Bad influences: On the Santoshi Shetty row, and damaging perceptions about mental healthcare in India

There is a long way to go until reliable mental health treatments including psychotherapy and medication are de-stigmatised. But if we keep blurring the boundaries of expertise, we might just be taking a step backwards.

Prateek Sharma July 10, 2020 10:42:15 IST
Bad influences: On the Santoshi Shetty row, and damaging perceptions about mental healthcare in India

Social media has emerged as a necessary space to initiate discussions around mental health — a space where mental health professionals, activists, people with lived experiences, and the general public can participate in the ever-growing and dynamic discourse. India has witnessed a rise in such discussions, ranging from dissipating the stigma and understanding mental healthcare to raising concerns over human rights, ethics and discrimination in the field. As important as this surge is, it has also indirectly blurred the lines between professional practice and personal opinions driving unqualified people to pose as experts offering mental health ‘services’.

A recent example of this hazard came up when an Indian fashion blogger, Santoshi Shetty, allegedly attempted to offer one-to-one sessions of ‘positivity’, charging Rs 1,500. What began as an Instagram post about self-care and her personal journey soon turned into an offer of paid professional help, for which Shetty received enormous flak. Social media users called her out for being unqualified, and insensitive for posing as an expert on mental health in addition to monetising what appeared to be friendly support. The outrage worked and the blogger pulled down the video, offering an apology for the same.

This is not the first or the last time someone on social media has attempted to pose as an expert on matters they may not understand outside their own experience. While these may be well-intentioned, it is crucial to understand the extent to which such propositions can influence the existing mental healthcare community and the idea of awareness that is slowly but steadily picking up in the country.

“I did my Master's in Counselling Psychology from TISS and after five years I started my practice as a counsellor at a very minimal rate and reduced it further during the lockdown. The effort and toll that it takes is far beyond the money,” says Chaitali Ipar, a counselling psychologist based in Nasik. “Professionals — usually with a doctoral degree or enough experience charge around Rs 1,500 — and that too on sliding scales. But it is not just about the fee; mental health services need to be full time jobs for professionals and not influencers or motivational speakers.”

Ipar believes that people who may need therapy also find it difficult to talk to a complete stranger and hence a known public figure who appears happy and successful on social media may easily deceive people into seeking help from them. “There's a stigma attached to the word, 'therapist’ driving people to rather seek help from a yoga instructor or a life coach. As much as we love and are curious about the field of psychology, we are scared to approach a trained professional as that gives an idea that the person was too weak to work on their own problems.”

Indians are only gradually learning about how mental healthcare works parallely and hand-in-hand with the field of medicine, not just in terms of the nature of psychological issues but also what it takes to become a professional.

Nikita Sulay, an MPhil trainee in Clinical Psychology notes that “psychotherapy or mental healthcare in general are spoken of so loosely [in India] that people think anyone can start doing it". "I have invested nine years of my life studying and training in Clinical Psychology. There are lots of theories and concepts that I am still trying to grasp. One needs to have a thorough knowledge of mental health issues, psychological assessments, different modalities of therapy and biological implications,” Sulay says.

To become a clinical psychologist in India one needs to acquire an MPhil degree recognised by the Rehabilitation Council of India (RCI) which requires two years of rigorous hospital-based training. One can also practice as a counselling psychologist with a Master's degree and a specialisation but that itself is not enough in the absence of experience and training.

Sulay says that while her education familiarised her with the varying degrees of mental health conditions such as obsessive compulsive disorder, depression, schizophrenia, anxiety disorders etc., the research and clinical supervision that were part of her training ensured she was always learning something new. "So when I come across posts where unqualified people are offering mental health advice or even therapy it causes resentment but at the same time, I feel concerned about the state of awareness people have,” she says.

Generosity may be at the heart of people offering to keep their DMs on social media platforms open for others to reach out for help, but there is an ethical responsibility that is often overlooked in such moves. Following a trend — “to be there for someone” — without understanding the dynamics of mental health support can further diminish hope for people who, amidst vulnerability, choose to break barriers of stigma and seek help.

“Alongside theoretical knowledge and skills, we pursue an ethical framework, a holistic and inclusive lens to work. Since all mental health experiences are different from one another, we are trained to be non-judgmental, empathetic and socially aware of how environment, society and biology impacts them,” Ipar explains. “This is something which people such as influencers or bloggers cannot grasp because they focus on blanket solutions of ‘being positive and productive’. Therapy is about understanding feelings, their implications, and finding customised ways of coping and working with them. It’s never one-size-fits-all.”

Being widely open to public scrutiny, the field of mental health is bound to attract opinions from all directions. While incidents like the Santoshi Shetty row ultimately attract outrage, it is also crucial to understand what motivates people to make such decisions in order to give them space to learn from their mistakes.

Smriti Joshi, lead clinical psychologist at Wysa and a member of Indian Association of Clinical Psychologists (IACP), observes that there are many reasons why people want to be seen as ‘psychologists or counsellors’ despite being unqualified. Joshi explains, “Firstly, lived experiences of mental health issues, therapy and personal growth may drive people to offer suggestions, measures that worked for them.” Lived experiences are extremely important for numerous reasons in mental healthcare and account for a great degree of assistance in decision-making processes and awareness, but they are not enough to comprise professional help.

“There is an ease in talking about these matters as everyday issues and the vulnerability of a lay person looking for more knowledge that creates opportunities to gain an audience and sometimes also money,” Joshi remarks. “It could be a genuine intent to help people but without proper training, qualifications or lack of understanding of the other person's context and experiences, such initiatives can be unhelpful.”

We have a universal tendency to perceive the world around us and the people in it based on our own terms coupled with the inability to differentiate between experiences. This tendency is central in motivating us to believe that what is helpful to us will also be helpful to others. “The virtual world to which we have now shifted encourages popularity which is often misused. This opportunity contributes to the grey area filled by people who consider their opinions or ways of dealing with challenges in their own life to be the right way,” Joshi concludes.

She quotes Maya Angelou, urging people to be “rainbow in someone’s cloud” by doing their own part in the collective process of making mental healthcare accessible to all: “One can do so much just by being there to listen, offer social and moral support and moreover encourage and guide them to [seek] professional help.” There is a long way to go until reliable mental health treatments including psychotherapy and medication are de-stigmatised. But if we keep blurring the boundaries of expertise, we might just be taking a step backwards.

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