December 8, 2019

Ask the Excluded, They’ll Tell you what Inclusion Is

Author: Sadaf Vidha

Hello, my name is Sadaf. I’m a psychologist by profession. I would describe myself as a curious person. I love to envision a world where we are all respected and cared for, with our unique traits and struggles. I also happen to be from a conservative muslim family and have experienced patriarchal pressures firsthand. I hope that this makes me the right person to understand the ground realities of a lot of people. Lastly, I have helped a lot of clients deal with a range of mental health issues and the environmental contributors of those. Thus, I envision a world of socially just mental healthcare and this is my attempt to make the field ethical and accessible for all.

I have a client currently in therapy, who has bouts of anger and sadness. His whole family is in therapy because I understood after assessing that his immediate and external environment had a large role to play in his current behaviour as well as how his life panned out.

For example, being pulled in multiple directions, his mom could often not care for him and would use violence to silence him when he would cry or demand attention as a child. Before he was diagnosed with a learning disability, he was hit at home and school as well as bullied by other children, as he could not study. The bullying and his mom’s use of physical punishment in turn made him absorb the idea that violence is the only way to get things done and get your due. After a particularly lethal suicide attempt, he was put in a rehab for over a year where he was chained and had to relieve himself in bed – note – there was no drug abuse from which he was experiencing withdrawal. He was just recovering from a suicide attempt.

Do we wonder then, why this young man is angry at the world and at his family? Why does he threaten and use violence to show his power and get his demands fulfilled?And due to all this, he completed his 12th std pretty late and could not pursue mainstream education beyond that.
This is just a small peck of how exclusion works. The client manifested a lot of his issues because of what was done to him and yet, he is held responsible for what happened and what he became.

The new mental health act of India and the general tone in which the government and the medical community speaks, still talks of psychosocial disability as something that happens to people randomly. But the fact is, if a person has safety, a source of income, a community to belong to and a meaning for life, much of the mental distress would just not happen. And think about what a big role the government has to play for safety, income and community. Are our cities constructed such as to allow safe and fruitful interactions between people? Are our countries and houses safe? Do most people have anything left after making ends meet?

If the basics to life are not sorted, how can we keep putting a band-aid all the time when the symptoms show up? As data collected and analysed by Bapu Trust shows, poverty is greatly linked with distress. Even having a pakka house makes a sizeable difference in SRQ scores! And the data also shows that women, children and minorities are most vulnerable (BT Analysis report, 2015).

True inclusion would be when the government does large amounts of preventive work to address these basics, and also ensures full participation of everyone in some sort of meaningful existence. Or else, even with treatment, people are always likely to feel that they live on the outside, and they never truly assimilated. Post modern ideas tell us how socially constructed reality is. And how can someone feel okay if they are not included to create this shared reality?

Find more about Sadaf here.

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