mental illness in South Asia ; a muted epidemic

by Areej Khan

If someone had a broken leg, you wouldn’t ask them to walk on it. You would lend them a hand, let them lean on you for stability and comfort them during pain. So why say to someone with a broken mind, ‘Just get over it’? Why is the hand withdrawn when the mind comes into question ? Where are the shoulders that millions of silenced youth need desperately?


In South Asia, mental health is a topic of controversy. It’s something at which parents and relatives shake their head to, or tell you to ‘shhh’ because it doesn't fit their ignorant and false sense of reality that you simply cannot be mentally ill if you are physically fine. For many South Asians that suffer in silence with mental disorders, a culture of shame and blame is all too familiar. Discussing psychological health is deemed taboo and a sign of weak-mindedness, a result of the preconceived notion that mental disorders are simply part of “life’s ups and downs” and if you seek help, you're being dramatic and ungrateful of all that you have. These dangerously negative attitudes are a cause of toxic stigma that seeps into the mindsets of older generations which results in constant talks of “come on get up, get going, we never had this in our era.”.The older generation’s lack of experience seemingly invalidates the feelings of today’s generation.


Not only does this stereotypical prejudice result in lack of social support and emotional neglect, but also in detrimentally high rates of suicide.To date, only a few countries have included suicide prevention among their health priorities and only 38 countries report having a national suicide prevention strategy.[2]. The World Health Organisation says that over 90% of suicide cases relate to mental disorder and that more than two-thirds of all suicides are preventable. Nevertheless, mental health support barely exists in south Asia, excepting Sri Lanka, to address the growing needs of the population.


Unfortunately, in the harsh reality we must accept, a broken leg will get you balloons, affectionate get-well-soon notes and a colourful cast bombarded with names and wishes but an unwell mind, however, will only grant you a neglectful response, invalidated feelings, forced silence and even worse mental health. Not only is it emotional abuse to constantly neglect someone's mental health, it consequently breeds an emotionless personality that cannot express, process or validate their own and others’ feelings. We can see this poisonous mentality take its course in the vast impact of toxic masculinity. Deeply rooted in South Asian societies, it has caused a staggering increase in cases of mental health disorders. Coming across a man who isn't afraid to cry or express what might, sadly, be deemed as ‘feminine’ is a rare occasion, compared to facing the cold and frigid exteriors that society encourages. Many may argue that is a moral principle in our culture which separates the behaviour of men and women. Gender may be defined by actions, but feelings are not. As a result of this thinking, many South Asian men have to combat their own internal battles along with mental health issues in hopeless silence.


Tackling toxic masculinity in our communities will help reduce a multitude of social issues — issues that mainly oppress women. What’s important to realise is that toxic masculinity, just like all stereotypes, does not only affect the person in question. When the symptoms of these enforced norms appear, families and relatives around the said person are impacted and may grow a distaste towards that illness and hence, question whether their emotions are valid.


To counteract this epidemic of blame and neglect, a way would be to increase the knowledge about the background and causes of mental health problems. The daily problems that the affected people experience are often the effect of a complex sequence of events for which the individual is only partly responsible. The stereotypes that surround this individual every day might even worsen the impact of their already muted disorder. Diagnosis might be unattainable as their symptoms are deemed overexaggerated and therefore, invalid. The responsibility of the individual for their own well-being is not unlimited. Self-stigmatization is also an effect of having a stigmatizing attitude towards others with mental illness.[3]



Another destructive mentality is that of mental illness and its impact on one's “izat” or ‘honour’. The question that seemingly justifies the lack of mental support is “Log kiya kahenge ?” or “What will people say ?” The magnified focus on reputation and public opinion are what scares many into silence. With the way things are, many of the youth have preferred silence. It’s easier that way but also lethal. Amidst a community that valorizes endurance, stoicism is embraced. Having an illness and that too, mental, clashes with the norm. It’s deemed a sign of weakness because controlling your emotions and burying them in the pits of your being, only for it to grow in size and come back tenfold, should be easy enough. Quite often, the word ‘mental’ in ‘mental illness’ is taken literally. The emphasis of it being only in the mind is a stereotype which allows society to believe that it's meant to be hidden which only brings in lack of sensitivity when approaching the case.


This is not a call for help. It's a plea for another option. Some people may voluntarily choose to remain silent. They turn to their God for help instead and that is perfectly okay. What is not okay, though, is the unavailability of family support. We cannot tell if people want to remain silent and keep to themselves when we give them no other option. The infamously toxic concept of one’s ‘izzat’ or ‘honour’ being compromised when one admits to having mental health issues is what causes many to live performatively, constantly attempting to maintain their honour at the expense of their health.

There's an inherent lack of collective empathy when it comes to mental illness. Often, the metric used is other people. They have it so much worse than we do so complaining would be an act of ungratefulness and ungratefulness would mean that we're just selfish. Therefore, a tendency to overlook, underestimate and ultimately, deny their pain is what holds back young brown people from treatment.


South Asian Americans—especially those between the ages of 15-24—were found more likely to exhibit depressive symptoms.[4] , as stated by the Asian and Pacific Islander American Health Forum (APIAHF). Additionally, it was also found that there was a relatively higher rate of suicide amongst young South Asian American women than the general U.S population, stated by another APIAHF report. The report also emphasized that mental health services were utilized less frequently by South Asian Americans., another example of how silence is glorified and seeking treatment is shamed. The stigma around the breaking of said silence means that there is a relatively higher risk of muted and mentally unstable South Asians resorting to self-harm and suicide. This delayed help-seeking is a pattern seen in abusive marriages as well, a result of a lack of social support, ‘marriage obligations’ and a culture of enforced silence.


This culture of deafening silence might just be something us desis might never overcome. We are careful with what we speak of, often glossing over the weak parts in a painfully harmful attempt to make it seem less raw and more nonchalant. It is ingrained in our minds to compulsively maintain an aura of nonchalance and ‘honour’ ,grimacing in embarrassment when we admit to anything that may accuse us of being something we have been taught to shame; weak.


Those that are labelled as mentally ill are subject to extreme amounts of social violence ; failing to recognise their suffering as a justified and valid human experience due to the faults in mainstream society. Understand that there is no inherent value in silence. Pretending that we’re fine when we’re not does more harm than good. Needing medicine is not an act of great shame , neither is confessing that you need help. Our society needs reform in regards to early diagnosis and accessible treatment but it begins with changing the mindsets of those who prevent the change we need, Sometimes, life is a double edged sword. We might risk our reputation or ‘izzat’ when we admit that we are not fine. But that just may be the only way we can survive.

Sources :

[1]Elias, P., 2015. The Silence About Mental Health In South Asian Culture Is Dangerous. [online] The New Republic. Available at: <https://newrepublic.com/article/122892/silence-mental-health-south-asian-culture-dangerous> [Accessed 19 September 2020].

[2] - Who.int. 2019. Suicide. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/suicide> [Accessed 19 September 2020].

[3] - Jacobsson, Lars. “The roots of stigmatization.” World psychiatry : official journal of the World Psychiatric Association (WPA) vol. 1,1 (2002): 25.


[4] - SOHRABJI, S., 2013. Suicide Amongst Indian Americans We're Stressed, Depressed, But Who's Listening?. [online] Connection.ebscohost.com. Available at: <http://connection.ebscohost.com/c/articles/89214043/suicide-amongst-indian-americans-were-stressed-depressed-but-whos-listening> [Accessed 19 September 2020].

a message from the author:

Areej Khan - executive leader + country rep. Pakistan + UAE

"I come from Peshawar , a beautiful city in Pakistan but was raised in Dubai , UAE. Growing up far away from my country created a cultural disconnection throughout my childhood. I had adopted more western traditions that helped me fit in , and neglected my own cultural identity. However, when I surrounded myself with people from different parts of the world, I was quick to realize that what makes us different is what unifies us. A society that accepts and appreciates people of different cultures breeds an environment for empowerment. Which is exactly why I wholeheartedly believe that education our youth is the starting point. In a world more diverse than ever, I am excited to be part of an organization that promises cultural growth and gives our youth the childhood that some of us had missed out on.”