 So, well, a very good afternoon, ladies and gentlemen. Rather, it's taking towards the time. It is time for us to now get to our final panel discussion. Well, what an engaging conference this has turned out to be. And it is now time for a rather very engaging panel discussion, which we'll be talking about implementing a preventive approach to combat mental health concerns workplace and beyond. While measuring progress on workplace mental health, its promotion and measures, what can the corporates do to create a safe environment for people with mental illness? And how can we make India more inclusive for people with mental illness? Well, ladies and gentlemen, for this exciting topic and hearing, it is time for us to now call upon the screen our esteemed panelist. First up, Dr. K. Madan Gopal, Senior Consultant Health, Nithya Ayo, Dr. Radheesh Gupta, Director, Government Institute of Medical Sciences, UP. We are the senior vice president marketing Columbia Pacific Communities, and the session shed is Ruhel Amin, Senior Editor, BW Business World, Executive Editor, BW applause. Well, with this, I'd like to heartily welcome all our esteemed panelists. Thank you so much for your valuable time with this, Ruhel. The screen is all yours. Thank you, Vamana. Thank you for this introduction. Am I audible to all my panelists? Yes. All right. Okay. So I think we don't need to emphasize more on the importance of mental health given the last two and a half years, a lot of focus has been on it. And rightly so, I think it concerns all of us. And it's the right time that we put it at the center stage and start talking about how we are addressing it, what needs to be done. How can we make it even more effective? So we have a great panel as introduced by Bhavna. I want to start with you, Piali. With you, my first question to you, Piali, is, in your view, how are organizations looking at preventive mental health care? Has there been a shift in the way they look at it? Thank you so much, Ruhel, for the question and a very good evening to everybody that's joined as well as to my fellow panelists. I'm very happy to be here. I must mention that I'm just recovering from COVID and I do have some post-COVID complications. So I'm coughing excessively. So do excuse me if I'm coughing too much, but I'll try to do my best. I'm going to introduce myself. Obviously, my professional designation is that I'm Senior Vice President Marketing at Columbia Pacific Communities. That's what I do for a living. But in the context of this particular discussion, I'm going to introduce myself as somebody with lived experience. So I am people with lived experience of mental illness. I was diagnosed with clinical depression and generalized anxiety disorder when I was only 13 years old. And so it's been 24, 25 years of living with this illness and trying to manage it as well as obviously working. And from time to time, I am requested to be part of panels because I also do a lot of advocacy work on mental health. And I have my own podcast as well. And certain publications ask me to write about this particular topic. And I've always said that we haven't even scratched the surface as far as doing something on mental health is concerned. We are very, very far behind. And I've always said that what I find unfortunate is the fact that it took a pandemic for us to take mental health seriously. When it is such an integral part of your overall health and wellness, in fact, it is health, which is why it is called mental health. I do not understand why we've sort of for years and decades together not paid attention to it, not taken it seriously. And in fact, done a tremendous amount of disservice by stigmatizing against people that have mental health issues. As far as organizations are concerned, and I have been a part of some very large organizations as well. I have to say that not much is being done. Yes, in the last two years, awareness levels have gone up. There is no denying it. Yes, I think today HR functions are taking it a lot more seriously. There are conversations happening with the leadership. They would probably do a bunch of surveys like a pulse survey or a Kerasack survey to figure out how their employees are doing. They would probably have mental health counselors on board to offer free support for somebody that's going through something. They would probably, certain organizations during the pandemic, announced a four day work week, only to go back to a five day work week. So we've seen a lot of these kinds of things. We've seen organizations say that there is going to be yoga and meditation available in the premises, etc. So yes, we have seen a lot of these initiatives, but are they enough or are they being done from the point of view of really, really looking at mental health seriously, or are they being done from the point of view of, hey, this is something that is going to increase my productivity and is going to help me get better ROI. I think that is the conversation that we need to have. And I think I'm glad that we have doctors today as part of the panel, because I think their point of view on this, as well as the point of view of people with lived experience is very, very important because corporates often do things, whether we like to admit it or not, because there is a certain agenda attached to it. I mean, you could do a whole bunch of HR related mental health activities, but that could be ultimately because you want to, let's say, look at certain business objectives, like better attrition rates or higher productivity. At times just a tick mark, but I have a separate question for that. I have a separate question for that. I'll come to it and let me go to Dr. Gupta at this stage. It's his initial remarks on implementing a preventive approach when we talk about it. How far have we come in this conversation according to you? Thank you, sir. Good evening, everyone, all my panelists, and me for you for inviting me for this panel. See, this is a very important topic in post pandemic that mental health is part and partial of our health and well-being. It is an integral part of the WHO definition that mental health, it's a physical, mental, social, and spiritual well-being. I think now we are taking post-COVID complete definition in mind whenever we are concerned with mental health. So this is, I think, a very, very important thing. And as a whole, we are in the government organization, but for corporate, private, everyone now have to look at the mental health of their HR, their employees. This is not only for their own safety, own security, but as well as also for the productivity and whatever outcome you want to expect from your employees, probably mental health is part and partial. Mental health is, you know, it's not only that they look happy or a lot of factors are there, a lot of these factors are there, which has leading probably post-COVID, which is much, much more important. So this actually involves their own personal problems. There are problems because of COVID. There are nuclear families, they have to take care of their families as well as their workplace. And if they do not look after equally the workplace, probably they are discriminated. A lot of stigma and their performance is actually deteriorating. So probably this is a very important part on the aspect of all stakeholders in government as well as to take care of this mental health in total. Dr. Gopal, we are very fortunate to have you with us. You are more qualified when it comes to implementing a preventive approach because it might need a regulatory push at times to ensure that it happens. But your initial talks when we talk about preventive approach to combat mental health concerns, how has it evolved over the years according to you? Parishan Mute. Thank you Rohit and thank you for this opportunity to share my thoughts and views. No doubt it's a very big issue and I will just take the things forward where Dr. Gopal has left. It took around 40-45 years to arrive at a definition of health, at least with the state of physical, social and mental well-being, not merely an absence of business. And for implementing that, I think some parameters were agreed, that is health for all by two thousand. At that time it was only focused on the health. And that approach was designed that is comprehensive with the primary and secondary approach. Then the goals were shifted from this health for the linear development of the statistics. Now we have moved from the health, from the disease, it was way back before the formation of WHO for disease. From there we come to the health with the indicator we tried to measure. From there we have now, the paradigm is now shifting towards the wellness part. That means if you are well, then you can always enjoy the physical, mental and social well-being. So we are focusing more on the well-being. Apart from that, if you talk about the regulatory things, we have the Indian Lunatic Act to 1912, where it was a involuntary admission and the doctors were responsible for the treatment. And it is the discussion of the doctors for providing treatment to the patients. Then in 1982, we are having a national mental health program. We started the national health program when in India was signatory to the Armata Declaration and we thought that at that time we should be doing something about mental health. There also we have started this mental health program, which was more of a centers towards awareness as well as preventing and providing treatment to the people. Then we had this national mental health act in 1987 where we have tried to see that from the involuntaryness, it has become a voluntary. That means the patient family and the patient of the person can take care of this. But the rights and other issues were not there, right of a mental person and the issues were not there. And since 1996, we are implementing the district mental health program where it is focused on more or less providing treatment through the district health network, providing the psychiatric services at the district hospital. We are having around 700 plus districts in the country and each of the districts will be providing that services which are there. Then it will more or less focus on the preventive strategies for screening of the population as far as providing treatment environment to the patient at that level. Then in 2014, because this was all centered on the treatment aspect, there were no rights issues. Then in 2014, we had that national mental health policy where we talked about the rights. I mean, we have seen the act from the rights lens, right of the mental person in this. In 2017, we had the national mental health act where we have talked about the criminalizing because even though the act was there, but there were other acts. The other CPR acts were there which were taking precedence for this mental act. The mental person was not having any right for the property. He was not having the ground for divorce and other things. If the person is not mentally sane, there were certain issues with that. So in that, all the things were addressed during this 2017 act. And with now, you see what change has come previously for the ECT therapies, no consent was required. Now, consent is required and NFC, she has required for providing that. Here, we have all from that level to this level. And the district mental health program might have seen that there would be many societies which have informed that the Mohalla level as well as the village level, which is trying to provide some preventive services to these people. So that's one thing. And in the course of this session, we can discuss and discuss all the rights of all of this. No, absolutely. I think you have given an overview of how things have changed. And thank you really for that. Piyali, as an expert and someone who has lived, you know, who has lived experience of what all it means that we are discussing. You know, how can organizations measure progress on mental health at work? What are the bigger challenges? And what are the right ways to do that? Right. Look, I mean, there are obviously different ways of measuring whether an organization has made progress on mental health or not, right? Like I mentioned earlier to you that there are several tools that there is a model called CARISAC, which, you know, somebody had sort of come up with at least about 20, 25 years ago, which a lot of companies do use. You could do a pulse, check. There are questionnaires where, you know, you kind of talk about whether an organization is able to give you decision latitude, is able to fight you with the kind of work and not overwhelm you with work and also is able to give you the right kind of support. And on this, you know, it is decided what kind of scores are given, right? But I think the point here is, like I mentioned earlier as well, what is the objective? What is the objective of doing this? You know, is the objective purely productivity-led, business-led? Because then I do not know if that is the right approach. On the other hand, if it is really about caring genuinely about the mental health state of people and understanding that mental health is a very, very integral part of physical health and the two go hand in hand. And there is, you know, there is no physical health without mental health. Then I think, you know, we are talking about progress, right? Typically, what is being done today is, like you yourself rightly said, it is a lot of pick-marks, right? We have done this, we have done yoga, we have done, we have done counsellor, we have done four-day work week and all of that, which is all fine. I mean, at least something is being done. But are you primarily and fundamentally encouraging open conversations in your workplace around mental health, giving people a safe and no judgment environment to talk about their struggles, creating platforms actively where these conversations can take place, and involving leadership who also show their vulnerability in order to come across somebody, in order to build a culture where vulnerability is not only accepted, but even celebrated. I think that, to me, is the right approach. I think that a lot of companies are probably not looking at the bigger picture. They're looking at mental health because today, suddenly, after two years of COVID, it's a huge talking point, and you cannot talk about mental health, and it's the cool thing to talk about or the in-thing to talk about. I'm glad that people are finally talking about it. But are you taking care of the brass tacks and the fundamentals? And the fundamentals here is mental health is a topic that is steeped in stigma. It is steeped in stigma. People suffering from mental health issues have always been stigmatized against that work. They've always been seen differently. They've always been, let's say, denied certain kinds of responsibilities. They've always been kind of bracketed as, let's say, difficult or whatever it is. Are you actively doing something as leadership to actually dispel all of that? I think that is really the need of the R. It's not so much about saying that, oh, on my mental health index, I have a mental health index, I've moved from 7 to 9. That's great. But what are you doing beyond that? I think that's really what we need to focus on. Thanks, Piyali, for sharing these insights. Dr. Gupta, I have a specific question for you. Mental health has gradually moved to, there's a difference of, like in the upper class and all these economically high classes, it's an issue that can be addressed. But in a state like UP where maybe a taboo in certain places, how do you ensure such conversations are accepted even? People who entreat themselves for mental health, I think it's not still acceptable in the larger part of the India part, of course, understands the Bharat part is still coming to terms with this thing called mental health. I think there's law of taboo. Is it correct? Am I right? And how do you address it? Thank you, sir. I think this is a very pertinent question. And what you said, for middle and lower class, still it isn't a taboo. For any employee person at a workplace, declaring himself not to mentally sound or describing or discussing something, probably, I think it's a taboo. And this what Madam Piyali has said is rightly discriminated and they are actually not given the due response to what they are supposed to do. So this is actually a role of leaders and then managers to ensure that mental health also should be taken care of at the lowest level. So what we have to have, we have to remove the stigma. It is not easy, it is difficult. We have to improve the communication at all levels, maybe horizontal, vertical, diagonal. People should have good accessibility to what Madam has said. There should be an active creative platform where people can actually express, may not be by name, may not be anonymously. They can launch feedback. Feedback is another way you can get. And anywhere, rather than people are coming, the higher ups can go to that particular level where they feel that people are not performing well or people. So rather than finding faults with them and then further discriminate, probably, they can find out the effect what is wrong and probably there, they can find out a lot of feedback. We in our own government institute, we have, you know, do the open Darbar. Open Darbar, again, people may not come, but at least they know that higher up, the hierarchy is actually sensitive to their issues and probably in one platform or other platform, they normally come out and we try and actually approach them directly or indirectly. So accessibility is one, taking feedback, good communication we can actually keep. And of course, anybody who needs to be helped, maybe, you know, free sort of a consultation or free checkups, free treatment, all these things, if you made these things available, probably more people will come out, more people will put up their problems and I think mental health of the organization can be actually improved. Absolutely, absolutely. Dr. Gopal, are there any regulations being, you know, thought of to mitigate concerns related to mental health at the workplace? Do you think we need a strong regulatory push to implement, you know, this? Rohail, it is very easy to say about regulation. This is a journey which we have made from the lunatic act to the national mental health framework which is there. So you see the progress which we have made, because talking about mental issues, talking about regulation as a solution, it's very easy said then done because do we have the regulatory capacity? We do have a mental health program. We are in the different level of implementation. The program is still to mature. It's almost 15, 20 years and we have to see that a long way to go. Regulation is not going to be that much important because we do have accurate standards that we will see you see the whatever programs were there in the 87 act, they have been rectified after 20, 30, 40 years, we have rectified that thing. It has now given rights to that kind of thing, but only thing for revitalizing this is to empower the person to sense how to use this enabling provisions which are there in the existing act, existing regulations. They're quite fair enough to at least safeguard the rights and interests of the mental health people. But having said this, there are larger more issues about the mental person. You see, it's not the person who repose that I'm not well and you see the way the things happen. In the government institution, you see people don't want to go back home because if the person is continuing, if they want to work until 9 o'clock, 10 o'clock without any work, if the person is not able to complete his work in this definitive time, as we mature, our attention span also comes down. We require some break from that environment. The mental problem is the last thread. It's not only the person who is coming and reporting. We have to find out ways of helping all these people. Regulation is not going to help you. We are having enabling provision. I'm just repeating that thing, but it goes way beyond that. You talk about the issues. One of the important issues is if the person is doing overtime, is he mental? That's a question which you have to ask. As Gupta Ji has rightly pointed out whether the administration or the other person, they are coming and talking and getting like or not. If a person is in a position, if he asks the feedback in a policier manner, what kind of feedback he will get? How many schools they are having counselors? It starts from that school level. How many of the people we counsel our children and other people? We say that you take that kind of attitude we are having. So a lot of work is required. It's not the regulation which will bring the kind of change, but we have to start work right from our ourselves. We start work from ourselves. How we treat the other person? Because the ambition has overtaken all the aspects and the value system is the ambition as well as making how much money you are making. That drives all the things. I start my day on time. I finish my day on time, but I am more productive than most of my colleagues. They sometimes wonder what is happening. So you have to see that if the person is particularly strong, then he will never cling because if they would look at the government functionaries and other, if they are trying to cling to the government that is office, that means something is wrong either with him, at home place or something is wrong. Because a person can't be having an attention span of right. We have to address these issues rather than it's a society. We have to address this issue. Regulation, building environment, but given the capacities, we can't be forcing people. So that's the challenge. We have to see that how we balance it out. And this problem is going to be with the ambition and the value system more or less coming previous videos to ignore it. The value system is money only. In what, why who can prove you have to create money? So if that value system is there, right from, it's not the upper class. The lower class also, this problem is there. Because mental health issues, they ultimately culminate into the substance abuse, the drug abuse, everything. The addictions and other things also link to the mental issues. It's not a simple thing. You have to look it in the different cabinet. And there are many social things to that. We have to address that thing. Absolutely. Absolutely. Of course, I think it's not just the regulatory pushes also, the awareness part of it and people being aware, unless they are aware, I mean, they won't even go for the treatment. Piyali, two questions for you. We have 10 minutes. So I have my last set of questions to you. First, one you mentioned, again, I'm coming to that lived experience. First, tell me, how can people with lived experience contribute to the mental health discourse in the country? And second, there's another taboo. I might say postpartum depression and not many people talk of even that part. So if you could respond to these two questions. Yeah, sure. Before I go on to these questions, I just want to add that the taboo of mental health is not just something that's in the lower classes. I think that's not the fact. In fact, I know a lot of extremely educated, foreign educated, established people who are seeing symptoms and are not taking treatment because they do not want the tag of being mentally ill. Because like Dr. Madan Gopal said earlier in the conversation, mental health was considered being lunatic. I mean, you heard about the journey of how from lunatic act, it's now become something else. And I think that association and that correlation of mental illness being something to do with being mad or not being okay or being unstable or being a lunatic is something that we still deal with. And it's very much prevalent even in upper class society as well as in middle classes and in all classes. Coming to the question of how can people with lived experiences that is PWLE, people like me, contribute to the overall discourse, a couple of things. One is I think people with lived experiences should be actively sought out for forums, for discussions, for discourses, for various activations in mental health and the awareness building initiatives of mental health to come and openly talk about their experiences. Now, everybody has a certain level of comfort in talking about it. Today, I can openly talk about my experiences of living with depression and anxiety. Five years back, I was not this person, right? And something in me changed and I decided to become an advocate. Now, not everybody is going to be an advocate and that's fine. But the ones who are ready to talk about it and the ones who actually come out and share their experiences should be sought out in organizations, outside organizations, to come and share their experiences so that people who do not have the illness know exactly what is it like to live with the illness and the symptoms. And more importantly, know that there is a difference between the symptoms of the illness and the human being. And often, because the symptoms often engulf the human being, we forget to look at the human being separately from the symptoms of the illness, right? And I think these are things that are very important to be understood, particularly in the workplace environment, right? The second thing that I want to say is that people with lived experiences are a very rich resource of all kinds of information. Now, whether that is information that is needed to do further research, whether that is the information needed to do a breakthrough study in mental health, for example, I have contributed a lot of my time towards these kinds of researchers and things like that. And the idea is to actually tap into that, right? And finally, the third thing that I want to talk about is that, you know, there's a lot of conversation today around diversity, equity and inclusion. We talk about DE&I all the time. It's the other buzzword. But what is really diversity, equity and inclusion? You know, diversity, equity and inclusion can't just be about hiring a woman's CEO. It can't just be about hiring 50% of the gender, just the gender conversation. Yeah, it is not just about gender diversity. That is yes, one kind of diversity for sure. But real diversity, equity and inclusion is about actively hiring all kinds of people with all kinds of experiences, whether they are mentally ill people, whether they're people with a physical disability, whether they're people from the LGBTQIA community, whether they're people in the autism spectrum, are you actively hiring people of all kinds, including neurodiverse people, so that your workplace clearly becomes something truly diverse for you to be then able to tap into, you know, the resources that you have and build policies that truly make your workplace inclusive. Otherwise, I think we're doing a great disservice to the whole conversation of diversity, equity and inclusion. So that I think is the first part of the question. The second part of the question was about, and I hope that answers your question. The second part of the question was about postpartum depression. Our postpartum depression is depression that affects new mothers after they have had a child. They suddenly slip into depression. I know of many cases, people that I have worked with, people that I continue to work with, people that I have the highest amount of respect for who have gone through this very, very challenging phase. And although I am not a mother myself, but I've gone through and I'm currently continue to go through depression, which is a life alterating, debilitating disease, which becomes very, very challenging to deal with when you are also having to get to work and get things done and, you know, carry out your responsibilities there. We have to understand that 20%, if you look at the data today, 20% of women in India, new mothers in India suffer from postpartum depression. That's one in five new mothers. It's as common as that. And yet, there are no conversations around it. There is again, a lot of misconceptions, stigma around it. And, you know, the more I think about it, the more I feel that it is because women in our culture have always been seen as, you know, as, as nurturers. And that is supposed to be our default role in the culture. Right? So you cannot somehow, you know, come to terms with this idea of a woman who's become a mother being depressed. Right? I mean, you sort of, you sort of by default thing that somebody who's a mother and has just given birth to a child is by default extremely happy and very content. But that's not, that's just not how brain chemicals work. You know, I mean, it is, it is a different phase of life that she's getting into her priorities in life have changed overnight. Her body is going through all kinds of changes that she herself is not being able to make sense of. And she's entering a phase of life, which she's not really prepared for. She has no firsthand experience of it. Right? So obviously, it's, it's, it's an extremely challenging time. And therefore postpartum depression is a reality. It is something hundreds of women are dealing with quietly, silently, not able to speak up at work. In fact, I remember this absolutely brilliant campaign that Prager News had done about three to four years ago on postpartum depression, which I think everybody should watch on, on, on YouTube. And, and it's, it's just something that organizations are ill equipped to handle. They have no idea how to handle this. They have not done anything to understand how to build a support system around new mothers and building a support system around new mothers is not just about giving them a crash and giving them maternity leave and giving them off time and things like that. It is also about understanding whether they are going through a severe mental illness and how do you then sort of, you know, support them. So I mean, those are my points of view on this. I hope I think that answers your question. Absolutely. I think I think really you have given a very elaborate input, you know, view of the problem. My last set of questions to Dr. Gupta and Dr. Gopal, Dr. Gupta, to you. What changes are needed to ensure that, you know, preventive mental health care becomes a top priority at all levels? First to you, Dr. Gupta. Yeah, thank you, sir. I think if you go through the whole symposium and ultimately this is what actually the take home message is for everyone who is listening and probably this is very important. Now, first and find out, I said, if you want to improve the mental health of any organization, probably you have to understand the facts. You have to find out what the work related risk factors which can actually are causing a great mental stress among the employees or the workers. So what is required to be done? You have to find out the causes. It could be a poor communication, both horizontal, vertical, diagonal. There's a very poor interaction between among the workers, who they are managers or seniors in any organization. So interaction is important. We have to encourage interaction so that they can come out with their problems. Then we have to train our people. One, you can compensate your or you can improve the efficiency of your workers or your employees by empowering them by good training, good skills, if you teach them. You have to look after in case they are working in an unsafe environment. So you have to see the safety of their environment. You have to improve their decision making. All the workers, they should be empowered if they wanted something to be done, something to be modified. Probably they should be given the liberty to change. Even our own organization's objective also should be clear. It is not only profit making or your goal achieving. You have to see the limitations in which they are working and probably they are doing their best and if you improve their working conditions, probably their output will definitely improve. Then we can promote the mental head by positive aspect of the work. We can make the ambience, good lighting, optimal temperature, availability of their recreational activity, availability of food, good canteen. I think these are various incentives. Then you have to have active measures to improve the mental health. You can have create some platform where people can come and have access. You can appoint counselors where actually they can go and interact other than interacting with their superiors. Probably they are much better. Accessibility we have to improve in the system so that people should come out. You can facilitate, you can empower, you can have some staff, developmental programs where probably they are more encouraged to join and probably their income and future prospects also improve. So overall you have to provide them free or subsidize your checkups, availability of treatment. So I think if you see in total, probably you can improve their wage and means to find out and their wage and means to improve the mental health of the organization. Final words Dr. Gopal. Well thanks. One of the important things at the place is that we should have a workplace policy for dealing with the mental health of the persons. One way is to adopt that ESG framework which everybody talks about but very few adopt. He said how we move towards adopting that ESG framework. We only create stress to the employees. Now we see that how to distress them by creating recreational activities and opportunities for them. It's very easy because many of the organizations for the sake of recreation they create a gym facility is there. But gym and other things only the persons who are interested in doing this or the gym method they would be going in. The other games also with the people can play and they can relax themselves. We have to create that kind of culture. The hierarchy has to cut across all the sections. It should not be that I'm the boss, you're the worker. They should play all played together. Then only the collective feeling and the commodity will come and the collective growth of the organization can happen. A lot of things to be done but the things have to start at our level. What best we can do to see that the person whom we are interacting at the house level, how we are treating with your household helps another person. It has to start from there. So how you treat your this colleagues and others. We have to start from ourselves and the organization can evolve and match around that. I will stop here. Otherwise a lot of things to be done is very easy to talk about mental health. This to be done, this to be done. But we have to match the people in changing their behavior. It has to start from us. So that we can talk and we can take it forward. I'm really sorry we're out of time but thank you so much Piali, Dr. Gupta and Dr. Gopal for sharing your insightful thoughts on this discussion. Thank you very much for your time. Thank you. Thank you so much. Thank you. Thank you. I esteem to upon this. Thank you for joining us today.