Psychosocial health of Northeast youth: Where is the pill to internal peace and stability?

It was from his accent that I figured out, he might be from Assam, so I asked him hesitatingly and to my surprise Pulakit (name changed) was from Dhakuakhana. I was elated, having spent over ten years living in the adjoining Dhemaji district it was a delight to meet a young man working as a floor captain in a popular restaurant chain in Bengaluru. I asked him what he misses most, promptly he responded boiled food ‘laasor’ and ‘ghoror saulor bhat’ (Homemade rice). While my Kannadiga husband understood ‘bhat’ Pulakit and me smiled silently.

Another beauty parlour in a commercial hub of Bengaluru passes off their staff as Chinese, whereas they are Bodo women from Udalguri and Kokrajhar; until one understands a little bit of Bodo or understands when the younger girl is addressing the older one as ‘Aabo’ (elder sister). These beauticians are extremely skilled in their work, and are highly in demand, however unlike Pulakit they were reluctant to engage with me in any talks about Assam. During lunch hour the smell of bamboo shoot warts in though the half open door of the upper room.

A view of Brigade Road in Bengaluru ( Photo- Sathyasree Goswami)

Bengaluru is known for people from North East India working in various blue collared jobs in large numbers, however a new location is Tirupur, the hosiery hub of India located near Coimbatore. My friend Nambi who runs an NGO called CSED there tries to raise voice for the workers in these factories amidst great resistance by the mill owners. He has pointed out to me that there are a lot of workers from NE now seen in Tirupur, who do not have access to any facilities that Tamil workers have and are unable to speak to the locals as well. Being a trained psychotherapist and working mainly with resource poor communities, I wonder what the mental health condition of these workers is who have left behind a rich culture of fresh food, community life and languages/dialects of a various hues of the hills and valleys.

Mikkel Borch-Jacobsen a well-known philosopher of psychiatry, psychoanalysis and hypnosis has widely written on the social construct of mental illness. It is common also now in Assam along with other NE states to pop pills for treatable psycho-social illnesses like depression, anxiety, aggression etc. Borch-Jacobson points out- "Each pill, each molecule creates a new condition—and a new market for pharmaceutical and biotech companies.” It is interesting to note that as companies develop more sophisticated treatments that target specific neurotransmitters or genes, various conditions are found to emerge that respond to those treatments of mental illness. A colleague of mine from Lakhimpur lost both his kidneys when he was around 30 years old as a side effect of (unexplained) headache medication. He was a firebrand activist of the area but was psychologically completely shattered when he understood the cause of losing his kidneys.

Ridden with conflict since the 70s the seven States have seen intergenerational violence and trauma. A study of 12 States carried out in 2016 by NIMHANS a premier mental health institute of India ranks Manipur as having the highest prevalence of mental illness at 14.1 percent. World Health Organisation has estimates depression and anxiety would emerge as the largest killer by 2020, and here we are in a new decade and yet unavailability of trained professional in public health services is a bitter reality for the north eastern states.

A 2017 publication by Dr. S. K. Deuri, the Director of Lokopriya Gopinath Bordoloi Regional Institute of Mental Health (LGBRIMH) Tezpur Assam and Dr. Shobhana S, Associate professor at the institute states that apart from Assam most of the other States lack adequate number of clinical social workers, psychiatric nurses, and clinical psychologist, for instance entire state of Arunachal Pradesh has just 2 psychiatrist and none of the other professionals. LGB Regional Institute of Mental Health also known as the Tezpur Hospital is the only regional institute but largely lacks adequate number of staff in spite of it being always overcrowded.

While determinants like unemployment, perennial armed conflicts, lack of infrastructures plagues the youth, who therefore come out of the region and live in squalid conditions in places like Bengaluru, Mangalore, Delhi to name a few cities. The psychosocial health of these youth and the psychosocial health of people living back in the north eastern states both need equal attention. Its two faces of the same coin, yet there is no focus on this aspect of development. WHO also predicts that by 2020, an estimated 20 per cent of India will suffer from mental illnesses, and there are less than 4000 mental health professionals in India.

As a part of my doctoral research that is exploring the links between medically unexplained pain and psychological trauma, the prevalence of such pain or other psycho somatic conditions of unexplained headaches, neck and back aches are quite prevalent even in the NE region. Exposure to trauma and violence and moving towards aggression while living in constant traumatic situations is also well researched, however there is sparse data from North Eastern States. One might therefore wonder when people are living in constant threats of violence, exposed to life threatening conditions, it is natural to seek more peaceful living and stable living conditions in the bigger cities. Yet do these cities really provide emotional stability and cultural acceptance? It is a known fact that people of North Eastern origin face constant threat in places like Delhi from the local landlords, on the streets and otherwise.

Neither back home nor in the work cities people of the North Eastern region of India live a life of wellbeing, will Pulakit ever be able to taste ‘ghoror saulor bhat’ in peace? The social and political construct of psychosocial wellbeing especially for a region like North East India needs special attention and along with working on determinants like unemployment and infrastructure development, the policy makers need to see that the psychiatric pharmaceutical industry does not swallow the people where prevention and management is possible without the pill.

Sathyasree Goswami

Sathyasree Goswami, currently lives in Bengaluru is a development practitioner, psychotherapist, and researcher by practice and a writer. She can be reached at [email protected]. The views expressed are the author’s own.