Dr.H.Chandrashekar- Vice President- Indian Psychiatric Society, Karnataka Chapter
• Dr.Mahesh Gowda- Director, Spandana Healthcare
• Ms.Bhavana- Cine Actress
• Mr.Kumar Jahgirdar- Founder / President CRISP NGO.
• Mrs. Rani Shetty- PARIHAR Helplines
and other patient’s family members.


THEME: Mental Health At The Workplace

Indian Psychiatric Society (Karnataka Chapter), Spandana Healthcare and CRISP NGO jointly welcome you!
Bengaluru. October 10th of every year marks World Mental Health Day celebration. The Theme for this year is Mental Health in At The Workplace.
Mental health is often neglected in workplace culture. The dire need to address mental health concerns becomes an important priority. A negative workplace setting may lead to physical and mental health problems, hazardous use of substances or alcohol, increased absenteeism and reduced productivity. A work setting that promote mental health and morally supports people with mental disorders are more likely to decrease absenteeism, boosts productivity and promote associated economic gain.
WHO confirms that 300 million people across the globe suffer from depression, a mental health disorder which is the second leading cause of disability. Interestingly, 42.5% of corporate employees in India suffer from depression (ASSOCHAM, 2015)

Some of the identifiable risk factors contributing to mental health concerns at workplace for individuals include:
• Job dissatisfaction, role ambiguity or conflict, poor stress coping mechanisms, poor interpersonal relationships
• Adjusting to job environment due to homesickness, excessive burn outs, lack of minimum physical activities
• Poor appetite ,unsafe substance or alcohol use ,bullying and psychological harassment

There is a substantial evidence which mentions that an individual with concerns of hypertension and type II diabetes mellitus will also have mental health problems such as anxiety and depression which are undetected and untreated further leading to poor quality of life. A person with cardiac issues will also have a co morbid psychological concern and so does a person with cancer or any prolonged illness.

The need of the hour is to build a workplace environment which promotes one’s well being with a holistic approach. Also, the work environment should be safe and friendly when a person with mental health concern may need help especially in cases of chronic psychological conditions.

This brings a view of the recent Mental Healthcare Act 2017, which was passed on January of this year. The bill had decriminalized suicide attempts, focused on rights of persons with mental illness and patient autonomy. Mental Healthcare Act guarantees every individual access to mental healthcare and treatment across the country.

However, there are certain concerns in this new Act. There is an advance directive clause in the mental healthcare bill which mentions that a person suffering from mental illness has the right to choose the type of treatment to be provided in advance and that a person can choose to nominate a representative for the same treatment. In the previous Acts, the family members and the legally authorized representatives were considered the natural guardians in the Indian family context. However this new alien clause of nominated representative strips the power of family members governing patient’s mental health and treatment decisions, unless and until, a person with mental illness has nominated a family member as nominated representative it cannot be deemed assumption.

In a worst case scenario, this may raise an eyebrow among the workplace environment wherein a person experiencing chronic psychiatric condition (such as schizophrenia and psychotic disorders), who may need hospitalization can refuse for initial necessary treatment even though he or she may be experiencing severe psychological distress. That individual may describe himself as doing well and absolutely fine though for others who may sense that individual is going through severe mental health concerns. So, admission to hospital becomes difficult for even co-workers or primary caregivers except in emergency, unless the individual with mental health concern nominates the same.

In future, there would be more challenges in psychiatric care though every individual has the right to access mental health he may be refusing treatment and also no family member could intervene. In all cases of treatment refusal mental health review board which is a judicial body will govern treatment related decisions.

There is a hope for building better workplace settings. In a recent article from WHO on creating healthy workplaces mentions that “A healthy workplace can be described as one where workers and managers actively contribute to the working environment by promoting and protecting the health, safety and well-being of all employees.” Further the article suggests that intervention can be put into action by enforcing health and safety policies and practices which include identification of distress, harmful use of psychoactive substances and illness and hence providing relevant resources to manage them. Additionally, the article makes a mentions on simple yet effective important steps been implemented in workplace such as ;
• Reassuring staff that support is always available, organizational practices that support a healthy work-life balance, employee actively involved in decision-making
• Career development programmes for employees, recognizing and rewarding employee’s contribution

As an individual, one can start identifying the signs of stress and work place burnouts. Some of them include;
• Poor motivation to do any work, increased or decreased sleep and appetite, increased absenteeism
• Lack of socialization, interpersonal conflict with co-workers, prone to accidents
• Suicidal and homicidal ideations, alcoholism and psychoactive drug use

Work Life Balance usually revolves on coping mechanisms to daily stressors encountered at both home and work environment. Stress and Time Management are the basics which most of the people recognize but putting into action is the key to tackle most of the stressors. Further, one needs to understand the importance of social support which helps in addressing emotional concerns. Importantly, people need to kill stigma and start seeking help with a mental health professional when their coping mechanisms are not helping in achieving significant outcomes.

Mental Healthcare Act 2017 – patients’ disadvantages

• Patients can legally make use of the directives to avoid treatment. Mental illness still carries a lot of stigma in India and most people tend to hide their symptoms and refuse treatment.
• The bill fails to consider the position of those suffering from severe mental disorders (like schizophrenia/psychotic disorders) who refuse to acknowledge their mental state let alone be capable of making rational decisions/choices and giving consent in writing regarding their treatment.
• Fails to provide easy alternate courses of treatment based on the severity of the mental illness, it appears that the judiciary is going to make treatment decisions. It’s even more worrying after looking at the current judicial state of affairs in the country.
• In such cases, precious time may be lost just waiting for the decision of the mental health board to start involuntary treatment.
• Also the vital role of the family members who form the crux of the support system for mentally ill patients in India (in terms of providing appropriate care and protection, decision making supervising/ensuring medication compliance admitting patients promptly when they become very well, etc) has been largely ignored.
• This may actually put mentally ill patients more at risk of neglect, manipulation, abuse or make them criminals when they act out on the symptoms of mental disturbances.

Need: Laws facilitating treatment and admissions for control of symptoms’ and recovery. If delayed treatment can lead to loss of productive life and when in conflict with law can lead to criminalisation and offenses.

We appeal to our friends in the media to give maximum coverage to this important issue concerning public interest.


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