Covid-19 Has Been An Unprecedented Episode In All Our Lives: Dr Samir Parikh

Dr Samir Parikh, Author, Eminent Psychiatrist, Director, Department of Mental Health and Behavioural Science, Fortis Healthcare in conversation with Dr. Annurag Batra, Chairman and Editor-in-Chief, BW Businessworld and Exchange4media , about his books in association with Rupa Publications and how Covid-19 has impacted the mental health sector.

Dr Samir Parikh feels the sheer task of going through Covid-19 and doing what one is supposed to do is a big job at hand. It is always frankly being all about work he feels. 

You have been in this field for more than 20 years, what is the change you notice when people talk about mental health as earlier it was a taboo to say ‘I am going to a Psychologist’. In the olden days people would say this person is mad. So how has the mindset changed? 
To be honest, yes there has been change, it will be unfair to say that we haven’t changed but it will be equally unfair to say that we don’t have a very long way to go. Even today we have a lot of stigma. Even today the portrayal has ranged from comedy, to violence, to psychopathy and crime but the sensitivity and research has not been convinced. I think our struggle as a country has also been the number of experts continue to be low. Broadly speaking we have a 800% shortage of all mental experts who put together as in psychiatrists, psychologists, counselors, social worker, clinical side we put all that together. Most of this population is in the urban cities. As you go away from urban India to rural India this expert density becomes lesser and lesser, which is where the challenge continues. Another thing is, I still feel that as schools and educational institutions have started imbibing mental health as a part of what they do, whether it is life skills, whether it is counselors, I still feel that India has to do a lot more.

How will this change? You mentioned that we are less in capacity by 800%. So why do less people choose to be mental health experts when there is so much need? What does society need to do, as parents, citizens etc.?
It is not that people don’t choose but in a medical college you have x number of seats allocated for each branch, so the number of seats and the deficit and how many years will it take for the deficit, that is where the challenge is. Similarly, in psychology the number of places where clinical psychology is available, the seats are not enough. I think that is one aspect. Also, deficit is one thing but people coming for help is another thing. That gap needs to be bridged. Only way that can happen is consistent conversations through media, making sure that incorrect myth, discrimination and judgmentalism gets stopped. Organisational visions need to include mental health outcome, where school and other educational institutes start looking at mental health curriculums and give life skills, empowerment for life skills in children, role models of the society need to speak about mental health.

Is there a toolkit, checklist, playbook about mental health and how does one find out that one has depression?
Depression is the single largest illness in the world. According to WHO 300 million people in the world suffer from depression. Depression happens by essentially when you are looking at a chemical imbalance and how do you identify sadness of mood, loss of interest, loss of pleasure, effect on sleep, effect on appetite, concentration issues, fatigue, feeling hopeless, helpless, worthless, feeling that life is not worth living. Some of these symptoms could trigger consistently over a two week period in time and this could be depression and if you feel that is happening to a colleague, a family member or a friend is having these symptoms, encourage them. They should go and meet someone starting with a psychologist, starting with a psychiatrist, starting with pills, but most importantly, start. I think that is the key aspect and depression is curable like any other illness. Coming to the mental health playbook, I think it comes down to the balance of life.

As a result of these uncertain times are you getting a lot of new cases, especially of fear and anxiety, panic disorders and would you advise medication or counseling? 
I don’t think it can as simple as that answer. One needs to be very clear about it, if you are diagnosing somebody with a panic disorder or some kind of an anxiety disorder and it fulfils the criteria of an illness then based on the severity you will decide whether the person requires counseling and psychotherapy or medication or both. That is one component. The second aspect is that are there an increased number of people been expressing stress and anxiety? The answer to that is yes. I do accept that stress, anxiety and it’s manifestations have increased by and large in these times but also which does not mean illnesses have increased.