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Awareness and Acceptance of Mental Health Issues and LGBTQ Community: The Two Overtly Neglected Issues of Our Society

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Standing in 2020, where we talk of a 5G network, possibilities of multiverses and what not- some very basic issues are still unacceptable, unrecognised by a huge mass of society. Two such issues, which recently made headlines of every newspaper and were almost sensationalised by the general media are 'Mental Health' and 'Same Sex Marriage'. The interview of Dr. Tirthankar Guha Thakurta, teaching faculty of KPC Medical College, who also extensively works on issues of mental health and gender and sexuality, is sure to give us multiple new insights, activating our thinking faculties.

Golden Cauldron: According to you, how much have we as a society achieved in making our social milieu more accepting and aware of mental health and its importance in last ten years?

Dr. Guha Thakurta: Well, with the advent of Mental Health Act and its implementation in the government hospitals, there have been a lot of developments in the health care system, as well as in the public domain. There has been an increase in the number of facilities under the Mental Health departments as well as a spike in the recruitment in these departments. But if you talk of the social change…well it does not arise simply out of a legislation. It takes time. Moreover, if there is an already prevailing stigma on an issue and people gradually start moving towards a non-biased view, sometimes what happens is, people tend to take refuge in defence mechanism to hide their stigma, which I find is more frightful. Hence, you will not find people directly ostracizing those with mental health issues, or calling them names, but at the very core, they are actually extremely stigmatised of these mental health conditions. This makes it a kind of an invisible stigma that is prevalent around us. This is sure to manifest in different forms. We can see people who are apparently very sensitive towards mental health issues, but if they themselves or any close ones of them are ever diagnosed with a condition, they vehemently fight back, saying they do not suffer from it- as if it is a bad thing to suffer from any mental health condition. There is a kind of a change noticeable in the form of the phobia probably, but at its core the problem remains.

Golden Cauldron: A very common confusion among people is when to approach a psychologist or a therapist and when to visit a psychiatrist. If you could enlighten our readers a little about this...

Dr. Guha Thakurta: In general, the mental health conditions have some biological basis and some social, environmental and cultural basis as well. Now, some disorders are more biologically inclined, like Schizophrenia- which is caused due to an increase in dopamine in the brain and there are certain conditions which are more culturally influenced, such as possession disorders, dissociative disorders, conversion disorders and such. But if you ask me whom to go to, honestly, I think, this should not be the concern of the patient. Instead, the psychologists and the psychiatrists should understand that they are dealing with a subject which requires inter-departmental collaboration. They should remove their ego and get educated about each other so that the social circumstances can be overcome. In general, a psychiatrist is the one who will prescribe you medicines for the chemical disorders, whereas, a psychologist is going to use behavioural and other forms of therapies. But we need to understand that all of these are the aetiologies of mental health issues, in various proportions in individual cases. It is very important that a psychiatrist is also psychologically aware and the psychologist also knows the limitations of psychology and must refer for medical therapy when needed. I suppose, instead of perceiving these two areas of concern separately, I would rather recommend a development of a system promoting psychologist and psychiatrist to work as a team, so that they can refer the patient to each other as and when required. But in general, psychotic disorders dealing with delusion and hallucination, definitely need medical therapy. Severe depression and suicidal ideation also need medical therapy. And as I said before, for adjustment disorders, behavioural issue, anger or impulsive issues I think both psychologist and psychiatrist can help, but a psychologist will be more helpful because it is a more behavioural manifestation rather than a chemical disorder in the brain.

Golden Cauldron: As you may be aware sir, recently, after the SSR case, people are talking a lot about suicide prevention and mental health in general. A lot many have come up in their social profiles, saying they are available for people to confide in. But I suppose, for those who are undergoing depression, anxiety issues or similar conditions, it becomes very difficult to open up or confide in someone. How do you suggest then, those who are willing to help, can actually help people in need of it?

Dr. Guha Thakurta: Yes, I think the most important way to be for the other person, is to be available for help, but not necessarily become a therapist. For instance, suppose I am not a doctor and someone calls me informing he or she is having chest pain. What should be my immediate action? I’ll reassure that I am coming in a minute, I’ll call the ambulance and I shall take care of the fact that the person is at once presented to a medical facility where chest pain can be treated. The point is, it is definitely good to have people around with psychological awareness, who assures their availability to us. But one think should be very clear, that people who are not professionally trained should never start their own hypothetical therapy. That can be disastrous. The non-structured counselling we tend to do with friends and close ones is not the therapeutic counselling. Letting the person know that it is okay to feel the way he or she feels, it’s okay to be depressed, reassuring his or her support and presence to the other person are very important. But then accompanying the person to a mental health facility is the right thing to do, instead of giving personalised therapy.

Golden Cauldron: Sir, do you feel that a preliminary mental health training is necessary for everyone at every work place and educational institutions?

Dr. Guha Thakurta: Of course! Of course! It is the need of the hour. It is not a luxury, but a necessary thing to do. It has to be understood that we are spending at least of six to eight hours per day, that also five to six days a week for a long period of our life, at our work place or educational institutes. Therefore, the work place becomes the next or second next place after our home, where we spend a large part of our lives. The quality of our lives depends not only on the environment we are living in, but also extremely on the inter-personal cooperation and empathetic relationships that we have with the people around us. So, on one hand, where family and understanding of the family members are important, on the other, it is of absolute importance that we are well acquainted with our work place colleagues, understand them and be empathetic towards them. This may not come spontaneously for many, so there is no harm in introducing some forms of workshops from time to time to orient them to and identify mental health issues and help them to intervene properly.

Golden Cauldron: Sir, now with your permission I shall move to my questions on LGBTQ Community.

Dr. Guha Thakurta: Yes, sure.

Golden Cauldron: First, I would like to ask, have you seen a better rate of acceptance of the identities of LGBTQ people, by themselves as well as by others, after the decriminalization of Section 377 in September 2018?

Dr. Guha Thakurta: (After thinking for a few seconds) In a way yes, in a way no also. See, as I was telling before as well, social change is a very slow process and it doesn’t happen right after the legislative change. One thing we all need to understand is, it is not the presence of Section 377 that alone was preventing the coming out of gay individuals. There were many other attributes working; for instance, the whole colonial hangover of the Victorian moral teachings of a sexless life, connecting virginity with purity of character, seeing sexuality under a vulgar light, considering anything other than heteronormativity as abnormal- these were, well a by-product of 377, no doubt, but were not directly associated with 377. Even when 377 is read down, many people cannot talk about homosexuality in their family. Maybe it is not only a law, but the long-term stigma that the law enhances, that prohibits people to live their lives freely and with dignity. But having said that, when at least the law is supportive and considerate of basic human rights of each individual, one advantage you have is, in troublesome situations, you know that you can move to the court for support. Yes, indeed people are coming out, but you know, I have witnessed several unpleasant incidents during this time as well. When, after 2011 the Delhi High Court read down 377, then a number of people became vocal of their identities. But when it was followed by 2013’s verdict of reenforcing 377, they were in a dilemma. So, when finally in 2018 it was finally read down in a wonderful way, many people are still afraid of what the Government is going to do with this particular act. So…yeah, in general the acceptance is increasing but I think that is increasing steadily from 1990s to 2020 through the series of cultural and legal activism that has taken place, through various publications, visibility in the media in a positive light- from being a character of caricature to a character of substance, there has been a cultural transition no doubt. These do influence the mindset of a society regarding a particular issue.

Golden Cauldron: The very notion of calling heterosexual people as “straight”, applying a sense of normality and others as “queer”, which loosely translates into “something odd or strange”, even being used in institutional disciplines as “queer study”- what is your response towards such a practice?

Dr. Guha Thakurta: If you see the history of the word “queer”, and this is true for many similar such words as well, the word “queer” has been reclaimed. Reclamation is one very interesting approach which history has witnessed again and again. It is a process where a particular word, that was used in a derogatory way to refer to a community, has been claimed back by the members of the same community with pride and thrown on the face of the main stream society. This is the cultural significance of reclamation. To give you an example; women, who dress not in the so-called conventional way as our patriarchal society dictates, have been traditionally seen as immoral, and are called sluts. But now we see there is a walk called “slut walk”, where everyone, irrespective of any gender, dress in weird fashion senses, reinforcing that “my identity does not reside in my dress.” Therefore, calling that person slut, makes no difference to that individual. Rather the word slut is being changed into a word of pride with positive connotation of being proud to carry oneself the way they want. Similarly, the word “queer” which was initially used to represent odd or strange behaviour, was reclaimed after the first pride march of 1969, in New York, which was the first pride of Stonewall riots. Gradually this word came into the urban vocabulary in a very positive sense. Now, when words like “queer studies” or “queer literature” are used in their reclaimed form, not associating it with the older meaning.

Golden Cauldron: We are so familiar with specific gender binaries, that even while talking about someone who doesn’t believe in such binaries, we tend to form a certain definition or structure, to suit our comfort. How do you perceive this need of categorising everyone when gender identity comes into question?

Dr. Guha Thakurta: You know, gender is the preferred role that we desire in terms of the stereotypes of masculinity and femininity, in a society, in a given point of time. It can vary- it maybe masculine, feminine, non-conformitive or it can be even of my own type. There is a wonderful saying that there are as many genders in the world, as many people there are; because everyone represents a different permutation-combination of various traits of humanity. No two people are exactly identical. Therefore, there should be as many gender expressions as many numbers of people there are on earth. So, yes, I personally do not believe the binary model of gender, which itself is a very hetero-normative model, where the concept mainly relies on the male-female paradigm. Considering male and female as only two parts of the spectrum is an easier way to look at it rather than viewing it as two sides of a coin.

Golden Cauldron: Do you feel sir, that the awareness and acceptance regarding both the issues of our discussion today- importance of mental health and LGBTQ Community, are anyhow limited to a certain class of people or profession?

Dr. Guha Thakurta: Well, I used to think in this way, but my ideas thoroughly changed when I started working at the community level. My idea initially was that one needs some kind of exposure or formal education in order to be sensitized to an issue. However, very surprisingly I have seen that it is those formally educated people who have enough vocabulary and social skills to hide their phobia as well. Thus, I feel there is no co-relation between the amount of formal education one receives and the amount of empathy or acceptance you develop for others. On the other hand, I have also seen equally phobic, stigmatised as well as accepting individuals in those classes of people who are unfortunate to receive a particular kind of education or do not live a particular socio-economic status. Hence, I personally feel that it is everywhere. Having said that, in the community, where the primal instincts are of survival, where there is much less luxury, less entertainment, where there is more a struggle for existence, for food and shelter; sexuality is more celebrated as one of those basic needs, and therefore the discrimination becomes much less. Of course, discriminations are there, but in some other grounds maybe. So, I have never experienced this kind of a corelation between class or socio-economic status and acceptance. I have seen the apparently educated people being extremely ignorant and homophobic, as well as accepting and again I have encountered people without any privilege, being accepting, at the same time being phobic.

Golden Cauldron: Recently, the Delhi High Court was told by the centre that our values doesn’t recognise same-sex marriage. Standing at the present time, even after decriminalization of section 377, what do you have to say regarding such comments?

Dr. Guha Thakurta: This is totally an uneducated comment. If you know about your own culture and civilization, you would know that India was a country where sexuality was celebrated in all forms. It is the advent of the Victorian culture and British colonialism, particularly post 1857, when the anti-sodomy laws were gradually implemented in various colonies, which became the IPC 377 in India. Even the British literature of the preceding age was highly discriminatory towards homosexuality and same sex love. If you research well, you will find out that homophobia is a western construct and not homosexuality. While these are all true, there is something else that needs to be said. Even if something existed in the past, it is not necessary that it has to continue and if certain things did not exist before, it is not obligatory that it cannot exist now. This is a wrong use of History. History talks to us about what has happened as an anecdotal evidence. It does not justify the rightness or wrongness of something. Citing that homosexually existed in India and that is why it should exist now is a very wrong use of History. Well, Sati also existed in India. Then, is that supposed to exist now? The validity of any opinion should depend on parliamentary debate, on science, law and ethics. It may cite History for reference, but it should never become the guiding factor for the existence or non-existence of any practice.