The recent Bollywood release Chichore may have been dismissed as a clichéd story. But its theme – depression among school and college students – is becoming a serious issue, especially in big cities like Mumbai.

India has one of the highest suicide rates in the world among youth in the 15-29 age group and depression is one key cause for this. Though media did report two recent incidents, that of a 24 year old student, from Assam studying at the School of Architecture and Planning (SPA) who committed suicide due to mental pressure and that of a 29-year-old student of medical college in Tamil Nadu allegedly due to overwork pressure, such incidents have now become routine news and get little media coverage.

A changing world

Today’s millennials have to navigate complex realities and challenges arising from globalisation, rapid urbanisation, change in the social fabric and technological change. Apart from academic pressure, self-image and sense of worth among students are threatened by social media, declining peer to peer relationships, shift to a nuclear family environment and migration. Earlier, when mobile phones weren’t that common, children used to go out more often and play with other kids, which meant more peer interaction. And in a joint family system, there was always some elder present to cater to the youngster’s emotional needs.

“If children’s emotional needs are not met, it shows up in their behaviour and academics,” said Meena Saldanha, principal of Don Bosco International School, Matunga. A combination of these factors along with the stigma attached to admitting mental health issues has led to an increase in mental morbidities (physical and psychological deterioration due to mental condition) amongst youngsters.

A study conducted by NIMHANS in Bangalore revealed that one out of five adolescents suffers from mental morbidity in India. Mental morbidities have both physical and psychological outcomes, which include mood disorders, panic attacks, depression, anxiety and eating disorders, to name a few which in turn cause suicidal tendencies.

BMC initiative to help students

Realising the severity and urgency of the problem, the Brihanmumbai Municipal Corporation (BMC) has launched ‘Smiling Schools Project’ which was launched on September 16th. “A student from a municipal school committed suicide which prompted us to begin this programme as soon as possible,” said Mahesh Palkar, BMC education officer. The project aims to reach out to 150 schools in the first year.

Under the programme, principals and teachers will be trained to identify a student facing mental or emotional distress. These students will be then given access to free counselling. Issues like bullying, stress coping mechanisms, peer to peer relationships, emotion regulation and self-care will be emphasised.

“Training teachers is of foremost importance as they are main point of contacts for students,” Palkar added.

The programme is expected to benefit 12,000 students in the first year and over three lakh students in the next five years. It will primarily be run by non-profit organisation Project Mumbai along with TISS, mental health professionals, other NGOs, and the BMC.

Shishir Joshi, CEO and founder of Project Mumbai, told The Hindu that mental wellness is a growing concern and this initiative will help mental health become a part of everyday conversation. The awareness aims to destigmatize it so that teachers, students and parents can accept it and take remedial steps. This will enable positive growth of students.

Overcoming social stigma

However, the programme needs to incorporate social factors in its domain. In a research paper titled “Health behaviours and problems among young people in India: Cause for concern & call for action”, published in the Indian Journal of Medical Research, researcher Sunitha Singh wrote:

“Most problems students face are linked with social determinants and lifestyles operating and interacting in complex environments that precipitate or trigger these conditions or behaviours. In India’s scenario, one of the main restrictions is the stigma surrounding mental health”.

“It is hard for parents to accept that their child is going through a mental health issue,” said Meena Saldanha. “In our school we counsel parents too. We have to explain that it is a health condition. Many of them come back and make appointments.” While children can have a holistic environment at school, it is important that they have a support system at home too.

“Nobody feels their child has a problem,” added Mahesh Palkar. “So, we will try to make parents understand that it is a health concern, so that it is easier for them to accept their child’s problem.” However, to enable parents and children to ask for help, the programme will have to include community drives at the mass level to change perceptions about mental health.

A yawning gap between demand and supply

For now, BMC has said that 50 counsellors will be trained and will work with 12,000 students in the first year, a ratio of 1:240. There is thus reason for concern as counsellors themselves may face burnout. The country’s mental health infrastructure is not equipped to deal with the increasing cases of teen depression.

According to data from the Union Ministry of Health and Family Welfare, India has only 3,500 qualified psychiatrists against a need of 10,000. With regard to other mental health professionals, such as clinical psychologists and psychiatric social workers, the ratio is even bleaker. While the BMC project will help students who have been diagnosed to get clinical help at government hospitals, it is unclear how this will work effectively in reality, given the poor resources and facilities available in many government hospitals. With a budget of just Rs 73 lakh for the project, BMC hasn’t mentioned any specific amount to be utilised to improve or create new mental health infrastructure.

Holistic solutions are essential

The major challenges that students face, which this programme will need to take into account, comes from the changing social fabric and the impact of digitisation. More families going nuclear, with both parents working, tends to create their own conflicts which their children become part of, adding to their mental stress. It is not that parents should be blamed but given the changing social dynamics, students today don’t have anyone to interact with or share their problems post-school.

“Most parents are working and have little time to address their children’s woes,” said Saldanha, “And with 24×7 access to internet, students are more prone to cyber bullying and manipulation of self-image. There is an increased sense of loneliness among these youngsters”.

While providing support at school is important, it is unlikely to have a holistic impact unless family conflicts and dynamics are simultaneously addressed.