By Isha Bhallamudi, with infographics by Vedant Trivedi and Amritha Elangovan

Note:
1. The views expressed below are not the official views of IIT Madras. T5E is a student-run publication, editorially independent from the IIT Madras administration.
2. This survey is based on data collected in March 2017.
3. Any content below is strictly the property of The Fifth Estate, IIT Madras. If you wish to re-use part or whole of the article, please contact: Varun Sridhar
– Email: [email protected] or [email protected]
4. You can like/share this article using the buttons at the end of the article.

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Today, 57 million people, or 1 in every 22 people in India, face depression. Estimates indicate that soon, one in five people will be facing some type of mental health issue. Yet most of us remain uninformed and unprepared for coping with mental illnesses. India took a notable step forward last year, at the time this survey was taken, with the Mental Health Care Bill 2016. One of its many noteworthy provisions is the decriminalization of suicide, recognizing that an attempt to suicide is not a crime but a cry for help.

Where do we stand on mental health issues in IIT Madras? T5E’s March 2017 survey on this topic among IITM students amassed a staggering 903 responses in only two weeks. Many hundreds of students took out the time to share their personal experiences facing mental illnesses. In this article, we present to you the survey data, as the following:

1. Perceptions: how do students perceive the extent of mental health issues on campus, sensitization levels on campus and student awareness about these issues?
2. Incidence: Which mental health issues are prevalent on campus, what are common sources of stress, and how many students – broken down by gender, caste, age, program, discipline, disability, and other features – face them?
3. Support Systems: How do students rate available support systems on campus? What are the most commonly accessed support systems, and what obstacles prevent students from using them?
4. Recommendations: What do students suggest for building a more inclusive and sensitive atmosphere on campus, and for improving the current mental health support systems?

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Part 1: Demographics

Here, you can view the profile of our respondents and the survey sample. As with all such surveys, we note that limitations of this survey include self-selection and self-reporting bias.

Out of 903 initial responses, we deleted responses from non-IITM students as well as duplicate data, leaving us with 883 responses.

Part 2: Perceptions

The first question we asked was an optional one: what do you think mental illness is? Many students responded with descriptions of particular mental illnesses or their symptoms. However, most respondents correctly identified that mental illness is a change in our mental makeup that inhibits us from functioning ‘normally’. This can take many forms and often involves a loss of control, reduction in productivity, inability to focus, a deviation from one’s regular routine, change in sleeping and eating patterns and so on. Many respondents also pointed out that mental illnesses can manifest without the person realizing what is happening. The causes of mental illnesses are not always clear, and can’t always be identified.

The majority of student respondents correctly answered that it is possible to successfully treat, resolve or manage most mental illnesses. This is a positive trend. It remains to be seen whether this knowledge translates into health-seeking behaviour: that is, does knowing that mental health concerns can be treated lead to more people seeking treatment themselves? We shall try to find the answer to this in a later part of this article.

At a first glance, an overwhelming majority of respondents (68%) feel mental health issues are common on campus. You can use the interactive infogram below to look at the responses to this question sorted by program. UG students (71%) are slightly less likely to respond affirmatively to the question, compared to PG students (81%). MA students have the highest affirmative response — with 95% of MA respondents answering that mental health issues are common in IITM — followed by MSc students (85%).

This question shows that most respondents acknowledge the reality of mental health issues on campus. However, a lack of empathy to fellow students facing mental health concerns seems to persist. 50 students shared detailed accounts of their experiences with other students and the GSB when it came to mental health issues. A significant proportion of this smaller subset (13/50) reported that their peers reflected the belief that mental illnesses do not exist and must be a passing phase. Such reactions can lead to a reluctance to talk about mental health issues openly and seek help, and indicates a need to increase awareness on campus. Many respondents also described feeling judged (13/50) and noticing a complete lack of empathy (11/50) among fellow students in terms of being sensitive or supportive. Here is a selection of unedited responses on this topic:

• “The most common responses to me telling anyone are “you don’t/didn’t look depressed”, “stop” and “why are/were you depressed”. There have been a few kind people but that generally isn’t the trend as far as I’ve seen. Most people equate depression to prolonged sadness.”
• “A lot of my friends thought I was being a drama queen.”
• “…I have also observed that in whatever sessions mitr conducts for the freshers, they try to avoid the words suicide and depression. I think that should not be the case!”
• “Many students thought that I was faking my depression and I could not get any support from any student. Though, I got support from my guide and hostel manager and warden. My counsellor also provided support. I think there are many students who have mental illness in some form or the other. It is just that they are not willing to get help. I feel students lack awareness on these issues which makes me sad.”
• “Nobody ******* cares. Everyone is going to judge you. It’s a privilege to not to be suffering from something that’s been stigmatised to this extent.”
• “Oh, there are plenty of secretaries who will dismiss mental illness outright.”

Next, we ask what specific mental health issues are affecting students at IITM, and examine their prevalence and causes.

Part 3: Incidence

Before delving into the incidence of different mental health disorders, we asked students to share their top sources of stress and anxiety. You can view the replies below, disaggregated by UG and PG study.

Respondents across both UG and PG study have clearly cited ‘professional future’ and ‘academics’ as their top sources of stress, followed by ‘relationships’ and ‘loneliness’. UG and PG responses differ only in two places: first, 45% of PG students cite research as a major stress point compared to 11% of UG students, and second, 72% of UG respondents cite academics as a major source of stress, compared to 48% of PG students. This suggests that initiatives to tackle stress must be appropriately targeted and contextualised in order to have maximum impact.

We also looked at this question disaggregated by caste. This yielded two significant findings: one, that 95% of ST students cited ‘academics’ as a source of stress compared to 68% of SC students and 62% of both General and OBC students. Two, 71% of ST students cited ‘professional future’ as a source of stress compared to 60-64% of SC, OBC and General students. This points to a need to find out the reasons behind such a high discrepancy especially in the first instance and to provide additional academic support for students belonging to the ST category.

100 students replied to the optional follow up question about describing specific sources of stress in depth. Most commonly, respondents described dealing with over-competition and a general sense of feeling inadequate no matter how many activities they took up (feeling either that they were doing too many or too few PoRs), as well as a lack of understanding from peers. The responses pointed out many unaddressed problems: apart from a culture of competition and isolation these include: loneliness caused due to lack of positive gender interactions, low funds faced by PhD candidates with family, bureaucratic and other obstacles in carrying out research, pressure and ill-treatment from guides, pornography addiction, administrative responses to students facing substance abuse and a lack of support (see below), being overwhelmed by multitude of career options, lack of nutritious eating, etc. A respondent shared that the punishment given for one instance of substance abuse had caused him to develop mental health issues rather than leading to better health and preventing the same. It may be worth investigating the reasons for students developing substance addictions; and working to eliminate these gateway factors through sustained support and engagement, rather than imposing strict punishments which may inadvertently work against the objective by pushing the student further into substance abuse.

“This semester I have been thrown out of my hostel and have been asked to live outside, for I was caught smoking weed. I cannot tell you enough how ******* traumatic this ‘punishment’ is. I feel like I’m wanted for a thousand murders and a hundred thefts. I had never experienced paranoia in my life before this semester and the last. Living on the run out of a bag. Obviously a family that doesn’t live in Chennai cannot shift here for their child, leaving behind whole lives. I cannot take a ******* semester off as well, why will anyone in their right minds say okay to that and agree to waste a year away. I’ll stop the rant.

tldr: I’d like to think I did not have any mental health issues before this semester and the kick out. I now do have them, I am beginning to go mad, I kid you not, I know it for a fact, my friends see it happening, I am paranoid, I have well-demarcated mood swings and I cannot concentrate or focus on anything. Woopd****indoo.”

Our next question asked whether respondents personally knew anyone suffering from mental illness on campus. An overwhelming proportion have responded in the affirmative.

This was followed by questions asking about the incidence of mental health issues among the respondents themselves, as well as a breakdown of these issues.

54% of all respondents reported facing some type of mental health issue and only 20% of respondents were able to reply with a direct ‘no’ to this question. Disaggregating this data by gender, caste, program, disability and age reveals crucial insights.

1. 100% of students (though a very small absolute number) identifying as neither male nor female reported facing some mental health issue (and cis-female students showed a slightly higher prevalence than cis-male students for the same). This indicates that differently gendered students face unique stresses that require targeted recognition and support.
2. The 20-25 age group showed the highest relative prevalence of mental health issues at 59% while the <18 age group showed the lowest, at 35%.
3. SC and ST students reflected higher rates of mental health issues, at 71% and 64% respectively, compared to 54% of OBC and 50% of General category students, again pointing to the need for targeted support.
4. 68% of disabled students said they faced mental health issues compared to 53% of non-disabled students.
5. Finally, it may surprise some, engineering students show relatively lower rates of mental health issues at 52% compared to all other disciplines: pure sciences and humanities and social sciences show similar prevalence at 60-61% while management stream reflects the highest, at 80%.

These cues can be used to investigate particular sources of stress if any and to inform the development of better, targeted support mechanisms.

What mental health disorders do students face? We dive into these specifics below.

The most common problems faced are depression (30%), anxiety disorders (18%) and suicidal thoughts (16%). OCD is also common, though not as prevalent as the above three. We must pay special attention to the responses related to suicide and self-harm. These include suicidal attempts, self-harm and suicidal thoughts. 28 students (3.17%) reported attempting suicide while 67 students (7.59%) admitted that they have engaged in self-harm. This is cause for alarm and a call to pay closer attention to the mental and emotional stresses faced by students. Many respondents wrote in that they are currently fighting suicidal impulses and thoughts. We request these students to please reach out for help and confide in someone. For example, you can call Sneha’s suicide prevention helpline at 04424640050.

An important note: these figures on suicide and self-harm should be seen in the context of India having the world’s highest rates of youth suicide. The prevalence of suicidal tendencies reported in our survey for IIT Madras is in fact much lower than the national average for youth in India. Some triggers may be campus-specific, but causes are more overarching than those confined purely to our campus and its way of living.

We were also interested in finding out whether there was any correlation between students with a high incidence of smoking, drinking or consuming marijuana – and their incidence of facing mental illness. Admittedly both our cutoffs are high (such as recording only those with a regular habit of smoking 10 or more cigarettes a week) and our sample numbers low, but there is a high correlation at first glance. Not to confuse correlation with causation: this does not necessarily mean that consuming marijuana, tobacco or alcohol tends to cause mental health issues, but it could mean that those who are starting to face mental health issues are more vulnerable to trying these substances and forming a habit or reliance. In any case, this needs further investigation. Students found abusing these substances may need additional support and mentoring rather than punishment and withdrawal of support, as tends to be the norm.

Student respondents also provided an account of the duration over which they faced mental health disorders and concerns. There is a large variation in the time frames, ranging from a few weeks to several years. Some students had been facing these issues from before the time they joined insti.

34% of student respondents said they are currently facing one or more of the disorders/concerns listed above.

Many individuals do not recognize it when they face a mental health issue. Sometimes, they come out of it naturally or by themselves, and at other times the issue intensifies till eventually they are forced to realize that something is wrong. We asked respondents whether they were aware that they were suffering a mental health issue, at the time they were facing it.

A large proportion (41.31%) of affected respondents were not sure if they were having a mental health disorder at the time of facing it. This shows that there is a need to provide increased awareness to students about various mental health issues and how to recognize them, so that they can seek help at the correct time and alleviate their concerns immediately. This is also a preventive measure as addressing mental health concerns at the right time can prevent them from solidifying into chronic or intensified disorders.

Finally, we asked respondents whether they themselves had been approached by anyone in need of help regarding mental health. The fact that around one-third of respondents had been approached for help by others indicates a positive trend. This should be built upon and expanded to create a healthy and supportive student atmosphere.

In conclusion to this section: around 140 respondents chose to share more detailed answers about their experiences with mental health issues, whether direct or indirect. Most of them linked depression to social anxiety and loneliness. Around 5% resorted to binge-watching TV shows to tackle mild depression, and some students mentioned that Litsoc events were a great help. Most of these respondents self-reported that they suffered from a mild form of depression. One respondent mentioned that stress related to research work had manifested as various illnesses over a period of time. In all, 80% of them had experienced depression directly.

Here is a selection of unedited responses which give a raw and powerful glimpse into the lived experiences of depression and other mental health issues:

• “Strongly considered suicide (not the first time) this morning at 9AM. Called 2 Medall counsellors and the Aasra helpline. NOBODY ******* PICKED UP. Researched suicide options – pills, slitting wrists, etc. Realised repercussions if I’m unsuccessful in killing myself. The possible mental and physical medical problems that I’ll have to go through (from what I read online), in addition to continuing feeling like an absolute pile of shit. Got phone call from parents (coincidental). Spoke to them. Quietly cried on phone when I began to think about what my death would do to them (they didn’t realise/hear me – were still talking about some family gossip shit while I pretended to listen). Gave one or two word answers to end call quickly. Yelled at myself for being so ******* weak and messed up. Screamed into pillow. Decided to not kill self. Went on living my shitty life. ******* coward I am no? I agree.” 
• “Honestly, it’s really difficult. One can either live through this experience as though one were in denial of reality. Or one could drag oneself through it and cook up a load of issues. I would say I’m somewhere in between. When faced with personal as well as academic pressure my mind simply caved in. Since I’m an attendance freak, four years of continuous classes and deadlines finally took its toll on me. I felt used and tired and helpless. I decided to take the week off to recuperate and centre myself. Instead I began cutting my hands. By this point I had ceased to feel pain. Cutting didn’t work. I kept at it because I didn’t know what to do. This is ongoing so i have no idea how this will end.” 
• “I don’t understand the point of me being alive.” 
• “I’ve suffered from severe social anxiety and depression when in campus. I find the general environment quite hostile for people going through stuff like this. There have been times when I did not come out of my room for days together and no one noticed, not even my wing mates. I missed many classes, but no prof questioned me till they had to check attendance to award a W.” 
• “The doctors in the Inst. hospital (other than the psychiatrist) seem to be very poorly informed and quite insensitive to mental health issues. When I approached them for the sake of a friend, I found their attitude quite paternalistic and dismissive of the suffering. It seems like if one is physically healthy but otherwise in pain, mentally or emotionally, the doctors do not care.” 
• “Unhealthy competition is one of the main reasons, despite being in an IIT and being an above average student myself within the campus, the atmosphere feels so hostile. It feels like survival of the fittest is placed upon the students every time with all these tons of graded exams and each person doing three to four extra curricular activities in addition. If anyone thinks that’s their passion, then they couldn’t be any more wrong.”

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