The goal, particularly in this new decade, has been mental well-being for most. Wealth and fame are highly coveted in today’s world, but many of those who have acquired it believe it isn’t enough if there’s no peace within a person.

Such has been the case with countless famous personalities and wealthy businesspeople. The most recent tragedy that portrays the very same was the untimely passing of Sushant Singh Rajput whose demise caused a stir in the nation. 

For Sikkimese people, mental health issues and drug abuse have been a curse. They are arguably the worst issues of the state; in 2015 the state of Sikkim had the highest suicide rate in the nation, and the latest NCRB data shows that there were 199 suicides in 2018, of which 143 were male and 56 were female.

It has been a common happenstance for people to commit suicide, news that different Sikkimese people go through and a tragedy another family goes through every year.

From 2015 to 2020, the curve that has gradually decreased came as some positive sign. With multiple steps by the Sikkimese government in the past and present, mental-health awareness is rising by the minute and with it hopes of normalising it increases as well. 

Mental disorders (or mental illnesses) are conditions that affect thinking, feeling, mood, and behaviour. They may be occasional or chronic, that last more. They can affect one’s ability to relate to others and function properly each day.

Mental Health disorders are more common than one would think, in the US, a country that most of the global population admires because of the nation’s lifestyle and culture, and borrows the same; 1 out of 5 American people possesses a mental health disorder, according to the US National Library of Medicine (NLM). 

World Health Organisation (WHO)’s Mental Health Action Plan 2013-2020, endorsed by the World Health Assembly in 2013, recognizes the essential role of mental health in achieving health for all people. The WHO website has detailed global info on different mental health disorders, and prevention and treatment strategies.

Their MHA plan includes 4 major objectives:

•more effective leadership and governance for mental health;

•the provision of comprehensive, integrated mental health and social care services in community-based settings;

•the implementation of strategies for promotion and prevention; and

•strengthened information systems, evidence and research.

There is an array of mental disorders that plagues Sikkim but still goes ignored or veiled because it is thought to be a heretic. More common types of mental illnesses include:

•Anxiety disorders, which include panic disorders, obsessive-compulsive disorder and phobias

•Mood disorders, which include Depression (the most common type of mental disease according to WHO), bipolar disorder, and other mood disorders

•Eating disorders

•Personality disorders

•Post-traumatic stress disorder

•Psychotic disorders, including schizophrenia

As per the NLM, there is no single cause for mental illness. Several factors can contribute to risk for mental illness, such as:

•Genes and family history

•Life experiences, such as stress or a history of abuse, especially if they happen in childhood

•Biological factors such as chemical imbalances in the brain

•A traumatic brain injury

•A mother’s exposure to viruses or toxic chemicals while pregnant

•Use of alcohol or recreational drugs

•Having a serious medical condition like cancer

•Having few friends, and feeling lonely or isolated

The NLM also says that character flaws do not cause mental disorders. They have nothing to do with being lazy or weak.

In Sikkim, some people still are seen to roam around the streets whilst being dismissed as “Laatas” and “Laatis”. Every Sikkimese would know about their town’s laatas and laatis. Dhurba from Namchi, Meena from Namchi, Chandu Don from MG Marg Gangtok, the “crazy” lady from Development Area Gangtok, Madan in Namchi, Danny from Singtam, Rita from Singtam, etc., are few names amongst countless others who roam around being teased or disregarded, while in reality, being tormented or pacified by their severe mental disorders.

The real bane in Sikkim has seen to be the laid back pacifist approach to the unknown which has become mundane, the question that arises is if people dismiss these severe mental disorder cases so easily, how can they ever be serious about other mental disorders that are harder to diagnose?

Disorders like Depression, Anxiety, and Psychosis are most common in Sikkim and these are the ones that mostly go unnoticed until it is too late.

A mental disorder diagnosis is simpler and common than one would normally assume, millions of people worldwide visit therapists and psychiatrists. The steps to getting a diagnosis include

•A medical history

•A physical exam and possibly lab tests, to oversee medical conditions that could be causing symptoms

•A psychological evaluation. Answering questions about one’s thinking, feelings, and behaviours to a psychiatrist.

Dr Saish Rasaily from Sikkim, a Senior Psychiatrist, Mental Health Activist, IMA Dr Ramachandra N Moorthy Awardee in Psychiatry 2018, and currently the HOD/ Addiction Medicine Specialist and Nodal Officer, Centre for Addiction Medicine, speaks about what mental health in an individual is supposed to mean concerning all the factors that a functioning individual is subjected to in life and society.

“There is no normal or abnormal when it comes to society as a whole, if something is practised by 90 per cent of the society for several generations in history it will be considered normal. It is mostly a behavioural pattern, the behaviour is considered normal if 90-95 percentage of individuals do it, for example, in most Asian countries idol worshipping is considered normal, this is culturally and socially accepted hence considered normal,” Dr Rasaily says.

He adds, “What a mentally sound person should do is have positive goals and ambitions, should have perseverance, be resilient to bounce back from failures and have a purpose; the person should be able to handle stress, the person should be able to socially interact when needed, have the empathy to understand emotions not just of self but also others, and after all the roles that the person is subjected to in life, be satisfied and content with his roles in life.”

“There have been strides that picked up since 2014,” a top officer from Government of Sikkim’s Mental Health Program shares.

2013-2015 saw many cases in Sikkim that put it on the top of suicide rates, and after that period the government also has been proactive to put a bar on this. Sikkim’s Mental Health Program and Suicide Prevention and Network (SPAN) Program are two of the most proactive programs that have helped flatten the curve in the previous half-decade.

With so many bright individuals in Sikkim, people, regardless of any given demographic or social conditions, often find themselves not fitting in and trying to find answers all by themselves. The programs set by the government oversees many aspects, depression and suicide being the most plaguing, hence most looked at. It is in cognizance of the government thus launching these programs to tackle the issues.

To address the high suicide rates in the state, Sikkim government launched a 24X7 crisis centre-cum-suicide prevention helpline at STNM Hospital in 2015. Former Health Care, Human Services and Family Welfare Minister A.K. Ghatani inaugurated the helpline -18003453225 .

Similarly, Sikkim Police has a dedicated helpline for crisis intervention centre intended for suicide prevention throughout the state of Sikkim. The helpline – 221152 installed at Police Control Room, Gangtok for handling distress calls and to provide immediate counselling to people in distress having suicidal tendencies.

The calls are for people in distress or for people calling for someone whom they care for. The 24×7 helpline is set to be attended by gazetted officers and the logs are to be maintained to record the call details and counselling, according to the Sikkim Police guidelines.

“The mental health program is going on and our people have been doing it with NIMHANS- National Institute of Mental Health And Neuro-Sciences. It is going on and the only thing is that people from NIMHANS aren’t visiting right now due to lockdown but they are in contact and we are exchanging papers and doing the needful,” says Director General-cum-Secretary, Health, Dr Pemba T Bhutia.

The officer from the state’s program informed that there are teams deployed in all the districts. The team, which includes psychiatrists, social workers, psychologists, etc. 

“We are training people so every community gets attention. Compared to earlier years, it is going good and we have sensitized people on this more so than ever. We are training PHC doctors, sending Psychiatrists to PHCs so we have earlier detection of mental health issues,” the officer says.

“We are doing a lot of programs and these programs are only to increase, we are reaching block levels but the intensity will increase,” the officer adds.

There are NGOs, organisations, forums, and helplines throughout the country and available for Sikkimese people as well. There are helplines provided by the SPAN Program and other NGOs whom people are supposed to contact without feeling subjected to any societal dogma.

It is evident that there is a rising awareness on mental health issues in Sikkim but the behavioural patterns towards mental health education remain sluggish even in people who are educated, the biggest give away being Sikkim’s disregard for the “laatas” and “laatis” who just get minutes of sporadic compassion whilst literally and figuratively screaming for psychiatric attention.

It is argued that normalising mental health issues and treating (socially) them just like one treats diseases like common cold or fever could work in treating (medically) them to dilution in the long run.

Read more related articles:

Lockdown and the Internet – does overconsumption of data affect mental health?

Let’s talk about men’s mental health, instead of saying ‘man up’

The neglected mental health crisis

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