A paradigm shift in mental health policy

It is a major crisis in public mental health ethics that psychologists align with counter therapeutic institutional policies that violate existing constitutional and statutory safeguards. File.
| Photo Credit: B. Jothi Ramalingam

On March 24, the Supreme Court of India formed a National Task Force to prevent the increasing deaths by suicide of students on campuses. It also directed the Delhi Police to register an FIR on the complaints of the family members of two students who had died by suicide while studying at IIT Delhi in 2023. That year, following a spate of deaths by suicide, the IIT Council led by the Education Minister directed IITs to ensure ‘zero tolerance’ to discrimination and provide a robust support system to students.

The institutional response to suicide is often individualistic and reductionist — it is almost always to appoint more psychologists on campuses. The socio-structural determinants of mental health, such as discrimination and biased institutional policies, are almost always left unattended. Even though counselling centres are active at all IITs, with the goals ranging from “creating a suicide-free campus”, “creating a stigma-free and empathetic environment for issues related to mental health” to “creating a campus conducive to happiness and peace of mind for its residents”, psychologists refrain from calling attention to the biased institutional policies that impact mental health.

For example, none of the official websites of the counselling centres at the 23 IITs employ the phrase “queer affirmative” or use trans-inclusive personal gender pronouns. Language is not just a collection of words; it is action. Gender identities, sexualities, and inclusive practices are areas of human experience and action in which language, knowledge, and power intertwine. The way language is employed strongly influences thinking, which, in turn, affects the way people act, bringing power into the equation.

The gender-sexuality exclusionary language points towards non-compliance with the existing legal frameworks and Supreme Court rulings. For example, official forms where gender by default has only two options — male and female — violates equal rights for representation of gender non-binary people that was granted by the Supreme Courtin the 2014 NALSA judgment. In 2023, the Supreme Court launched the Handbook on Combating Gender Stereotypes, recognising the need to use unbiased language, which not only reflects the judge’s interpretation of the law, but also their perception of society.

Research has shown that pronouns are crucial linguistic resources for supporting trans and non-binary students and suggests strategies for a trans-affirming pedagogy such as collecting pronoun information and dealing with pronoun misuse. The deployment of gender pronouns signals identity-safety and promotes the perception that the institution is procedurally fair for sexual and gender diverse people. Using gender-inclusive pronouns and establishing inclusive frameworks and anti-discrimination policies are preventive public mental health care interventions that need to be prioritised as they de-escalate mental distress.

“Teachers talk only about grades. A grade is the parameter by which students are judged as good or bad,” a student said. This is antithetical to the ethic of care that honours and respects the value of just being human. The objective of the classroom should not only be confined to producing intellectual scholarship but also to cultivating compassionate, non-judgemental, and empathetic communities.

Fragile attendance policies implemented idiosyncratically by teachers pose serious challenges to mental health. In order to cultivate cultural safety and empathy in the classroom, it is important that teachers and students interact regularly. In the context of documented institutional discrimination and its fatal mental health impact, classrooms are to be nurtured as safe, kind, and democratic spaces. The current policies on mental health, limited to increasing mental health services, need a paradigm shift to a bottom-up approach focused on the classroom that maps various experiences and nurtures sensitivity to contexts and diversities. Teachers are pivotal in this regard.

It is a major crisis in public mental health ethics that psychologists align with counter therapeutic institutional policies that violate existing constitutional and statutory safeguards. Counselling centres have to mobilise all possible resources at multiple levels so that care becomes the central value. Similarly, embedding ethics of care into institutional policies to respond to avoidable mental distress to make every human life meaningful is more important than landing a human on the moon.

Sudarshan R. Kottai is Assistant Professor, Department of Humanities and Social Sciences, IIT Palakkad