Part 4: Support Systems

In this section, we review the existing support systems for mental health on campus and provide students’ ratings and feedback for each of them. 

We began by asking respondents whether they had sought help on or off campus to cope with their mental health concerns. Discounting those who marked ‘NA’ on this question (20% of the total number of respondents), 40% of the remaining respondents had sought some type of help.

Looking at the primary sources of support, we see that an overwhelming number of students (32 %) chose to approach friends and family for help rather than professional services. The fact that so many reached out for help is a positive sign, however it was outside the scope of this survey to show what proportion of the approached friends and family were able to refer the concerned person to professional support systems. This is an important consideration that points to the need to sensitize campus inhabitants about where to refer friends and family who need help, as it shows that people may not be able to reach the right sources for recovery.

So what prevented the remaining students with mental health concerns from seeking professional or informal support? A number of barriers were identified. The most prevalent reason, worryingly, is that students felt seeking help would not make any difference. This perception is one that must be tackled using awareness measures. There also seems to be mistrust of counsellors and a general fear of judgment or rejection from the person being confided in. This, also, is a perception problem that needs to be worked on from the counsellors’ side. In addition, it is a call for the student community to build a more inclusive and supportive environment where people will feel comfortable enough to seek help for problems they cannot solve on their own.

Did asking for help, help anyone? It would seem that for most people who sought support, this step made a positive difference, or at least a “somewhat” positive difference, across the various categories of individuals approached for support. To those reading who feel that seeking help will not make any difference, this shows otherwise! So do seek support for the issues you are grappling with, whether from a friend, family member or a counsellor who you trust.

What is really clear from our sample data is that overwhelmingly, it is family and friends who seem to make the maximum difference when it comes to feeling better and taking actions to tackle mental health concerns. This again reinforces the need to build supportive internal environments for our friends, students and juniors.  

We were specifically interested in students’ feedback about the institute counsellors and psychiatrist. Responses show that more students are dissatisfied with them than are satisfied; however the majority of respondents who have availed of these support systems have given an average rating. Either way, it is clear that there is some room for improvement when it comes to institute counselling services. An anonymous feedback mechanism is suggested in order to address the concerns of students.

Before moving to the last section of this article, here is a selection of comments from respondents detailing their negative experiences with institute counselling systems (edited for length and to protect confidentiality):

• “…When nothing seemed to work, I figured I should approach the psychiatrist available at our institute hospital and this actually turned out to be the most horrible experience of all. On the day of my appointment, I arrived in 10 minutes late to the session. I was greeted by the psychiatrist with, “I come here for a limited time. I have to leave in about 20 minutes. So make it fast.” (My phrasing might not be exact to the word but the gist is conveyed). It already had set a precedent for an uncomfortable meeting. I had a hard time picking up pace with my words and a few minutes later, he dozed off. Yes, he dozed off. Shook his head to keep himself awake. It happened twice in the 15 minutes I spent there. I hope I do not have to explain more. At this point, I decided I will not seek any kind of help any more from within the institute. If anything, it might only do me more harm than good. When someone is speaking in their most vulnerable self, the least they expect is to be heard. I did not feel that. It would not be very surprising if someone tipped their decision the wrong way while having suicidal thoughts, if this is the kind of experience they had.” 
• “Worst.. Simply worst. Once I called them seeking help as I was experiencing suicidal thoughts after breakup, they said I should meet them next week.. ****** up service.” 
• “Medall counselors are good in motivating and boosting confidence. But they do not understand academic constraints. There is a huge mismatch between what Medall counselors think academic pressure is – and what it actually is. They just motivate but they can’t help us academically. Professors can help us academically but they won’t do it because of their ‘BUSY’ schedule and private projects or other commitments.” 
• “Lol is this the real life? Medall counsellors, really? Why would any student go ahead and open up to a random adult with a certificate, when the adult probably has a hotline under his/her desk? The void of the trust element is a gaping chasm, a screaming abyss. Seeing as admin has eyes everywhere, I for one am never going to approach an on-campus mental health support systems”. (edited to remove identifying features)

Part 5: Suggestions and Recommendations

Only 12% of respondents felt that current sensitization and awareness efforts are adequate. How can IIT Madras become more sensitive and supportive for those going through mental health issues? 189 respondents shared their suggestions to make the institute atmosphere more inclusive and support systems more effective. The most common request was for raising awareness and discussion on this topic in campus. We summarize their recommendations below:

Self-help:

“I think being able to simply initiate dialogue and have conversations about mental illness without any prejudice is the most important thing. Instead of asking people to talk about it, we should start talking about it ourselves.” (survey respondent)

• Everyone should know how to identify common mental health issues so that they can seek help
• Educate people that such issues are commonplace and can be treated
• This can be done through the ‘Intro to Research course’, ‘Life Skills’ course, information can be distributed through mandatory awareness sessions, on IITM and T5E websites etc, brochures and pamphlets especially for freshmen, EML lectures, Townhall sessions, etc.
• Students should also know how to respond to fellow students who need support
• Students should know who to ask for help

Academic and professional pressure:

“Insti policies are backward and unaccepting of modern thinking especially when trying to approach adults. Medall has a good reputation although I have never approached them. But the unrelenting judgmental vibes for issues such as relationships, substance abuse and parental pressure puts off many students from seeking help.” (survey respondent)

“Faculty need sensitisation workshops, MiTR office should take it up with insensitive faculty. There are some faculty here who have a long history of harassing their students, but the Department or even the Dean’s office does not take any action. Students cannot stand up for themselves because of the inherent power imbalance in the relationship.” (survey respondent)

A common request was to reduce academic pressure and rigid rules, and to balance academic rigour with flexibility.

• Personal stories from profs who faced similar pressures as students would help a lot
• Need for institute level policies on mental health which recognize the issue and allow some measures/relaxations for distressed students
• Relationships between profs and students can become better and more friendly
• Freedom to choose courses will decrease stress, leading to happier and more interested students
• Professors should be sensitized and trained to be able to recognize and refer students and be able to distinguish between lethargy and depression
• Facads rarely take an interest in students and they should be actively involved
• Faculty should encourage dropping courses when an individual is under stress
• Free attendance policy
• Compulsory seminars for research guides about maintaining ethical and supportive relationships with students
• Students cited a lack of trust with the administration, requesting that admin understand the reasons behind instead of immediately punishing rule-breaking behaviours like smoking and drinking.  

Loneliness, Inadequacy and Isolation:

“Our institute is majorly focusing on professional success. I feel most of us lack the compassion or the empathy that is required to care enough about others to make a positive difference. Indifference is rampant.” (survey respondent)

“Restructure the system, make it less hectic. Understand that people do not become better awesome beings with mere academics or PoRs but through emotional capabilities, social cognition, compassion and atmosphere of love and care. Insti life crumbles friendships and socializing skills. It makes people too busy to talk to neighbours and friends. Here everyone is selfish and lives for material gains.” (survey respondent)

• Increase interaction among students through socializing events which act as stress busters
• Hostel atmosphere should be more pleasant and interactive
• More informal events like karaoke that people will enjoy, rather than only having formal competitions like debates which only confident and established people participate in
• More informal events in local languages

Counsellors and support systems:

“I feel insti has ignored the mental issues that people face at lower levels. Things are only treated seriously when they go reach a threshold and I think in insti’s case, that threshold is very high. I think efforts should be concentrated at having sessions to tackle the milder issues so that they don’t escalate any further into major mental disorders.” (survey respondent)

• Mandatory regular checkups for every student
• Every semester, a stress test for all students to gauge stress levels on campus
• Follow-ups for those visiting counsellors (many said there were no follow-ups and that this affected them badly)
• Mandatory counselling sessions during placements
• Anonymous feedback system for counsellors so that quality of counselling is maintained
• Counsellors should be more easily accessible and visible
• Confidential talking booths
• Sessions for freshies on “how to cope with adult life” and navigating through new challenges (including maintaining self esteem, time management, etc)
• Awareness about who to approach for help
• Informal student support groups for those tackling mental illnesses

We also want to share some noteworthy responses by respondents which could not be addressed in earlier sections (unedited):

• We also need to ensure we are able to differentiate between what could be a generic behavioural trait or a phase of mood from mental health disorders. Being broody over a breakup is different from depression, though it can lead to that. We must also talk with experts on how to perform self-diagnosis and come together with students at CFI to develop a system/platform to seek help””. 
• Many of the problems that PhD scholars face have to do with the guide. It would be helpful if they (guides) are sensitized about these issues. Very often the mental health issues are confused with incompetence by them (while pretending to be completely oblivious to the root cause: which is them), which is just plain wrong. They should create an environment where one is allowed to fail and fail with dignity. Not everyone is comfortable interacting with Mr. KnowItAll who considers yelling at others his birthright””. 
• This question is quite ambiguous, but I shall try to answer it as best as I understand. I suffer from mild depression. I am not sure for how long I have suffered from mental health issues, but my most conservative estimate is three years. That is after the first year I came to insti, as now I am in my fourth year. But I do suspect shadowings of some of the symptoms from when I was 15. The symptoms became worse in my second year, when I started having intense mood swings, existential questions haunting me day and night, the political crisis outside fueling the fire. The academic pressure also affected me and I started buckling under the pressure of the assignments, unable to write, feeling worthless, feeling blue all the time and even suicidal at times. When I started reading up more about the symptoms I had on the internet, I felt that I was clinically depressed. But, as any depressed person, I also felt that this was me trying to escape from my duties and responsibilities- being a lazy ass. My family and friends also seemed to think the same as whenever I aired this concern that I am probably depressed, they struck me down by telling me that I am overthinking it or that it is just a phase and shall pass. It did not. When it got quite worse I sought help with MedAll, but the counselor that I first met did not seem to believe my reasons for feeling depressed. I felt discouraged and did not return. The next semester, I lost a dear friend to depression, who took his own life. This led me to realise that every human life, however insignificant, still had value for they are entangled in this huge mesh of existence, which depressed people do not usually realise. I decided to seek help, also encouraged by my partner who was seeking help for mental health issues as well. The counselor I then met reaffirmed my suspicions and sent me to the hospi psych. The psych prescribed me meds, but I decided to go off of them partly due to circumstances, and I felt fine. Something a bit more traumatic happened to me after this that led me to further cement my belief that I wanted to live. After that the counselor was satisfied with my results and I have been off counseling and the doc for a year now. I have on and off episodes of depression and panic episodes. My functionality and socialization is still badly affected, but I can sleep in the nights now and wake up in the mornings, which in itself is a big change. Sorry, if this is too long and if this is not what you guys intended by the question. But I hope it provides insights”.

Conclusion

This survey indicates that a significant number of students are facing stresses and pressures of various kinds, which often crystallize into specific mental health concerns. Top reported sources of stress include academic pressures, loneliness and feelings of inadequacy. Due to a broader lack of awareness about the types of mental health issues and about how and where to seek help, students may not be able to recognize when they require help and to know how to go about it. Many students have sought help both within and outside the institute to heal themselves, and a large proportion of respondents recognize and call out the need for supporting each other as students and cultivating a more sensitive and friendly atmosphere in the campus. This is a positive trend.  Students also recognize that awareness is key, and that the first step to solving a problem is recognizing that there is one. 

This survey shows a clear need for creating awareness about mental health issues, providing information about how to support peers and friends facing such issues, and emphasizing that they are treatable, common and nothing to be ashamed about. As far as support systems go, while it is great that we have dedicated counselling services, respondents have pointed out many problems in using them. However, along with specific criticisms, our respondents have also provided comprehensive suggestions about what they think will help improve overall mental health on campus. We hope that this survey leads to steps taken in the right direction in expanding and improving support systems available to students who need them. And we hope that our readers feel a little more encouraged to get help and ask for support, when they find themselves stuck with recognized or unrecognized stresses and mental health concerns.

The Fifth Estate