How one research institute is building a culture where #ItsOkayToTalk

With inputs from Hina Lateef Nizami 

They say when you are an adult, you show up, no matter what. I did show up. At my laboratory,  ten days after I lost a parent, and I showed up every time since then. Convocation, weddings, birthdays, farewells… I would show up no matter what. What nobody knew about, were the number of hours I spent staring at the ceiling when I was alone. I was going about my life distracted, unaware of what was going on beneath the surface. There were many of those days, that would be normally perceived as ‘a great day’ but all I felt for years was my insides sinking – in a jostling shopping mall, in a lecture hall, and in between meetings.

At the play organised by Manan, a student-led mental health awareness initiative. Illustration by Hina.

“Behave yourself. This is not how you speak,” yelled the young woman wearing a placard labelled BIPOLAR DISORDER. “I only asked you to wait, I have other customers waiting,” came the retort from the actor playing the role of a shopkeeper. The woman’s friends reassured the shopkeeper and turned to her, “What is wrong with you? You are overreacting.”

Watching this, I felt a lump in my throat as I thought about all the times that I had “overreacted”. That one scene from a play written and directed by Manan, a student-run mental health initiative at Translational Health Science and Technology Institute (THSTI), had me ruminating for days. Come Saturday the following week, I was at the psychologist’s for an appointment, soon to be diagnosed with ‘situational depression’.

When asked about the genesis of Manan, Hina Lateef Nizami, its convenor and a PhD student at THSTI says, “I went into therapy early this year, after more than a decade of struggling with my mental health.” 

“With mental health issues being a taboo even amongst educated folks, self-awareness comes at a huge cost. I recognise my privilege. I noticed people hushing their voices when talking about mental health issues, and decided to do something about it at my own institute THSTI. I pitched the idea and the administration gave us the platform and the support for the event. Manan, which translates to the act of pondering or thinking, is an effort to sensitise people towards the need to let go of this stigma and shed the associated tags of ‘weakness’, ‘overreaction’, ‘negativity’ and ‘overthinking’.” Today, we see students themselves expressing a need to be sensitised. Manan is heading where it was intended to.

With Manan in full swing, a student Parul (name changed) turned up at the Executive Director’s office requesting to see a student counsellor –  this was a first for us. I remember her request leaving my colleague and me baffled. We didn’t know if we had one and if yes, who it was. Turned out we did not.

@THSTIFaridabad seems to have a good model. We could look into something like that.

— Anurag Agrawal (@AnuragAgrawalMD) July 24, 2019

In response to this, the Executive Director of THSTI Gagandeep Kang and Dean Shinjini Bhatnagar suggested collaborating with Manas Foundation, a team of experienced psychologists. The psychologist I spoke to said they had never been approached by a PhD student. I was at their office in Okhla, Delhi, accompanying Parul for her first session. Her visits were financially covered by THSTI. Following this experience, we realised the need to be prepared for such situations. We requested the Manas Foundation to arrange a referral system for THSTI as we did not have an in-house establishment to help students. Under the system, I was identified as the point-of-contact at THSTI, meaning students would get in touch with me when they feel the need to see a counsellor. When they do, I arrange for an appointment with Manas Foundation on a convenient day.

We have also begun group sessions with a psychiatrist to sensitise students about mental health. Through these closed-door sessions, questions such as ‘What is mental health?’, ‘Why is it important?’, ‘Why should one talk about it?’ are addressed. This provides students a space to talk about issues they think are affecting their mental health. Being the coordinator for the institute, I attended the open sessions, took notes that documented common issues raised by students. These notes remain with me and are not shared to maintain student confidentiality. Whenever necessary, individual issues are brought to the attention of the Executive Director for due action. A few one-on-one sessions are arranged with the visiting psychiatrist, whenever a student requests it.

A two-fold problem

I must credit the senior management’s support for this increased emphasis on mental health at THSTI. We see that the challenges are two-fold, as students and young PIs face different issues. Gagandeep points out: “For students, resilience is hard to build, especially when they have to deal with new work environments and colleagues without readily accessible friends and faraway families. Yet, having some ability to handle difficult situations without being overwhelmed is essential. Mental health underpins their ability to be who they are and continue to grow. It is the responsibility of institutional leadership to create an environment that challenges students, as well as supports them to achieve not just professional success but personal growth and maturity.” 

And then there are the PIs. “How well young PIs are able to handle the pressure to compete and to perform at their best as independent investigators vary from individual to individual. Some are able to balance their personal and professional lives and keep moving forward with sustained enthusiasm for science. Others struggle, both personally and professionally, and blame themselves, the administration or the system. This also put those working with them at risk. Without counselling, mentoring and support, the latter types of young PIs create an unhappy lab and contribute to a fractured institution. Providing the support for young PIs to deal with stress, competition, and competing demands on their time, is not simple, but should be done to benefit them and those around them,” says Gagandeep.

These conversations with Gagandeep and Hina, and the fact that many of us wait so long before recognising the need to see a therapist, made the institute realise that most individuals do not know when they should ask for help. An experiment fails and we blurt: “I am depressed”; we think it’s okay to call someone “mental”; we call it OCD (Obsessive Compulsive Disorder) if we cannot leave the kitchen slab unclean before going off to sleep. We DO NOT know what mental health means. We DO NOT know what mental health disorders look and feel like.

As I sit back and look through my notes from the counselling sessions with students, I also see how  Manan can develop further. Someone going through mental health issues may not be able to holistically heal if they are not supported by their supervisors, labmates and other staff they frequently work with. All PhD students could use a little more empathy from their supervisors. Groups and individuals were more at ease while attending these sessions when they go back to work under a team leader who understands that the student spent the last few hours on themselves and it is okay. Labmates need to understand this too. A pep talk after a failed experiment or having a relatively experienced labmate to tell you that ‘nobody gets it right the first time’ is all one needs.

A wonderful example of collective support on campus is the ChinUpAndGreet initiative by the Indian Institute of Science which has a very simple and profound method. This tells how simple gestures can make the next few hours easy for someone who is having a bad day. There have to be reminders that it is important to ‘Take a pause, breathe and then again move’.

Manan is a much-needed initiative that took conversations from being mere whispers in corridors, washrooms or cafeteria tables to professionals who are better equipped to hear us out and provide support. I had these conversations inside my head for a long time (and I think many others do too). Since we started, we have found common issues to brood on. People who have faced mental health issues, those who have dealt with them and those who brushed them under the carpet are now all in the same room. 

Editorial note (by Hansika Chhabra): The idea of holding closed-door sessions with students in the presence of a mental health practitioner is credited to Sukanya Ananth. Approaching sensitive topics with nuance, empathy and compassion, is often lost in circles without trained professionals to broach trauma with seriousness and incusivity. During one of our conversations on the matter, Sukanya responded with the suggestion of implementing this idea at the institute level! I pitched it to Siuli, who wonderfully enough, implemented it at THSTI. Siuli has been working out any kinks in this system, and aims to make it customisable for other institutes to adopt.

This piece is part of a series supported by India Alliance.