as a lecturer. Why do you think that happens in most of my first classes?  May be because we are overwhelmed with the single story about the perception of teacher wrapped in Kurtis or Sari or a middle aged woman with books in hand and glasses on !!

A friend of mine from Germany calls Nepali Food as ‘Daal-Bhaat’ instead Daal-Bhaat as one of the Nepali Food. Why do you do think that happened? May be because she stayed in a place where Daal-bhaat has been only served and she didn’t explore enough cuisines around !!

We hear a story of a person from another person, make a perception about him or her with the story told to us and treat them accordingly. Does it sound familiar? Why do you think it happens to you? May be because we don’t like to keep ourselves in other’s feet to expand our horizon to multiple stories or may be we made up our mind about someone or something with a single experience we have!!

If you said Yes to my most of the ‘question marks’ above, then don’t you think you are under the danger of single story?

Now the question is how to get rid of the influence of the SINGLE STORY?

We, whoever is working in the social field, strongly advocate the need of ‘NON JUDGEMENTAL ATTITUDE’; but we almost forget that our brain is smarter and faster than we think. When is the last time you decide anything or thought any thought without being judgemental or influenced? When is the last time your brain automatically looked at multiple stories to conclude about something?

I know it’s absolutely difficult; it’s difficult to stop brain from being auto-pilot of its thought, difficult to pass judgement or stop reaction in situations, difficult to stop making impression of someone or something instantly?

But what if we have multiple stories already? Then, is it really impossible?

Of course NOT!

Here are few things we can do to help us ourselves to get rid being Judgemental; so next time if you think you will get trapped in being influenced by single story, mind these ones:

  • Learn about the Multiple Stories:

Learn more about the stories, people, places, beliefs, everything. Just have multiple stories about one single thing. Learn from Books, talk to people, visit to new places but just don’t make a perspective on the basis of single story you make. Let Brain to see the things from the multiple angles. So, next time when someone referred Africa as a country, your brain instantly says: No, it is a continent.
(You had Africa in your mind as a country, right? I told ya, Brain runs on autopilot and this autopilot was fuelled by the single story fed to us)

 

  • Listen More:

Have you heard the phrase-Reading in between the lines? Do it, literally!

We trust explicit information and it’s good to do so, most of the times. But there are also multiple sides of the same story, try to find what it implies then merely believing in the singularity of the explicit meaning.

So that next time when someone says something and you hold grudges toward that being, you read the lines in between the expressions, their situations and multiple factors before you jump into the conclusion of that being.

We listen slider

  • Be Non-judgmentally Judgemental:

Non-Judgmentally Judgemental, Interesting? I know, Right?

I never understood this concept when referred by one of my friend, Sujan, until recently when I am trying to explore more on having Multiple stories.
As we cannot stop our brain to stop working in its automatic mode instead what we can do is to feed it with multiple stories, perspectives, information, experiences, interactions so that we start giving benefit of doubt to people around, start accepting them the way they are automatically. If we cannot help ourselves being non-judgemental, at least we can accept the fact of ourselves being judgemental and accept the way we are and help our brain with the power of MULTIPLE STORIES.

(Got the idea? Confused?! Okay, we will discuss about it sometime again)

I know its Easier said than Done. I have had my own share of struggle to stop holding grudges and feeling bad about people and situations. I had my own share of instances where many decisions and explanations were done on the basis of single story, I still do that sometimes. But now, when I have known the power of PERSPECTIVES and MULTIPLE STORIES, it’s much easier for me to be non-judgemental and not get trapped in between the single story to come to the conclusion.

Ending with one of the very relevant story of my life:

I am asked, multiple times: Why are you so nice to people? How can you be so nice to everyone? How can you be so comfortable to be around to the person whom you exactly don’t like in person? Do you fake it or you are serious about being good to everyone?  My answer used to be, most of the time: After all, it’s just a life to live and why to not be nice to everyone.

 

But the UNTOLD answer and my Understated reason (which I share to very few ones) is: I do so, because of my strongest belief in the MULTIPLE Stories; multiple stories of the individuals, situation, places and their actions and belief systems. How can you judge a person with a single story you have of them with a single experience or single information?

Trust me, the time you start stopping to get stuck in SINGLE STORY and believing and exploring the MULTIPLE STORIES, you will be a different person.
Not just in your relationship, but in the information and perspective you build like in the video I have shared at the end.

Perspectives Matter!

Multiple Diverse Stories Matters!

P.S

I wanted to write something related to ‘Perspectives’ for sometime and my exposure to this video during one of the workshop I attended regarding ‘Narrative Approach’ encouraged me to pen down this article.

Link:

https://www.youtube.com/watch?v=D9Ihs241zeg&t=20s

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/ )

Why Can’t we have Luxury to say ‘I am not Fine’?

”Why can’t we have the luxury of saying – ‘I am not fine’ when we actually feel so: not fine and emotionally down?”

This question is haunting me for a week and it all started when I asked a friend of mine, who is an expert in Psychology:  How are you feeling? He clearly seemed to be feeling down and mentally unhealthy. But his – simple reply was ‘All good, I am fine’. I am sure he might not want to share it but my question is: Would he say the same if he had a headache or fever or fractured hand? I am sure, no!

When WHO has defined Health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’; why cannot an individual has a luxury of saying ‘I am not feeling fine’ when they are in a low mood or feeling not good mentally?

 

No matter how much we try to advocate the change in awareness in mental well-being and how much we talk about our Emotional and Mental Health, unless we be true to our mental wellbeing and emphasize as it exactly like of Physical Health, it’s never going to be any different.

May be we are focusing so much on being strong and portrayal of Heroic figure or controlling our sadness, we force ourself not to speak up about it. May be we are teaching our kids to look stronger and not show our failures. So next time, if you are feeding your kid with these: make sure to remember: Health is the combination of Physical, Mental and Social-wellbeing and to fully function, you got to feel healthy in every ways.

Here are the few statements I tend to hear elders preaching or few songs expressing which I have reservation on. Watch it out, if you are doing the same next time:

  • If you are teaching your daughter – ‘Queen will always turn pain into Power’ or ‘Big girls don’t cry’. Stop right there, right then and there.                                                                                                                                                                                                                      If you feel happy or pleasure or excited or any other pleasant emotion, why cannot you feel suffocated or cry? Negative emotion is just another emotion. Tell them to Let it go, speak it out exactly like what you do with your positive ones.

  • ‘Sometimes all you can do is Chin up, Hold your tears and Move on’.
    But I ask you-Why?

Why should you ever do that if you feel like not doing so? Why can’t you have luxury to feel down and cry it hard if you wish to? Is there any crime in not feeling well, it’s your life and your have every right to feel anything you feel like. Let people know about it and seek help!

  • ‘All’s well that Ends Well (Or, In Hindi: Anta valaa toh sab valla)’.                                                                                                                                                                                                                Is it okay to suffer in the journey just with the hope of good end?
  • ‘Cowards Cry (Or, In Nepali: marda rudaina)’.

If you are saying so. Seriously?

Trust me, It’s okay to feel. You aren’t weak. Don’t let anyone tell you different.

  • ‘Its easiest to Pretend that you don’t care rather than to admit that it’s killing you’.

    I don’t think so. Pretending is never easy especially the thing you feel. Like John Lennon said my friend ‘One thing you cannot just hide is when you’are crippled inside’.  Also pretending does more harm to yourself.

Dear friend, the one-liners explaining how should you behave in Public or how should you control your emotions will remain in use in every language, in every culture and in every forms. We are brought up in the culture where expressing sadness or negative emotion is the sign of being coward or lazy or the sign of trying to get away from the reality. But psychological and emotion focused researches explains that being able to feel our feelings actually makes us stronger and more resilient. When we allow ourselves to fully experience our feelings, it actually help us sort out what we really want and think. Feeling helps outlef in a safe and healthy and we are actually less likely to act on them in destructive manner.

You can trust on psychological facts and figures that, it’s possible to feel hurt without acting victimized and feel anger without being destructive; it’s possible to feel fear without hiding and feel heartbreak without breaking down.

So when next time you are verbally feeding your kid or explaining your friend on how to behave or stop the sad feeling, think back and ask yourself: Would you do the same if he has bodily pain, would you still ask him to suppress the pain and tell him to be stronger?

I understand sharing can make one feel worse, but how can you say that without trying?. I am sure sharing your pain, insecurities, fear can be daunting sometimes; and here i am not saying it should be shared to every next person you see; but to the ones whom you trust and most importantly atleast to the counselor if you really want to be helped.

Since quoting John Lennon once again: ‘One thing you cannot just hide is – when you’are crippled inside’; so why try it when it’s going to do more harm then benefit, my friend!
Let it out!

 

 

The power of activity: Nepali mental health patients find purpose in occupational therapy.

– Jenny Joyce, Kripa Sigdel and Sujan Shrestha

world ot day 2017

In the sunlit courtyard of a mental health residential facility in Boudha, Katmandu, men and women sit drawing and painting hand-crafted paper balloons, decorating the entrance to the 100-bed Amrita Foundation Nepal building.Patients here are on a journey of recovery from various mental illnesses.“When I’m drawing, I’m not inside my own mind anymore” says one of the men who regularly suffers hallucinations.

Nepal is still emerging from the devastation of an earthquake in 2015 that killed at least 8,000 people and left over 700,000 homes destroyed.Adding to a litany of challenges that already face the country  – crushing poverty, a decade of insurgency and continuing political instability – incidents of mental health problems appear to be on the rise since the earthquake. There are reported cases of increased suicide rates in the districts worst hit by the earthquake like Sindhupalchowk. While no official data exists on the prevalence of mental health illnesses estimates suggest around 20 to 30 percent of people in Nepal suffer some form of mental health problem.

Significant strides have been made in decreasing infant and maternal mortality rates and improving access to health services. Sadly the same cannot be said for the realm of mental health. It is perhaps the most neglected health issue in Nepal, demonstrated by the government expenditure of less than 1% of the health budget on mental health and the existence of only one government-funded mental hospital.It is alarming that Nepal was ranked 7th in the world for its suicide rate, according to the World Health Organisation in 2014.

Occupational Therapy

Amrita Foundation Nepal in Boudha is a privately-run mental health facility where patients suffering from illnesses including bipolar disorder and schizophrenia attend therapy sessions including some run by occupational therapists from the United Kingdom. Occupational therapy, sometimes called “OT”, aims to improve physical and mental health through engaging individuals in activity.Routines of everyday life like cooking and washing as well as leisure pursuits such as sport and music are activities that “occupy” our lives and help give it purpose.

Occupational therapists believe that a person who cannot participate in these activities because of a mental or physical ailment cannot achieve their potential and can find themselves left behind by society. Enabling people to regain and maintain crucial life skills is vital to a successful recovery from ruptures in life like family break-ups and natural disasters.

OT is a well established health profession across many countries globally. In Nepal, however, it is still in its early stages and OT practitioners are a rarity amongst the health and social care facilities around the country. The Association of Nepal’s Occupational Therapists set up in 2008 is working to promote the profession and raise awareness. Their efforts connect international occupational therapists working in Nepal with Nepalis who have sought OT qualifications abroad and returned to practice at home.Until now no educational programmes for training occupational therapists have been established in Nepal.

Wakeup Call

The earthquake in 2015 served as a wakeup call for both the government and the public to acknowledge the importance of mental health. A deluge of programs launched by NGO s and INGOs are seeking to address the growing needs of earthquake survivors suffering emotional and mental turmoil. It is essential to exploit this newfound awareness to bring about a more sustainable approach to mental health in Nepal. Positive changes are happening. The government for the first time has allocated a portion of the budget to implement mental health programs in different districts, work that is mainly being carried out by NGOs. In addition a new mental health policy has been drafted which is expected to address the gap in mental health delivery in the country.

One of the biggest challenges faced by Nepal is ensuring that all aspects of mental health care are integrated rather than only pursuing medical or biological treatment. Occupational therapy fits in this holistic perspective of mental health which can play a major role in helping the recovery and adjustment of mentally ill people.

On Friday, patients at Amrita Foundation Nepal will gather in the garden and build a tree sculpture to mark World Occupational Therapy Day 2017 which celebrates the profession internationally. Recently one of the patients at Amrita explained how living with depression and having nothing to do meant that “days are long but months and years slip by fast”.

To ensure patients like him do not pass through life feeling this way and to enhance the quality of life for mental health patients alike, it is crucial to provide opportunities for people to be occupied.

( Jenny is a occupational therapist from London )

The article was featured in Republica on 27th October, 2017. To see the online edition of the article in Republica click OT DAY 

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 )

SUICIDE AS THE WORST OPTION OF ALL: DON’T CHOOSE TO HAVE NO CHOICE

Take a minute change a life is the theme of world suicide prevention day 2017.This highlights the importance of speaking up, taking the time and listening. Today 10 September 2017 is the 15th world suicide prevention day and is designed as a worldwide commitment to preventing suicides to the public’s attention and to help society do what it can to prevent suicides now and in the future.

Nearly 3000 people on average commit suicide daily according to world health organization .Every year about one million people die by suicide and up to 25 times as many make a suicide attempts .Behind these statistics are the individual stories of those who have for many different reasons ,questioned the value of their lives. More people die from suicide than from murder and war; It is the 13th leading cause of death worldwide. Each one of the individuals is part of a community. So communities have an important role to play in supporting those who are vulnerable.

suicide help

Let’s talk about some warning signs of anyone having suicidal thoughts: feeling helpless, self-loathing, mood swings, hopelessness, talking about wanting to die or to kill oneself, talking about feeling trapped or in unbearable pain, sleeping too little or much, withdrawing or feeling isolated, decreased social contact, saying goodbyes to love ones, severe anxiety or agitation, talking about being a burden to others, sudden changes in personality, paranoia, increasing drugs and alcohol usage etc. A high proportion of suicide cases suffered from mental illness before committing suicide. It is said that more than 90% of people who die by suicide have a diagnosable illness often clinical depression, and often in combination with anxiety or substance use disorder and other treatable mental disorder. But it doesn’t need to be serious mental issues always, sometimes lack of somebody listening to us may be the reason behind choice-suicide. Sometimes unable to cope the overwhelming life situation may lead to suicidal thoughts.

There is so much more to experience and suicide is too permanent solution to temporary problem .PLEASE SEEK HELP”. Why not to tell your family, friend, doctor, tell anyone but do not stay SILENT” and end up choosing the worst option : SUICIDE .

Suicide is not a solution of problem .Suicide is the worst option of all. Each breathe we take is important so why not to live your life to the fullest rather than ruining it by ending own precious life. Thoughts of suicide are not your fault. They are often a product of some unbalance in your system mentally or physically or both. Suicide is the “END GAME” so “NEVER TRY TO PLAY IT”.