This is a concept coined and developed by founder Deepa Pawar, pushing us to radically widen the scope of Mental Health by positing it as a social justice issue. Below is a write up explaining the same, excerpted from various writings and speeches by her. All content belongs to her, and cannot be reproduced, modified, or used in any way without consent.
Mental health justice has been spoken about before in the sense of making mental health services more accessible, inclusive, equitable and just which is certainly needed. However, I argue that we need to go beyond this towards Mental Justice. Because when an individual from a vulnerable social identity (of gender, caste, class, sexuality, nationality and so on), experiences any kind of mental health issue such as an illness, distress, or imbalance, the root causes of this condition can be found in the injustice, discrimination or violence that they have faced directly or indirectly because of being a part of said minority community.
When we speak of mental health, it remains limited to the treatment of an individual, but when we speak of these communities, we cannot speak of their mental health on only an individual basis – we need to realize that the constant violation of justice that they face in social, political, economic and every other field impacts their communal, collective as well as individual mental health. The response to such mental health impact too needs to come from a space of Justice – which comes from our Indian Constitution. Mental Justice is when individuals and communities are able to access their rights of development, opportunities, participation, leadership, and other rights in a dignified and non-discriminatory manner that the Constitution safeguards. The Constitution has taken a meaningful stand for the development, opportunities, participation, leadership, and other rights even of the person who stands at the very end of our social hierarchy. Mental justice of this very last person can be ensured, if we systemically uphold the values of the Indian Constitution.
To understand the need for mental justice, we need to delve into history to understand ‘mental injustice’. Any group oppression begins with mentally oppressing members into feeling weak; this is sustained over decades, and eventually normalizes discrimination and violence inflicted upon marginalized communities. I myself belong to the Gadiya Lohar Ghisadi nomadic community. We have traditionally been ironsmiths who melt iron to make tools and weapons. When I read and hear the limited histories available of my people, I wonder – how did these communities who were once so strong as to stand up to the mighty British, become so weak as to accept the subsequent deprivations and discriminations that legally and socially criminalized them? I realize that over generations, mental terror must have been created by overburdening us with unending and insurmountable problems, finally forcing us to lose courage. Communities such as the SC, ST and NT-DNTs have suffered such historical exploitation and disenfranchisement, amounting to mental, along with other injustices.
To understand how this level of deprivation could be made possible, we need to see these issues from the lens of collective mental oppression or what I call ‘Collective Expectations’. Collective expectations are carried out with political design, they are not imposed spontaneously.
Let us take the example of a newly married young woman. She leaves her family, her friends, her entire way of life to start a new life in a new home by making a lot of adjustments in the new environment. She must surely feel confused, lonely, anxious. However, she is collectively expected to be happy, always smiling, content in her ‘true’ home. If she looks unsure, she is asked what possible reason she could have to look unhappy. Within a few weeks even days, she is then collectively expected to “give good news” that is news about her pregnancy. In a few years this collective expectation becomes unbearable and she starts thinking that there is something wrong with her and she begins to make rounds of doctors.
Similarly, collective expectations have slowly corroded away at the mental confidence and dignity of deprived communities.
Such collective expectations do not remain only expectations, but over the years – and because they are are held up by dominant groups – they become social norms and sanctioned behaviours. At times they seep into social and even legal practices, such as police behaviour towards NT-DNTs. Then, collective expectations may turn into collective violence. Collective violence when it is manifest, such as in incidents of mob lynching, is visible to the eyes. I say that many more invisibilized and subtle forms of collective violence are unceasingly carried out against groups such as the nomadic & denotified communities, which can be termed as ‘mental mob lynching’.
The majority of research around mental health is written in a Western tongue that does not respond to the diversity and complexities of Indian society. For eg., the Nomadic and denotified tribes (NT-DNTs) being one of the most vulnerable communities in this country, don’t have houses, let alone toilets. Criminalized, ostracized, and without legal protection, the mental well-being of such historically marginalized communities is rarely considered, which is a grave social injustice. I use ‘justice’ in the language of our Constitution, which has consciously taken a stand to ensure the rights of self-preservation, participation, development, and leadership to every Indian citizen, including those who stand at the very end of our social hierarchy.
In order to ensure this, the current scope of mental health itself needs widening. From being a space for individual counselling, relief, guidance and treatment, it should include the concept of mental justice, because communities’ dignity is core to their members’ psychological well-being.
Recommendations for Mental Justice of ground communities
- Article 15 of the Indian Constitution that says that no discrimination can be done based on caste, religion, race, color, creed, language or any identity. If we follow this as a guide and achieve it completely to its roots, then we can certainly achieve Mental Justice especially for vulnerable communities.
- The space of mental health itself needs to widen its scope; from currently being a space for counselling, relief, guidance and treatment, it needs to develop as a centre for mental justice. It needs to take a Constitutional approach, as a means for the very last person in the social hierarchy to be able to access their mental dignity.
- Field work should be made a strong part of mental health studies curriculum, like it is for social work education. Research centres, academic institutions and mental health experts need to research the community’s structure in India; that is, we must study gender, caste, creed, race, ethnicity, religion, etc., which form the basis of communities, to widen our understanding of how to tackle mental health issues in the community.
- Institutions, systems and stakeholders that work with a universal approach, that is the police, education system, Self Help Groups, Home Guards, Aanganwadi workers, ASHA workers and so on, who are trained, experienced workers – who reach every household on a regular basis, should be included as mental health service providers. Mental health literacy, services and indicators need to be added to their training curriculum and work responsibilities, while increasing their compensation.
- Policies and services across sectors will have to evaluate themselves from the point of view of mental justice of vulnerable communities. The police system, health system, education system, economic system need to evaluate how their policies, implementation and behaviour – or lack thereof – affect the collective mental health of such communities.
- As the mental health sector is becoming more community oriented, we as mental health practitioners will have to increase our risk-bearing capacity. We have begun to accept that reasons for creating mental distress are not just individual but also social. We will have to go beyond that and accept that riots, atrocities, caste & gender violence, and anti-social political decisions create mental health problems. We will have to increase our power within the mental health space, to support clients facing mental health problems due to such issues, by widely interpreting the Mental Healthcare Act 2017 and from a framework of mental justice.
- Most important, we need to empower the mental health movement of India to represent our needs and recommendations internationally too. For eg., the mental health indicators in the Sustainable Development Goals are highly limited; they only speak of decreasing mortality due to suicide. We need to increase our movement’s strength to recommend widening of global mental health indicators.
- The goal of the Mental Health Movement should be that the subject should become common enough to become a part of every issue; just as matters of Gender, Caste, etc. are taken up across movements, mental health needs to cross cut across all issues or movements.
Based on this, Anubhuti has created its Mental Justice training module, which we have conducted with colleges, schools, elected corporators, administrative stakeholders, community women & men, teachers, healthcare providers, sanitation workers, etc. across Thane and Mumbai districts.
Anubhuti has also released a research report done in 2019 with 1000 college students across Thane District to understand their mental health issues, social causes and support required to be mentally healthy. The report highlights this concept of ‘Mental Justice’.
More resources on Mental Justice
Article in the EPW, February 2021: https://www.epw.in/engage/article/mental-justice-nt-dnts-context-pandemic
Where Social Justice Meets Mental Health (PDF) – in Reframe 2019, pg 36