Photo courtesy of Koslanda

Today is World Mental Health Day

Mental health has been a cause for concern in Sri Lanka for some time. A civil war for 30 years, a tsunami in 2004, the Easter Sunday attacks in 2019 and the present economic crisis have undoubtedly had repercussions on the mental health of the Sri Lankans that endured all this.

Poor funding, lack of understanding on mental illness, a dearth of skilled professionals and a reliance on tertiary care have affected the treatment of mental health, especially in the rural parts of the country. This issue has only been exacerbated by the social and cultural stigma associated with mental illness. Research conducted on the stigma of mental illness in Sri Lanka indicates a link between the community’s view of the person with mental illness and their view of the family. These concerns inadvertently affect the future and ability of family members to find suitable partners for marriage and contribute financially in a low income household. There is also a lack of understanding about the causes of mental illness as people are led to believe in supernatural phenomena of evil spirits and accept the wrongdoings from a past life.

Language is a key part of how the stigma persists and should evolve to educate people on mental health conditions, thereby removing any barriers to treatment and recovery. In everyday conversation, the topic of mental health conditions is frivolously passed as an insult or joke. In fact, the mere mention of the word Angoda makes people chuckle as it is associated with ‘crazy’ or ‘mental’. The media play a contributory role in their lack of ethical reporting practises around mental health related problems. The media, however, could be a valuable ally in dispelling myths, initiating public debate and presenting inspiring tales of people living with mental illness to educate the masses.

This has led to people being reluctant to engage in earnest conversation and communication about the problems they are struggling with due to fear of judgement and isolation from the community.

Situation in Sri Lanka

According to statistics released in 2011 by Dr. Neil Fernando, Head of National Institute of Mental Health, almost 4,000 people die by suicide every year. In 2016, the Institute of Policy Studies quoted the suicide mortality rate per 100,000 population to be 14.6 per cent. With the present economic crisis, there is a bigger mental health crisis that cannot be ignored as families struggle to make ends meet.

Universities are microcosms of the larger societal problems. This year has seen an increase in the number of deaths by suicide that has taken place in state universities. While mental stress has been a prevailing concern across all age groups due to the economic climate, it is important to acknowledge the great deal of challenges and difficulties faced by university students. The factors that led to the death of these students are unknown but many reports indicate anxiety, loneliness, exam stress and sub-culture within the university to be some of the leading causes.

Factors affecting mental health in young adults

High rates of homicide, self-inflicted injuries and suicide are the main causes of death among young people, indicating widespread psychosocial stress among community members.

Suicide ideation refers to thoughts or ruminations of wanting to end one’s own life. Although not all suicidal ideations lead to the loss of life, it is important to understand that these thoughts exist prior to death by suicide. There are many different risk factors associated with suicide ideation. Some of the strongest risk factors include previous attempts at suicide, financial problems, low socio-economic status, family history of suicidal behaviour and underlying mental illnesses.

In the current economic context, the need for adequate coping knowledge is as paramount as understanding the stress amongst university students that relates to completing their higher education, concerns over unemployment, poverty, destitution, feelings of insecurity, marginalisation (including biases) and economic disempowerment.

Coping mechanisms

The experience of stress is universal. There are two distinct parts to a challenging situation – the problem itself and our reaction to the problem. Having strong coping mechanisms can help us navigate through these challenging situations and is a learned behaviour.

Change is frightening and most often, comes when we least expect it. The first step towards managing sudden changes in our environment or circumstances is to recognise and accept that it is happening. The economic climate adds a layer of uncertainty that may be bringing up an influx of emotions and problems. Acknowledge how you feel by writing down your thoughts or any uncomfortable sensations in the body such as tension. Our thoughts are our internal dialogue and, by being aware of how we feel (emotionally and physically), we remind ourselves that we are in control of what we tell ourselves, rather than our emotions. When you have become aware of your thoughts, take account of the triggers that precede these thoughts. What were you doing before you felt sad? What led you to cry or feel angry?

Once you are able to see the problem clearly, place some distance between you and the stressor. This will stop you from feeling consumed by the thoughts and help you to focus on problem solving. Try breaking down the problem into manageable parts to create an action plan with the help of friends and family, if necessary. For example, if you are feeling overwhelmed about upcoming exams, plan a study routine that involves breaking major tasks into smaller chunks.

Research indicates that a strong social support network can help build resilience to stress. A common misconception is that we are alone in our struggles but more likely than not everyone we meet needs a little assistance and support. Instead, reach out to friends and family strategically. It may be that some friends and family members are good at listening or sympathising while others excel at providing the practical support you may require like bringing over food.

When life gets overwhelming, it helps to seek meaningful and pleasurable activities to help reduce the stress. Although the first thing that people do when they are in a difficult situation is drop their leisure activities, it is worth doing them anyway as they may give you a fresh perspective on the problems you face. Shift your perspective to finding a balance between reducing the stress you feel and continuing to achieve small, personal goals. One of the biggest mistakes people make is trying to transform their whole life using one objective. Instead, try setting small and achievable goals such as waking up in the morning at a certain time, finishing a household chore or sticking to a daily routine.

If self-help is not working and you are struggling to deal with a particular situation, seek the help of a mental health provider. They can help you to identify situations and behaviours that might contribute to the stress and suggest adaptive coping methods to better manage the circumstances.

We’ve all experienced stressful circumstances and incidents. When under a lot of stress, it’s normal to feel overburdened with feelings and thoughts. However, it is important to talk to a mental health expert if stress is a regular occurrence that impacts your way of life, ability to make decisions and results in symptoms of anxiety and depression. If you’ve previously tried to fix an issue, keep in mind that it is vital to try different approaches until you find the ideal solution or combination of solutions. Allow yourself the grace to accept that while there will be days that are challenging, there will also be days that are less challenging.

If you’re feeling distressed and/or having trouble coping with your emotional experiences, please contact the following services below for assistance:

Crisis Support Service: 1333, National Mental Health Helpline: 1926, Sri Lanka Sumithrayo: +94 112682535 / +94 112682570, Shanthi Maargam: +94717639898, Sri Lanka National Association of Counsellors: +94710898473

Dulari Ranasinghe is a Counselling Psychologist and the Founder of Mind Leap Counselling Services.