By Arunima Rajan

In an interview with Arunima Rajan, Akash Lanka, a psychiatrist at Kauvery Hospital, says that the shortage of mental health professionals and limited access to care will persist unless psychiatrists are regarded on the same pedestal as surgeons.

Akash Lanka, consultant psychiatrist, Kauvery Hospital, Bengaluru says that compared to the last 20–30 years, people are more aware about mental health issues. They are more interested in getting help for mental health issues. “People also use words in a blank sense. People use terms like they are depressed when they feel low, or they panic and say they have anxiety. There is a bit of both; there is more awareness. The current generation faces burnout, which their parents give them because they give advice that is not relevant to them. Earlier, the economy was better, with difficulty in procuring jobs and settling. Compared to the current generation, even though they have many more degrees, they tend to struggle to get decent jobs. The awareness in the current generation is much more because of lack of stability. Also, people have the facility to use the internet for minor and major disturbances they are facing. They know when they need to meet a professional for help. They also google a lot and often reach the worst possible conclusions, which ends up worsening the conditions they are having. We see many people trying to get validation from AI. People end up taking their lives as well, which is a threat to themselves and other people. So, there are pros and cons in how people approach mental health,” he explains.

Helplines offer Anonymity and Accessibility

Moving from awareness to support systems, Lanka points out that the bottom line is initiatives which government are taking are helping. “There are helplines for individuals who need help and feel embarrassed to discuss with those they know, and initiatives like Tele Manas allow them some anonymity, and that helps. It is also more accessible. We need more professionals and volunteers for helpline numbers, but funding matters,” he adds.

At the same time, he warns that shortage of mental health professionals is a problem that may last forever. “If we see the medical field, psychiatry is one of the lesser favoured specialties. Medical students usually prefer general medicine or surgery. There is a deficit due to lack of interest among society. Psychiatrists are asked, why did you end up taking psychiatry. But no one asks that question to a surgeon, they would rather be in awe. They even end up asking, are you able to read our minds. There are so many misconceptions among individuals. There is stigma associated with the field,” adds the young healthcare professional.

Data deficit in Mental Health

Adding to these challenges, research that we rely on is data from outside the country. There is a data deficit because many cases are underreported. Maybe only 5 percent of cases are reported. Many families do not approach hospitals because of stigma.

The Debate about Psychiatric Medication

Turning to treatment practices, he adds that it is a known fact that medication makes you drowsy. One of the known side effects is sedation. Many individuals do not consider the fact that it depends on the dose and the type of condition. Patients do not look at the risk and benefit ratio. If there is more benefit, that is when doctors prescribe something. If patients are closer to diabetes or asthma, we look at these aspects. The addictive property is also a concern among individuals. Many do not go for reviews for several years for sleep disorders, and then they get addicted. If they had come to a psychiatrist, the doctor would have told them, but they would not have gone to an expert.

Why in Person Care Matters

Speaking about technology and its limits, he says, “Continuity of care can be challenging in such cases. I would not say never trust technology. There should be regulations to monitor it, and if it is approved by a governing body, then it is acceptable to use. But it's always better to meet a professional in person. People might get some validation from an online entity. It's different receiving advice from a person. Some of my patients prefer meeting in person because they feel heard, they don't even like online consultation.”

Influencers and Mental Health

On the influence of social media he adds, “It’s a good thing that influencers talk about mental health issues online. Individuals will feel validated and become more aware. They realise that mental health struggles are something many go through. Instead of being called mad or stupid, they will feel more validated. There are good things that influencers can do. There is also a risk of spreading misinformation. It is also important to give accurate information. It is important to have some bit of regulation, but not to the extent that the voices are curbed.”

Adolescent Mental Health

The mental health of children and adolescents, Lanka notes, deserves equal attention. “Around 50–60 years ago, there were ten children in a household and they never got any attention, but kids would be supportive of each other. Today, there is increased awareness and care, but it is more in the middle socio-economic sector. There is also carelessness. The reported incidence of autism has increased, though part of this may be due to better recognition and diagnosis. Parents often hand out their mobile phones so that children stay quiet in public settings, not realising that excessive screen exposure can affect development. ADHD is often dismissed as children being naughty. Neglect also leads to substance abuse, with children picking up smoking or some gateway drug at a young age. Today, parents are usually busy, whereas back then at least one parent was present,” he concludes.

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