Columns Indian Scenario

Hidden in plain sight: A mental health crisis in academia (Part 2)

Debdutta Paul, Annapoorna P K & Shreya Ghosh

While the importance of addressing mental health concerns within academic circles has been recognized time and again, progress has been hampered due to many factors, not the least of which is a paucity of data. This article is the second in a two-part series where we will examine the status of mental health awareness within Indian academia and discuss possible strategies and interventions to improve the situation. Part 1 can be read here.

Mental Health Survey2

In the first part of this article, we delved into the status of mental health-related awareness and the primary causes of mental health concerns in Indian academia. Based on a survey of 883 academics from across the country as well as direct interviews with researchers from 31 different institutes and universities, we identified several common factors associated with mental health issues, including biased hierarchical power structures, lack of work-life balance, unrealistic standards for success, and lack of job security.

Our findings suggest that a major driver of the high incidence of mental health-related issues in Indian academia is a general lack of awareness about mental well-being, coupled with an acceptance of poor mental health as the norm.

Many academicians appear to accept that the high output required to maintain competitive academic activity may be achieved only with a generally poor state of mental health. Consequently, mental health issues tend to be neither talked about openly nor taken seriously. This, in turn, gets reflected in the infrastructural and systemic frameworks of mental health support, which are often inadequate to combat the depth and pervasiveness of these issues.

In this article, we will review the results of our survey on the availability of mental health services on Indian academic campuses. We will also list a set of recommendations generated on the basis of the survey, that may be adopted and applied by academic institutions at all levels.

As a part of the survey, we asked the question, Does your Institution/​University provide counselling services to its students and staff?’ While 58% of the respondents answered in the affirmative, the answers to this question from different individuals in the same institutions or universities contradicted each other in a number of cases. This implied that even when counselling/​therapy services are available, knowledge about them may not be universally available to those working at these institutes.

To those who mentioned that counselling services were available in their institute/​university, we also asked if information about these services is easily accessible. 19% voted in the negative, suggesting that a good fraction of institutes did not advertise the available services adequately.

When we asked the survey respondents whether, on a whole, they find the mental health support systems at their institution/​university to be adequate, only 32% answered in the affirmative. However, when we asked whether they know whom to contact in case of a mental health crisis, 57% of the respondents said yes. This suggests that while the majority of respondents may not be placing their full reliance on campus counselling services, they do have an idea of where to obtain help in the case of an emergency.

We next sought to understand the quality of such mental health services, as reported by our survey respondents who indicated that mental health services were available on their campuses. According to the answers provided in the survey, only in about 48% of the cases did a counsellor visit the campus more than three days a week. In 31% of the cases, only a single counsellor was available to deal with the concerns of the entire population of the institute. It is possible that such restricted hours and increased workloads would affect the quality of the services, as well as the level of trust that academics put in these services.

What is also striking is the high percentage of respondents (up to 53%) who admitted that they were not well-informed about the details of the services (i.e. who answered I don’t know” to the questions above). This also points to a scenario in which the numbers don’t tell the full story. Even when an institute provides mental health-related support structures, lack of clear communication and orientation of campus members towards these services can keep academics from taking full advantage of them.

From our interviews conducted on the target group, we found that sometimes, availing the facilities on the campus is not perceived as safe exercise. Some of the interviewees alleged that the anonymity of the services was sometimes violated and details of private conversations were revealed to those higher up in the academic hierarchy. Another interviewee mentioned that their pleas to have a regularly functioning counselling service in their institution have been ignored.

In view of the above data and insights, we have put together a list of recommendations to improve the status of mental health in our academic institutions. In making these recommendations, we have also drawn from crowdsourced suggestions collected from both the survey and interviews.

Acknowledge, identify, and investigate

The first step must be to acknowledge that there is indeed a problem, followed by a sincere attempt to understand why. There need to be more studies enquiring into the state of mental health on our campuses and identifying the factors most closely linked to mental health-associated challenges. It is likely that these would vary in form and severity from region to region and community to community, making it imperative that the studies are conducted at small (e.g. at department level), medium (e.g. at institute level) or large (e.g. state or national level) scales.

Strategise for better management of mental health crises

43% of the respondents to our survey said they didn’t know whom to contact in case of a mental health emergency. This points to a concerning gap that institutions and universities should take immediate steps to address. Some ways in which this can be done are:

  • A core team of volunteers can be set up who can help direct individuals who require counselling or treatment.
  • A set of faculty members can be identified who can volunteer to provide first-point-of-contact counselling to students.
  • Information regarding 247 helplines or counselling services (telephonic or online) should be made available to everyone on the campus. This should ideally be advertised and displayed prominently, through posters, leaflets, handbooks, and the institute’s website.
  • Members of faculty who advise students can be provided sensitisation and mentorship training and encouraged to maintain an approachable relationship with their students and other lab or academic members.

Improve mental health support facilities

Our data indicate that the present level of mental health support available on the majority of our institute and university campuses is inadequate to meet the needs of researchers, staff, and students who work there. This calls for steps to ensure more and better support facilities, perhaps using some of the institutes and universities that appear to be serving their communities well in this regard, as models. Here are some ways in which this can be achieved:

  • Regular mental health awareness sessions in the form of seminars or workshops should be held. Proactive steps should be taken to ensure that information about such services is easily accessible and available to everyone working on campus.
  • Steps should be taken to ensure that on-campus mental health support is inclusive: students, postdoctoral researchers, temporary/​permanent staff, and members of the faculty should all be able to freely access the services of the support cell.
  • On-campus counsellors should be trained and vetted properly. Highest standards of patient confidentiality should be maintained during all interactions. It is also suggested that the support service be situated in a location which allows visitors to retain their anonymity. While seeking help to manage one’s mental health is something that need not be hidden, owing to the unfortunate, unhealthy judgement that this tends to receive, several people may not be comfortable sharing this information and may be discouraged from seeking help if forced to do so in a public manner.
  • Given the limitations of on-campus services, regular tie-ups with external counselling options should be made, to which individuals in need of long-term therapy can be referred. The costs of these sessions should be borne by the institutions as a part of the regular medical coverage.
  • Informal sessions about mental health within smaller groups should be encouraged, along with setting up and maintaining active and independent community support systems and peer support groups. Setting up an online forum where students can talk freely about their issues, possibly within the institute, could also be considered.
  • Finally, steps should be taken to promote therapy and counselling as ways to achieve general mental well-being, and not simply as solutions to severe mental illnesses. This can also help in reducing the stigma around seeking help for mental health issues.

Address the root causes of mental health problems

While addressing mental health-related issues is a necessary step, it is also important to look at the structural or systemic problems that give rise to these challenges in the first place. Based on the results of our survey, we suggest focused efforts in the following areas.

  • More balanced student-advisor relationships: Students should have access to mentorship from multiple faculty members, either in the form of a thesis committee or an equivalent provision, to avoid a power structure with a single point of focus. Advisors and principal investigators should be trained on student wellness in general, and mental health-related awareness and problems in particular. Rules of professional conduct should be spelt out and followed strictly. A system of independent, anonymous feedback on advisors by students which is reviewed and acted upon would also help in this regard.
  • Greater awareness about mental health within academicians in positions of authority: Researchers should take steps to educate themselves about mental health and receive training in dealing with such issues in a sensitive, professional, and transparent manner.
  • Better complaint redressal systems: This would ensure a stronger safety net for those facing untenable situations and circumstances, and help improve conditions.
  • More transparent and fair evaluation systems for academic success: More holistic criteria for evaluating academic performance should be adapted at all levels, from student assessments to tenure decisions.
  • Mechanisms for continuous assessment, review, and improvement of mental health services: One way to achieve this is an independent mental health advisory committee that regularly meets with faculty and administrators to determine gaps in support and ways to address them. Collection of anonymous and open feedback from those who use the mental health services should also be encouraged.

Provide long-term solutions

Finally, we acknowledge that these problems do not exist in a vacuum and are influenced by the overall socio-cultural fabric of our communities. Proactive steps to eliminate social (religious, gender, caste, class, etc.) and economic biases will go a long way towards reducing the burden of mental health challenges. Improved infrastructure, including better living conditions and remuneration for those lower in the academic hierarchy, would also help in this regard. Other steps can be to proactively encourage extra-academic activities, provide better facilities directed at improving work-life balance (e.g. day-care and parental leave) and to challenge prevalent assumptions about how the ideal academic’ should look, act, and behave.

To summarise, while our study brings to light several challenges in relation to the mental health situation in Indian academia, it also provides us with an understanding of certain key areas where focused effort may pay large dividends. We hope that this will begin a continuing dialogue and discussion on mental well-being on our campuses and encourage institutes and individuals to step up with efforts to address these issues.