The Clownselors

Spandana Datta

Talking to the founder of Clownselors, Sheetal Agarwal, on the impact of medical clowning and challenges of working during the Covid-19 pandemic.

May is recognised as Mental Health Awareness month. The concept of a Mental Health Awareness month came into being in 1949 in the US. It was initiated by an organisation called the Mental Health America, previously known as National Association for Mental Health. The idea is to raise awareness and educate the masses about mental illnesses and to reduce the social stigma around mental health every year in May. It aims to initiate an active dialogue about suicide and its prevention, an issue that is seldom discussed. As Glenn Close says, “What mental health needs is more sunlight, more candor, more unashamed conversation about illnesses that affect not only individuals, but their families as well.” The theme for Mental Health Awareness Month, this May is “Tools 2 Thrive”. “Tools 2 Thrive” lays out practical tools so one may effectively manage one’s mental health and increase their adaptability, irrespective of the circumstances. 

“Clownselors are a volunteer-based group that practice medical clowning. To get an insight into their work of medical clowning, what it entails and the inspiration behind it, we reached out to Sheetal Agarwal, a sociologist, a social anthropologist by training, lecturer by profession and the Founder of Clownselors.”

In India, organisations are endeavouring to not only create awareness around mental health but also actively improve people’s mental health conditions. Clownselors is one such organisation. They are a volunteer-based group that practice medical clowning. While medical clowning is a common practice in the west, it is steadily gaining popularity in India. To get an insight into their work of medical clowning, what it entails and the inspiration behind it, we reached out to Sheetal Agarwal, a sociologist, a social anthropologist by training, lecturer by profession and the Founder of Clownselors.

“Medical clowning is a therapy to aid in the healing process of patients at hospitals using dance, music, magic, drama, etc to reduce pain and anxiety.”

“Medical clowning is a therapy to aid in the healing process of patients at hospitals using dance, music, magic, drama, etc to reduce pain and anxiety”, says Agarwal. Speaking about the importance of mental health in hospitals, she explains: “The focus of hospital care is usually on improving the physical condition of the patients while overall well being is normally neglected. Mental health goes hand-in-hand with physical health, but is rarely considered. Medical clowning focuses on the overall well being of a patient. It is a distraction therapy that demystifies and humanizes the whole hospital environment for children & adults. The concept of medical clowning is that no hospital bed should deny a person his/her right to be happy. Clown doctors create an enabling and supportive environment through interactive play and humour that facilitates a patient’s adaptation to the hospital setting and improves their acceptance of medical procedures and staff. Medical clowning also helps reduce stress and fear in guardians and hospital staff.”

“It involves hospital ward visits from ‘clown doctors’ who are specially trained clowns.” 

Medical clowning aka clown care is a healthcare facility. It involves hospital ward visits from “clown doctors” who are specially trained clowns. Medical clowning is the brainchild of Patch Adams, a doctor and a clown! As a social activist, Adams believed that creativity, laughter and joy served as a catalyst in one’s healing process. He devoted forty years of his life to ameliorate the American healthcare system as he brought medical clowning into being.

Referring to its establishment as a “beautiful accident”, Agarwal talks about the inspiration behind Clownselors: “Clownselors came into being by itself, a beautiful accident. I was at a Moved By Love retreat in Ahmedabad in January 2016, where a woman named Dhara introduced herself as a medical clown. I grew up fascinated by circus clowns but heard the term ‘medical clown’ for the first time. I was intrigued so I looked it up on the Internet. I loved the concept of medical clowning and loved the idea of sharing smiles and reducing the pain of those who are suffering at hospitals. I wanted to try it myself. I contacted Dhara enquiring about medical clowning groups in Delhi but unfortunately, there were none. I was keenly interested and so, I would enquire constantly until one day, she suggested that I start medical clowning in Delhi. I said no way… I have no background in theatre and I have always been an introvert. How could I possibly start something like this?”, initially hesitant, Agarwal decided to go ahead with it.  

On how it started, Agarwal says: “Days passed but the thought of clowning stayed. One night I posted a random status update on Facebook, asking how many people would like to share smiles and give a purpose to a simple smile? I got 33 responses. I needed 15 volunteers and hospital permission to start clowning. I wrote to the Health Ministry of Delhi seeking permission to clown at a government hospital. They liked the idea and a meeting was fixed with the director, Dr Anup Mohta of Chacha Nehru Baal Chikitsalaya. He loved the idea and gave us permission. We were supposed to have a workshop that could not happen. On 9th July 2016, 5 volunteers dressed as clowns entered the hospital singing and dancing, the whole atmosphere changed. We started with OPD and covered the entire hospital spread over five floors. When we came out I could not stop smiling. I was smile hungover and so were the volunteers. Clownselors was born!”.

“Clownselors comprised merely five volunteers in the beginning. But today, the scenario looks different with Clownselors spreading smiles almost everywhere: ‘We have had 200 plus people volunteer at different clowning sessions and there are about 16-18 regular volunteers. We not only clown at hospitals but all kinds of vulnerable spaces like old age homes, orphanages, slums, refugee camps and the like. We also organize awareness campaigns using clowning as a medium. We conduct Free Hugs Campaigns, clowning workshops and sessions on stress management and team building’.”

Clownselors comprised merely five volunteers in the beginning. But today, the scenario looks different with Clownselors spreading smiles almost everywhere: “We have had 200 plus people volunteer at different clowning sessions and there are about 16-18 regular volunteers. We not only clown at hospitals but all kinds of vulnerable spaces like old age homes, orphanages, slums, refugee camps and the like. We also organize awareness campaigns using clowning as a medium. We conduct Free Hugs Campaigns, clowning workshops and sessions on stress management and team building.” 

“Although an effective practice, medical clowning can be intimidating for some, especially for those with coulrophobia. Furthermore, a ghastly portrayal of clowns in movies and books has led to a negative perception of them. Agarwal explains: ‘We respect each individual and their experiences and engage with them according to their needs.’”

Although an effective practice, medical clowning can be intimidating for some, especially for those with coulrophobia. Furthermore, a ghastly portrayal of clowns in movies and books has led to a negative perception of them. Agarwal explains: “We respect each individual and their experiences and engage with them according to their needs. If a person is scared of clowns, we try not to bother him/her but engage with people around them, which makes them comfortable, eventually.” A challenge like this can be tough to handle but the volunteers at Clownselors have managed to navigate their way around it. “When parents see their child engaged and happy after days, it immediately changes the perception of a clown in their head. We have had so many experiences where parents were initially suspicious and slightly uncomfortable too. But when their child smiled, they thanked us with tears rolling down their cheeks.” 

With the onset of a global pandemic, medical clowning groups, worldwide, were affected deeply. Like everyone else, Clownselors was hit hard. “Coronavirus disrupted all our clowning sessions”, Agarwal expresses with grief. “Since March 2020, we have hardly been able to visit hospitals as hospitals are allowing doctors and staff and not medical clowns. We have lost our projects at hospitals like Apollo.” 

“COVID-19 also gave us opportunities to spread our wings and reach every part of India through virtual sessions. We conducted sessions on mental health at universities, stress management sessions for corporate sectors, clowning workshops for children and adults and clowning sessions for children at different shelter homes.”

Though the impact was rough, her team has managed to make the most out of the situation with their virtual sessions. “COVID-19 also gave us opportunities to spread our wings and reach every part of India through virtual sessions. We conducted sessions on mental health at universities, stress management sessions for corporate sectors, clowning workshops for children and adults and clowning sessions for children at different shelter homes. We made videos and sent them to COVID-19 patients to cheer them up and their families. We also made videos on the importance of self-love and self hugs and making mundane tasks fun during the lockdown. We also conducted clowning sessions at migrant shelters during the last lockdown. This April, we were invited by the government of Meghalaya to conduct clowning at various hospitals in Shillong. We even clowned at a Covid ward at NEIGRIHMS Hospital, Shillong.” 

“People are quite receptive to mental health awareness especially once they experience a shift. When a simple act of smiling or laughing reduces the anxiety levels or when a child is not eating and starts eating after engaging with a clown, it changes the perception of the guardians.” 

Globally, it is the youth who have taken an initiative to create and engage in a dialogue about mental health awareness. But are most people receptive to their ideas? “People are quite receptive to mental health awareness especially once they experience a shift. When a simple act of smiling or laughing reduces the anxiety levels or when a child is not eating and starts eating after engaging with a clown, it changes the perception of the guardians.” But are the elderly equally receptive? Agarwal confirms, “At old age homes, the receptivity is higher as they crave human interaction and feel so much better after playing with the clowns. After a clowning session at an old age home, an old lady told us that it was the first time in her life that she had laughed so much and felt absolutely elated!”. 

“Even in 2021, the stigma around mental health is massive. It is this social stigma that prevents people with mental health issues from getting help, which in turn, makes their issues even worse. As individuals, we can grasp and discuss the gravity of good mental health. But as a society, do we practice what we preach? ‘Unfortunately, people are not aware of mental health. The stigma attached with mental health is real’, says Agarwal.”

Even in 2021, the stigma around mental health is massive. It is this social stigma that prevents people with mental health issues from getting help, which in turn, makes their issues even worse. As individuals, we can grasp and discuss the gravity of good mental health. But as a society, do we practice what we preach? “Unfortunately, people are not aware of mental health. The stigma attached with mental health is real”, says Agarwal. However, there is a shift in perception when patients respond positively to medical clowning. “We have heard doctors, patients, guardians say there is no point of this therapy, and medicines will do the work. But when they see the impact they believe in the power of such therapies and also how physical and mental health are interrelated.”

No endeavour comes without its challenges and for Sheetal Agarwal, a couple of challenges are inevitable, even today: “Since Clownselors is a volunteer-based group, one of the challenges we face is the availability of volunteers. Secondly, hospitals like the idea but are not willing to pay so sustainability is always a challenge.” 

Although Clownselors is a fairly recent initiative, they believe they possess the “zeal to heal” people. With their mission to improve the overall well-being of people, Agarwal says anyone can volunteer with them. “People can volunteer with us by registering on our website. People can help spread awareness about our work through social media and help us get connected with hospital authorities. People may also contribute and donate to our organisation.”

Although Clownselors is a fairly recent initiative, they believe they possess the “zeal to heal” people. With their mission to improve the overall well-being of people, Agarwal says anyone can volunteer with them. “People can volunteer with us by registering on our website. People can help spread awareness about our work through social media and help us get connected with hospital authorities. People may also contribute and donate to our organisation.”

With medical clowning causing ripples of positive change worldwide, more and more countries globally are considering it as a complementary approach, along with medical treatment. Clown doctors have infused hospital corridors with laughter and positivity, leading to an improvement in the health of most terminally – ill patients. Maybe laughter, truly, is the best medicine. 

Spandana is an English Literature graduate who loves writing and aspires to rebel against prevailing conventions, one day at a time. She is a Staff writer at Bol Magazine.

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What it Means to Live with Depression

Mahima Sood 

Mahima Sood shares her personal experience of living with depression, how it impacted her life and why it’s important to talk about mental health

Trigger Warning: Depression

This January, I was out with a friend, walking around town and talking about things that are fun to talk about, but you can’t quite recall them in retrospect. We decided to end the day at Zara; there were people all around and the place was buzzing with conversation and laughter. The last thing I remember is waiting for my friend who was trying on clothes before everything went blank. 

“My friend rushed me to the ER, where they admitted me suspecting a stroke. 36 hours, morphine, CT scan, and spinal tap later, the neurologist declared me physically healthy, with alarming levels of stress. ‘What are you so worried about?’, he asked, and I had no answer.”

It started with a headache, which gradually intensified until I was unable to talk and started sobbing incessantly. In half an hour my mouth and hands froze. My friend rushed me to the ER, where they admitted me suspecting a stroke. 36 hours, morphine, CT scan, and spinal tap later, the neurologist declared me physically healthy, with alarming levels of stress. “What are you so worried about?”, he asked, and I had no answer.

“Depression has been the single constant in my life.”

Depression has been the single constant in my life. I say this with an acute awareness of the privilege my birth accords me: I come from an upper-caste Hindu family with educated feminist parents who are more liberal with girls than their contemporaries. I have a partner who understands my condition and is supportive, and friends who tolerate my sudden disappearances. My skin color and body type put me in the conventionally good-looking demographic – I point this out because I have people in my extended family being shamed over their complexion and body on a daily basis. Financial security allows me to pursue my passion. What is it that causes me to pause every once in a while and feel inconsolable with a grief that is so familiar, so consistent that it’s akin to breathing?

“My early twenties were a whirlwind of new experiences littered with long spells of denial about my worsening mental health, and my inability to do anything about it. I’ve gained and lost interest in people, jobs, hobbies, and my own well-being. I’ve fallen into a deep sleep after a day full of joy and laughter, only to wake up wishing I didn’t exist.”

Ever since I can remember I’ve had a constant feeling of dejection and sadness eclipse everything else. I have faint recollections of my childhood — blurs of undefined emotions that speed past, with one that stands out — disappointment. I had a happy, normal childhood. Yet, I always felt alienated and undeserving of that happiness. My early twenties were a whirlwind of new experiences littered with long spells of denial about my worsening mental health, and my inability to do anything about it. I’ve gained and lost interest in people, jobs, hobbies, and my own well-being. I’ve fallen into a deep sleep after a day full of joy and laughter, only to wake up wishing I didn’t exist. At least once a day, for the last 20 years, I have thought how wonderful it would be to stop existing, and how that would take away the pain I have brought upon myself and my loved ones.

“Throughout all this, I’ve managed to masquerade this part of me and pretend to be normal. Good grades, jobs, relationships and lifestyle. It felt alien and inappropriate to acknowledge my emotions, let alone allow them to surface.”

Throughout all this, I’ve managed to masquerade this part of me and pretend to be normal. Good grades, jobs, relationships and lifestyle. It felt alien and inappropriate to acknowledge my emotions, let alone allow them to surface. There would be moments when I couldn’t control it of course: normally culminating in bouts of sobbing. I once cried over not liking a T.V. show’s vamp, something I used to watch with my grandma every night. There was this time when I burst into tears during an appraisal meeting with my manager because she didn’t criticise as much as I thought she would. Once, my father sat on a bed that was freshly made, and I burst into tears because I couldn’t smooth over that last crease.

In retrospect, it seems I was trying to make up for that void by focusing on external achievements.

To give you some context, I have always prided myself on having wildly productive days, where I manage to get a week’s worth of work done in less than 24 hours. I am focused, sail through problems, and get great results. I will eat right and work out and read and spend my time well. However, I still feel hopeless. Balance this against six days where I do nothing but stay in bed, and avoid all social confrontations, and viola, that’s an average week in my life. Last weekend, my psychiatrist texted me to ask how I was doing. I replied, “meh. Been really productive though”. It’s almost as if I carry a fool’s hope that high functionality will magically cure me of whatever it is that ails my mind.

“What I learned was that no pill can cure us of the varying degrees of mental turmoil we go through and that each experience is different.”

When I first went on medication almost two years ago, the experience was different than what I imagined it to be. Books and movies had prepared me for a surreal transformation, where all my misery would obliviate with a single pill. However, what I learned was that no pill can cure us of the varying degrees of mental turmoil we go through and that each experience is different. The medication releases doses of Serotonin, the chemical that makes us happy, periodically in our brain. Each drug comes with its set of side-effects, and it’s upon the patient to decide if the tradeoff is worth it. Would you give up on a regular sleep cycle or bowel movement to manage your condition? Recovery is a gradual process where the onus is on the person to take actions that make the condition easy to manage and control outbursts that shatter every illusion of normality.

“I finally have the help I’ve always needed. I have initiated conversations with my family and friends over my condition. I have started medication. I’ve gone on and off both therapy and medication until I found the combination that works best for me.”

I finally have the help I’ve always needed. I have initiated conversations with my family and friends over my condition. I have started medication. I’ve gone on and off both therapy and medication until I found the combination that works best for me. My preconceived notions of mental health, how mentally ill people behave and how the treatment works have been redefined by my own narrative. I’ve begun to view the world with my own kaleidoscope where logic and emotions often amalgamate, but I try to stay calm and manage it the best I can.

If I, with all my privilege and resources, could walk into a store and, for the lack of a better phrase, “lose my shit”, anyone can. Millions around the world suffer from varying severity of mental illnesses. These conditions cannot be quantified into a set of consistent symptoms, but that does not render them even fractionally less severe or less important than physical ailments. We are dealing with a crisis that cannot be generalised based on symptoms, with each person manifesting it differently. Thus, the onus is on us, as a society, to collectively be responsible for the well-being of those around us.

Mahima is a Data Scientist who also runs a writing retreat in the Parvati Valley.

Design by Hemashri Dhavala

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Speaking to Frontline Mental Health Workers

Vinay Agrawal

Two mental health practitioners explain their experience of working in the frontlines during the Covid-19 pandemiC

Mental health is an essential component of wholesome health and yet it is rarely talked about. Rendered invisible and used sparsely in the conversations, its moorings with stigma, shame, misconceptions and an arsenal of such connotations, frequently pose a hindrance in acceptance. The Covid-19 pandemic has exacerbated the state of mental health affairs at various levels – micro and macro, individual and  collective.

“The strict lock-down, curb on mobility, a multitude of restrictions, never-ending stream of work, uncertainties among a host of other factors have contributed to a shift in emotions and have led to mental discomfiture.”  

The strict lock-down, curb on mobility, a multitude of restrictions, never-ending stream of work, uncertainties among a host of other factors have contributed to a shift in emotions and have led to mental discomfiture. With the caseload touching an average of 80,000 every day, a news cycle that can be fittingly described as negative and toxic, and our tendencies to doom scroll on social media, has resulted in our mental health taking a toll like never before. 

This shift is increasing our susceptibility towards a variety of emotions like panic, anger and gloom. As helplines continue to ring off the hook, and emotions run on the edge and extremes, the mental health experts (who are also Covid-19 front-line workers) continue to battle issues and emotions of their own. 

“The parallel pandemic of mental health is very much real and occurring as we speak, on a minute by minute basis, and it cuts much deeper than our understanding.”

The parallel pandemic of mental health is very much real and occurring as we speak, on a minute by minute basis, and it cuts much deeper than our understanding. Speaking to Bol Magazine, two experts share their insights on learnings, unlearnings and explain what it takes and means to be a mental health expert during the Covid-19 pandemic. 

Dr Rajesh Kumar: Founder & Director UDGAM (a mental healthcare & rehabilitation centre) and Consultant Psychiatrist and Psychotherapist at MAX Super-specialty Hospital, Delhi, says: “This pandemic has affected all professions and age groups, including psychiatrists. In our profession, we have detailed discussions with the patient so covering the mouth and the nose is a must. An increasing number of patients were seen in private OPD rather than in a hospital set-up. On the one hand, patients were increasing, at the same time psychiatrists were at the risk of exposure.” 

“Negative thoughts, anxiety symptoms and depression were more prevalent among patients and these symptoms were affecting the practitioners as well. Mental health cases have been on the rise, and psychiatrists and psychologists have been visiting hospitals despite the risks involved.”

“Negative thoughts, anxiety symptoms and depression were more prevalent among patients and these symptoms were affecting the practitioners as well. Mental health cases have been on the rise, and psychiatrists and psychologists have been visiting hospitals despite the risks involved. Although they attend counseling sessions in Covid wards, psychiatric patients remain very uncooperative and very vocal, increasing the risk of disease spread through droplets. Many do not follow protocol medicine intake and other methods to prevent infection. Such behavior increases the risk of getting infected from them. Uncertainty, anxiety, negative thoughts of patients related to job loss, financial loss, death, health-related issues have also been affecting mental health professionals.” 

“Covid patients at isolation wards in indoor set-ups have been frequently seeking face-to-face counseling or consultation by psychiatrists. As Covid patients were seen more in government hospitals, health professionals there were experiencing more burn-out than those in privately-run hospitals. Many patients are worried about infection, job loss, financial loss, and staying away from the family. Several have suffered from panic attacks and depression. Fear, sadness and irritation were common, varying from mild to severe.”

“Online psychiatric consultation, a new model in mental health care, is helping lots of people suffering from emotional illnesses and has also reached the rural population apart from serving the urban. Patients who shun visits to the psychiatrist are also benefiting from this new normal line of treatment.”

“Online psychiatric consultation, a new model in mental health care, is helping lots of people suffering from emotional illnesses and has also reached the rural population apart from serving the urban. Patients who shun visits to the psychiatrist are also benefiting from this new normal line of treatment. Online audio or video calls, zoom meetings are some of the methods that are helping large sections of the population in identifying, treating and preventing mental illnesses. Keeping updated on knowledge about the infection and following proper preventive guidelines are the first step in making the health professional calm. Sound sleep, following a proper daily routine, spending time with family, exploring hobbies, book reading, mindfulness practice are some of the healthy ways to keep calm during the time of the Covid pandemic.”

Dr Anju Sharma: Doctor, International Speaker, Wellness-Holistic Coach and Founder of Musical Healing Band, “Sound of Infinity” explains: Pandemic has impacted the mental health of mental health experts very badly. Nowadays, people are acknowledging every single emotion. When the pandemic started, it was easy to make people understand to wear the mask and follow the precautionary measures. But due to economic reasons, people must work and step out of their house. This makes it difficult to ensure safety and the frustration level is overtaking the stress.” 

“The mental health of both mental health care as well as a physical health care expert has been impacted more than the normal citizen. Above all these, the main issue is we are not getting time to express or heal ourselves. As health experts, we are more worried about others and the worrying part is the ratio of a doctor and patients, which is- 1:3000. So, the condition is not good.”

“As a health care expert, we visit the hospital when many cases come. When we come back home, people maintain distance. The mental health of both mental health care as well as a physical health care expert has been impacted more than the normal citizen. Above all these, the main issue is we are not getting time to express or heal ourselves. As health experts, we are more worried about others and the worrying part is the ratio of a doctor and patients, which is- 1:3000. So, the condition is not good.” 

“Initially, I used to come across stories of domestic violence, suppression. When the pandemic started affecting the jobs and businesses, the cases regarding work and money related issues were more. These days, people are so stressed and are least bothered about relationships and virus. The only thing they are worried about is how their life will go forward. All these have made frustration as a predominant emotion.”

“if you see the health care professionals, they are spending the entire day in their PPE kit to keep the virus at bay. In our job, we have to meet new patients every day, and we must treat them while being unaware of their Covid-19 status.”

“A lot of awareness camps and seminars regarding mental health support are going on. People are talking about it on different platforms and are acknowledging their mental issues as well. It has its negative side also, that is, people are being more scared about diseases that did not exist earlier but prevails now. As health experts, we don’t have time to express our emotions and feelings and can’t even take a day off to rest. The lockdown was considered as a vacation time by the people. Even after the unlock phases, people are stepping out to visit restaurants and shopping, and the worst part is some of them are avoiding wearing masks stating the difficulty in breathing as a reason. But if you see the health care professionals, they are spending the entire day in their PPE kit to keep the virus at bay. In our job, we have to meet new patients every day, and we must treat them while being unaware of their Covid-19 status.” 

“After all the day’s work, we go back to our family and expose them to the risk of getting infected. Secondly, there is a lot of workload and because of the lack of resources, we are doing almost all the work with no family time. This impacts our family relationships. The other thing is if we get a normal sore throat, we must quarantine ourselves to protect the others around us. All these are making the doctors silent and aggressive at the same time. We too are on the same scale of emotions as any other human being. I believe sound therapy has had a wonderful impact on the mind, body, and emotion.  I keep myself calm through sound. Do not stress over thinking about the future. Try to make the best out of the present time and work on what makes you happy. I am following the same.”

“A 2017 survey by World Health Organization (WHO), points out staggering cases of depression and anxiety in India. A year before that, a global health study conducted by Lancet placed suicide as the prime cause of death among Indian population, in the ages, 15-39. The recent figures, too, are far from encouraging. According to a 2019 study by Mental Health Research UK, 42.5% of Indian corporate workforce suffers from depression and other mental health concerns.”

“The WHO pegs such economic losses at 1.3 trillion USD (exclusive of GDP shrinkage and rising cases due to pandemic) over a period of 2012-2030. In a recent interaction, a WHO official was quoted saying, ‘We think that mental health is a forgotten aspect of Covid-19’.”

The concerns of such nature further translate to economic loss. The WHO pegs such economic losses at 1.3 trillion USD (exclusive of GDP shrinkage and rising cases due to pandemic) over a period of 2012-2030. In a recent interaction, a WHO official was quoted saying, “We think that mental health is a forgotten aspect of Covid-19.” In a nutshell, the conversations around mental health continue to remain invisible, and its access limited. But, mental health is very real, and it’s time we start normalizing it. 

Vinay is a reader who also happens to be a writer. Passionate about arts, and culture; his binge list somehow continues to grow on a daily basis. He also aspires to be a plant-parent and a Bach-flower practitioner, someday. 

Design by Hemashri Dhavala

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INTERVIEW WITH RAASHI THAKRAN: PART 2

ADITI KUMAR SPEAKS TO RAASHI THAKRAN WHO’S ACTIVISM LED TO THE CREATION OF INDIA’S FIRST NATIONAL MENTAL HEALTH HELPLINE KIRAN 1800-599-0019

Content Warning: The article mentions Suicide

If you or someone you know needs help, call 1800-599-0019 to reach KIRAN, a 24/7 national helpline set by the ministry of social justice. You can also mail icall@tiss.edu or dial 022-25521111 (Monday-Saturday, 8am to 10pm) to reach iCall, a psychosocial helpline set up by the Tata Institute of Social Sciences (TISS).

We spoke to Raashi Thakran, a Mental Health activist who’s change.org petition “#StandAgainstSuicide: to Launch a National Helpline number for suicide prevention” with over 4 lakhs signatures became successful last month with the launch of KIRAN (1800-599-0019) a 24/7 toll free national mental health helpline for those in distress. 

Read Part 1 here.

EXCERPTS FROM THE INTERVIEW PART 2:

GATEKEEPER TRAINING

What policies can be implemented? 

Policymakers can help by making sure that Gatekeeper training is offered to people across the country. Gatekeeper training can be taken by anyone and everyone It’s a one hour long training. It helps you prepare and make sure that if someone in your vicinity is struggling with suicidal thoughts or with their mental health, you are able to respond. And you can yourself be the first responder. You can identify early warning signs and provide early intervention. 

Gatekeepers have played a very important role in suicide prevention and they are also able to then direct people they know to mental health services, to actual professionals. So now since we have this knowledge we can create an army of mental health warriors if nothing else. You don’t have to have a background or a degree. You can just be there and know the warning signs. This is the most basic thing we can equip ourselves with. 

QPR – Gatekeeper Training – Question, Persuade and Refer – Tells you how to question a person about suicide, how to persuade them and help them and how to refer them. It’s like CPR, people who know QPR are not doctors but they can save a life. People say it’s an American training that doesn’t apply to us. Fine, don’t go for QPR, create something for an Indian context and circulate that so it can reach the common people of the country and that’s how you spread awareness. 

This idea that everybody in the community also has a responsibility for those around them. So even if we don’t know that much about the technicalities of mental health the gatekeeper training or even a general idea that someone might be suffering can help us respond really fast. What would you suggest the community can develop to fight against the increasing mental health issues that people are having during Covid losing jobs, being isolated etc.?

Now more than ever we are realising the power of community. You need a support system to fall back on. Especially during such times. So, in terms of people losing jobs and unemployment, it comes back to the government and policymakers that it’s important for them to become more inclusive and have policies that help people. We are talking about Atma Nirbhar Bharat so actually go to the grassroots and create policies for migrant workers. The government needs to be looped in. 

As a community, it’s important for us to reach out. You don’t have to do something grand and change millions of lives but simply reach out to people in your circles who you think might be suffering. Check in with your friends and family, check in with the person who’s just lost their job. Check in with the person who’s at home but home is toxic for them. It’s a very difficult situation for a lot of us. Have gratitude for yourself and reach out to people who you know are struggling. That’s the least we can do. 

Right now more than ever it’s very important to understand that we’re on the same team and we have to work as a community and make sure you atleast are there for the people you care about. That’s what I’m trying to do. 

Since you’ve been conducting so many sessions. So, people must’ve come up to you with their own stories so can you share some stories of positivity and resilience? 

There’s so many. Every session I’ve had a lot of people come up to me and say they want to share their stories. 

One incident that I always talk about and it’s very close to my heart. I had just finished giving the talk in IIT Delhi and I was waiting for my auto outside and this one lady approached me and said, “I was in the audience and I heard your story and I have myself been struggling with depression for a long time now and I haven’t had the courage to ask for help, I have even felt suicidal and now after listening to you I want to get better, I’ve booked an appointment already and I am going to see a counsellor this weekend.” She then started crying and we hugged and it was such a beautiful moment. Now she’s doing so well, she’s opened a restaurant and is nailing life. 

One of my friends reached out to me just yesterday and he said that last year he was going through a very difficult time and he used to self-harm and yesterday he messaged me and said it’s been a year since he had done that and just wanted to share that with me. It’s beautiful seeing how far people have come and how resilient they are. There’s so many stories. That’s why I love what I do and this is why I do what I’m doing because I get to meet such people and hear such amazing brilliant stories. 

That was really heart-warming. I have a final question, we have a lot of social activists writing for us. We understand that social activism can be stressful. How do you deal with the stress and pressure and what would you suggest to other activists who are trying to make a change in society? 

I’ve been doing this for a while, I am 22 years old and a lot of times what I face is the fact that I am too young to be doing this. There’s a lot of people who tell me that you’re 22 and we would like you to talk about certain things and not talk about certain things. That said, the response that I’ve received has been overwhelming and amazing. I know that my work also brings change as I am able to make sure that I’m able to help a couple of people. 

To activists who are driving change I think it’s very important to just keep doing what you’re doing. You will get comments and it will get very tough especially if you are sharing a part of yourself, like me, I have to share a very very personal story, a very tragic story and every time I talk about it, it’s difficult. But, it helps someone out there it helps people. So, I guess to anyone listening don’t let anyone tell you that you’re too young, too old or too qualified or not qualified enough, people always have something to say don’t let that get to you. Just keep doing what you’re doing and you’re amazing and awesome and you’re doing amazing work and I think that’s what matters. Even if you don’t see results right now you will see it in the long run you will see that you are driving change. All of us in fact, all our stories are so important and unique and they need to be heard and that’s what I’d like to say to anyone listening. 

This will really help our readers, if they are first time writers and this can really encourage them to write and share their stories. 

Stories are very powerful, they can inspire so many people. So, use that tool and own your story. I think that’s the most important thing. Kudos to you for being a platform that holds space for people. 

Aditi is a Law undergraduate student at the University of Cambridge, and recently completed a diploma in Conflict Transformation and Peace-building. Reading and painting in her spare time, she aspires to challenge the structural dimensions of injustice through her educationShe is a Deputy Editor of Bol Magazine.

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Interview with Raashi Thakran

Aditi Kumar speaks to Raashi Thakran who’s activism led to the creation of India’s first national mental health helpline KIRAN 1800-599-0019.

Content Warning: The article mentions Suicide

If you or someone you know needs help, call 1800-599-0019 to reach KIRAN, a 24/7 national helpline set by the ministry of social justice. You can also mail icall@tiss.edu or dial 022-25521111 (Monday-Saturday, 8am to 10pm) to reach iCall, a psychosocial helpline set up by the Tata Institute of Social Sciences (TISS).

We spoke to Raashi Thakran, a Mental Health activist who’s change.org petition “#StandAgainstSuicide: to Launch a National Helpline number for suicide prevention” with over 4 lakhs signatures became successful last month with the launch of KIRAN (1800-599-0019) a 24/7 toll free national mental health helpline for those in distress. 

Excerpts from the Interview: 

COPING WITH THE PANDEMIC

How have you been doing? How are you coping with Covid and everything (happening around it)?

I think now it has become like the norm for me, for most of us I feel. Now we are sort of getting used to that and I am working. I am working from home right now, I am not going to the office. It has been alright, it has been pretty chill. Just spending time with my family. 

So do you have some specific things you do to maintain your positivity and would you like to recommend something for other people who are also feeling very isolated at this time? 

One thing that I really try to do is sort of stay connected with my family and my friends. Since my mom is here and my dad is away, we catch up every night, we have our regular video call sessions and that really makes you feel like you are connected and you can talk about certain things. I try to regularly have sessions with friends and it’s a stress buster for me. 

For myself what I try to do is that I basically try to stick to a routine, I think that has really worked wonders for me. I make sure that even if it is work from home, it should not extend into your personal life. And since I have struggled with mental health issues- I take medicines and I struggle with anxiety and my sleep and so I have to maintain a routine, I have to sleep on time I have to wake up on time, otherwise my whole system just goes haywire and I don’t want to go back there. So I always try to do that and I’m eating healthier home-cooked food. 

I think people have started to increase home cooked meals and the whole experience has come up now when the family comes together and cooks something.

I am also trying to learn how to cook because I’m the worst cook. I don’t know anything so my mom is also taking this time, because she has found me stuck at home so she is like ‘I’m going to teach you how to cook and how to prepare meals and just eat better’. I think that has really helped. And at the end of the day I make it a point that at least once a day I go out, even if it is within my society, because getting that fresh air is so important, with precautions obviously. Getting that sense of connection with nature is really important. So that is how I am trying to cope with this time. And I know it is going to be a while before things even begin to get back. I don’t think it will ever get back to how it was, but some normalcy starts to set in, so it will be a while before that happens. 

You have actually given us some great points- maintain a routine, social distancing is not emotional distancing, keep in contact, make your own meals and make sure you spend some outdoor time. 

Do the things you love or things you have been pushing for a while. I’m trying to read more, I had piles of books in my house but I would never get around to reading them. So I was like a hoarder without ever getting around to reading. So many of us are guilty of that. But I have tried to utilise this time to do something new like cook and read. So yes, that is something that people can try. 

Have you been playing your guitar?

I’ve been playing my guitar as well. But I do it during the weekends, weekdays are a little packed with work. Even when it is work from home it is a little packed. But yes, I have been getting back to singing, playing, and writing a little bit. I had been away from my blog for a really long time. I hadn’t had time to even think of writing something but now I am getting around to it. 

HOW HAS WRITING HELPED YOU

Since you are mentioning writing, I wanted to ask you how it has helped you in your journey. And what would you like to say to other people so that if they are suffering they can find fellows in their experience?

Honestly, writing has been therapeutic for me in a way, because sometimes it is very difficult for me to talk about what I am feeling. Which is also why therapy sessions are a little difficult for me because you have to talk about what you are feeling. I am trying to work on that but at the same time there is something that my therapist also recommended – that when you are not able to speak to someone, when you are not able to say the words or find the words, you write it down, whatever it is you are feeling. That way those emotions and that negativity will get out of your system. 

A lot of times I am also very self critical, so that is another technique that my doctor told me that – you tend to criticise yourself a lot especially when you think it, so thoughts are really fast, they just come to you, in minutes you would have pointed out ten different things you hate about yourself. But when you write it down, that slows down the process. And at the same time she also said to try to write down things that you love about yourself and the qualities that you love about yourself. So that is how I think I got into journaling, writing and I started my blog and then it became all about whatever I know, whatever little knowledge I have I try to put it out in the world and whoever needs it can read it. That became my safe haven and so many people reached out. Also in terms of sharing my story online and writing that down I think it really helped me cope with my loss and my grief as well. So writing has played, again, a very very important role in me coming to terms with whatever has happened since the past year. 

FINDING SUPPORT GROUPS 

You talk about coping with an experience. I read that you were looking out for support groups for families that have suffered from a loss of some kind, especially of a family member. Have you been able to find that support in India? Is it coming up now like on social media websites? 

Coming to support groups, last year onwards, as soon as this happened to us, we were in a very difficult position because as survivors of suicide loss we were looking for a community. We were looking for people who understood and it was very difficult for us – at that point at least – to find a support group or find people with similar experiences. Because come what may when you find people who have been through something that you have as well, you feel like you are not alone and that helps you cope with the loss. I think for the longest time we were just looking for that support system. 

But I was in Pune at that time and we did not find many support groups in Pune, although now I think a lot of online support groups have come up in India – there is one support group by Wildflower Mental Health which is amazing. They have a session almost every week. Similarly there is one support group for survivors of suicide loss which happens every week and it is organised by Sisters Living Works. Now they are coming up, but at that point it was very difficult for us to find those support groups in Pune, and that too in-person support groups. Because we were looking for groups where we could just go, sit, meet people, and share whatever it is we were going through. 

At the end of the day we found an online support group on Facebook, but again it was not an Indian support group/not India based, it was an international one. It was for families who were dealing with suicide. I think that really helped us, we are still part of it, knowing it doesn’t matter where you are around the world. People are from different countries and continents, but grief looks very similar for all of them. Everyone can relate to what you have been through and they can empathise. That was something really beautiful that we established in that group. It has been a place where we found a lot of peace. All three of us. 

ON INTERGENERATIONAL DIFFERENCES IN UNDERSTANDING MENTAL HEALTH

When you are saying that initially it was difficult to find support groups, it just makes me think if it is something to do with the differences in generations. For example the previous generation’s understanding of mental health and now the (conversations that) are emerging. People are more open to talk about their experiences, they are more open in crying out for help. Would you like to say something about that? 

Mental health has evolved drastically over the past couple of years as we know and now this generation, like you said, is more aware, more informed in terms of mental health and also because it has more exposure and definitely because of the internet and social media because previously our parents did not have these resources. They did not have access to all of these means of information. To some extent I think that could also be the cause of why our generation is struggling with more mental health issues and so much anxiety because studies have shown that it has led to a rise in mental health issues, anxiety, depression, so that could definitely be one of the reasons. 

At the same time our parents are not as exposed to it as we are. So we are not on the same page. And I think that leads to that communication gap and generation gap. I believe that if we want to come on the same page we have to make sure that we are the ones who bring our parents up to speed. And the key to that is communication and having a conversation with them. Trust me your parents will never not want to help you. They want to understand. They want to see what is happening. But they are just not able to understand because they have not been exposed like we are. 

So maybe if we try to meet midway and we bring them up to speed, make sure that they read more articles about mental health, they are more sensitised, they read and they watch news channels and they watch movies which talk about these issues so they get our perspective and they are able to see things from our lens. So I think that would help get us on the same page, and decrease that communication gap especially when it comes to mental health. Not just mental health, for a lot of different issues as well. If we are able to bring them up to speed with that, we can feel more comfortable reaching out to them, for help, if needed. 

ACCESS TO MENTAL HEALTH RESOURCES FOR WOMXN AND LGBTQIA COMMUNITY

That we should be precursors of change and that we should bring everybody to at least the same level of understanding. For example all the social prejudices and stereotypes there are about women and they have so many social pressures, (and) that affects their mental health. For example if you see historically, ‘hysteria’ has been related specifically with women. Even pressures that non binary and LGBTQIA communities face in society. How can we bring everyone together to address these issues and the impact they have on our mental health? 

For LGBTQIA community, women, there has been research (that suggests) that they  are more susceptible to having mental health issues like depression, anxiety and other disorders compared to other people, which is why it is very important for mental health to be intersectional. Just like we look at intersectionality in feminism and other issues, it is important to look at that in mental health as well. 

There needs to be diversity, there needs to be inclusion. There has been research that they (LGBTQIA community) are also more likely to go for mental health support services, compared to other communities (social groups). Again, they are the people who reach out to mental health services more than we (other groups) reach out to them. 

It is very important for these services to be non discriminating, because a lot of times these services have their own biases and they come into the picture. In fact there is one study where it is quoted that people from minority groups are more likely to drop out of treatment because they feel that they are not understood by the practitioner, by mental health professionals. So they are more likely to not get that medical help, even if they get it they are more likely to drop out.

From our end we can make sure that these services are accessible, affordable, non discriminating, unbiased, inclusive. As outsiders to the community, we can be better allies in reaching out to them, understanding their perspectives, having conversations and not fearing the unknown, so that we can have more positive and empathetic safe spaces. 

THE KIRAN HELPLINE 

About the Kiran Helpline, can you tell us how it works so that we can explain it to the readers? 

They have done a good job when it comes to availability, they are available in 13 languages. They are working with 26 different institutions that are spread out all across the country. They have also taken into account the north-east region as well as the Jammu region. They have 600+ volunteers and these volunteers are all mental health professionals and experts. They know what they are doing and they are empathetic. I spoke to a couple of psychologists (whom I called) and they have been really understanding and I think they are in it for all the right reasons. 

When you call up the helpline number there is a welcome message, and then they tell you to choose the language, once you choose the language they ask you to choose the region (from) southern region, western, northeastern, Jammu and finally the state. The procedure is long, we have to think how we can shorten it. Since it has only started I’m sure there are going to be a lot of modifications, they will incorporate all those suggestions and feedback. I feel it is a very important and a great step in the right direction. 

What do you think the next step should be and how responsible do you think the state should be? Because this helpline puts a responsibility on the state- that you (state) are the first responder, you have to make sure that you connect the person to the service. What is the next thing the state can do in improving mental health problems, and crisis and responding fast, well in time?

Talking about the helpline number, a lot needs to be done. Just because it has been launched does not mean the job is done. First we need to check how the helpline number is working. So I think the next step for the state and for the ministry should be (to) conduct a survey, once they have completed a month/ two months, as to how many calls you got, what sort of calls you got, how many people were you able to direct to more concrete help in their area. I’m sure the ministry will do it, they might even be chalking out the plan as to how to do it but it is something that needs to be done and that data needs to be put out. I think that could be the next step now. Keep incorporating and auditing this helpline number, it is very important to make sure that this helpline number stays and functions properly. Because what happens a lot of times with the helpline numbers is that they just fizzle out. We don’t want that to happen, I’m sure the government and state don’t want that to happen. 

In terms of long term goals, what I feel is that they can and should work on the Mental Health care Act 2017 and implement that properly. It is something that they should definitely look at. Also we have suicide prevention policies, its not been implemented in India. Lot of countries have implemented proper suicide prevention policies and that has shown results, the numbers of deaths have gone down. I think that is again something the government can look at and should look at – why not have a policy in place?

Another thing that might be farfetched right now but countries have done it- the UK has a Minister for suicide prevention, so why cant we have a minister with a cabinet rank if not for suicide prevention, for mental health and mental wellbeing. 

Continued in Part 2…

Aditi is a Law undergraduate student at the University of Cambridge, and recently completed a diploma in Conflict Transformation and Peace-building. Reading and painting in her spare time, she aspires to challenge the structural dimensions of injustice through her education. She is a Deputy Editor of Bol Magazine.

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