Money or stigma: What keeps you away from mental health treatment?

“Get help”, “consult a professional”, “mental health treatment is a must”: these are the few advices making rounds on social media following actor Sushant Singh Rajput’s tragic death by suicide last Sunday. While the much needed conversation on mental health is now being acknowledged in the country, it is time we also look at how affordable mental health treatment really is.

Preethika Palani, who’s been dealing with anxiety for over a year now, is yet to seek professional help. Asked why, she blames the exorbitant fees charged by psychologists.

“The therapy charges per session were high everywhere I enquired. It will cost you anywhere between ₹1,000-5,000 per session, depending on your condition. How can it be so expensive? It’s like mental health is just for the rich,” she says.

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Six months ago, Preethika also wanted her father, who was dealing with mental health issues, to see a therapist. But he backed out seeing the charges.

While working professionals can still afford the treatment expenses, it’s burdening for the younger lot. “It’s not that we cannot afford the treatment, but it is also true that it is very expensive. But coming to younger people, they consider high costs a reason not to get help. It is a concern when money becomes an inhibiting factor,” says Suhasini, an IT professional who is now undergoing therapy. She says consulting a psychologist and psychiatrist together will cost a lot.

However, psychologists don’t agree to the fact that mental health treatment is expensive. Dr Anupa, a senior psychologist based in Delhi, says the rates are very reasonable compared to western countries.

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“I don’t think charges are very expensive. Youngsters working in big MNCs spend ₹2,000-3,000 on dining outside. But for mental health, they don’t want to roll out money. This is an exhausting profession; we will be charging money,” she adds.

When asked if the counselling fees should come down, Akshata*, a psychologist based in Mumbai, says, “Reducing rates is not the solution. The government’s directives for mental healthcare should be made more holistic. There isn’t even a governing body for counsellors. More colleges and courses need to be brought in the syllabus. We need more specialists for our existing population.”

Dearth of quality and quantity

As India is heading towards a major mental health crisis, there is also a huge dearth of mental health professionals in the country with an estimated number of only 0.047 trained psychologists per 1,00,000 people who are in need of mental healthcare, reports Outlook.

“There is a complete dearth of psychologists in our country. In the US, it is mandatory for schools to have in-house counsellors. Here, most of the schools don’t,” says Dr Mini Rao, a psychologist.

Mental health treatment is far different from physical health treatment, especially when it comes to counselling. One cannot find the right therapist in their first attempt. Suhasini had to look around for years to find the right therapists for her.

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“Even if you find therapists who charge less, they are not of great quality. Also, sometimes the expensive ones do more harm than good, actually. To find the right one it takes years. You have to keep going to new psychiatrists and tell your story all over again. It is very exhausting, which is another reason why people don’t go for such therapies,” she says.

“How equipped are psychologists in our country?” asks Tabish Ahmed, a peer counsellor based in Delhi. Talking about the sensitivity of handling issues, he says that many therapists are not qualified to handle issues related to sexual orientation, ghosting, etc.

One needs to do proper research before going for therapy. “Counsellors with six months’ diploma are very dangerous. They don’t have the expertise to counsel. That scares me. Nowadays, anyone is becoming a certified counsellor. If you ask me, they will cause more harm. People should do their homework before going for counselling,” says Rao.

Do free helpline numbers help?

Plenty of suicide and depression helpline numbers are being circulated widely on social media platforms, but one doesn’t know their qualifications and efficiency.

Aditi Ghatole, a Mumbai-based counsellor who is currently providing free therapy sessions amid COVID-19 crisis, says, “Talking about helpline numbers, they will work as much as they are paid. Pay them well. There is a lot of effort that goes into sessions. These volunteers who attend calls are trained for a short period of time. But I don’t have data on how good or bad the helplines are, its just there are very few helplines available”

Aditi, who also works for the NGO ‘Aarambh’, says that there are only a few NGOS who train their volunteers really well.

She, however, feels that helpline numbers or any first aid services should be well funded and backed by the government.

Hello people!
I am a Trauma informed Counsellor with experience in the field of Sexual abuse.
I am working Pro-bono for anyone who is living with depression and anxiety & can't afford therapy. If you're in urgent need of therapy pls dm here or mail me at aditigha@gmail.com.

— Aditi ghatole (@adtgha) June 14, 2020

Money or stigma?

Mental health treatment is yet to be mainstreamed in a country like India which regards it more like an embarrassment. Not just the less educated or the less aware, it is the same even among the millennial and the educated crowd.

“Most importantly, to tell yourself that you need to go to a therapist; in that itself I am noticing a lot of stigma. Many times people don’t tell their friends that they are seeking help as they may think it shows vulnerability,” says Suhasini.

Is it just the high costs that keep people away for mental health treatment? Dr Rao doesn’t think so. “It’s not even about money. It’s still the stigma. People still think crazies, lunatics go to psychologists. My patients don’t want to be seen walking into my clinic. Such is the embarrassment. Parents are also a problem because they are so ashamed of their kids getting treatment. Youngsters come without their parents’ knowledge. I want it to become as normal as going to physical doctors,” says Dr Rao.

(Please reach out to a mental health specialist if you need support or know someone who does. Helplines: AASRA: +91 98204 66726; SAHAI: 080 25497777)