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“In Pakistan, mental health has never enjoyed parity with physical health”

An interview of human rights specialist Daanika Kamal, founder of The Colour Blue, a social enterprise which empowers those facing mental health challenges

“In Pakistan, mental health has never enjoyed parity with physical health”

The News on Sunday: How did you start The Colour Blue? What’s the philosophy behind the name?

Daanika Kamal: Almost five years ago, I was diagnosed with clinical depression. My journey with depression is best described as a process of trial and error. What worked and what didn’t – what triggered and what settled. Despite the support I received from family and friends, depression convinced me that I was alone in this struggle. That’s where TCB came in – it started as a safe space for those who needed to escape the chaos of their own minds. I launched TCB last year, in the midst of my divorce – it was my stability and safety as the world around me spiraled into chaos. A year on, TCB has grown into an institution which houses advocacy, services, community engagement, research, policy and legal developments relating to mental health.

As for the name – Blue, as a colour, is commonly used to indicate emotional distress and sadness (‘I’m feeling blue’), but we also see it being associated with serenity and calmness, reflective of the sky and natural waters. The colour blue is therefore a double entendre of sorts – similar to the minds of those struggling with mental health. The name is also a play on the book, The Colour Purple (written by Alice Walker in 1985) which stands for liberation of the mind.

TNS: What does The Colour Blue do differently?

DK: One of the greatest barriers to mental health is that symptoms are typically invisible in a physical sense. As humans we tend to naturally gravitate towards that which falls within the scope of our five senses. Mental health symptoms can rarely be heard or touched, and this compounds their dismissal in society. At The Colour Blue, we use art to present mental health visually through our Creative Residents, a group of local, varying artists who have used their art to shed light on mental health as a means of advocacy, or use it as a therapeutic resource.

TNS: Can you tell us a bit about your background in human rights, and how that was perhaps a unique entry point to mental health advocacy?

DK: I have been often asked this question, and it’s typically followed up with ‘how come you switched your field?’ – I genuinely don’t feel that I have switched my career path, rather, I’ve just chosen a distinct focus within the same one. Under international law, and throughout my training in human rights law, we have maintained that health is a fundamental human right – but somehow we keep limiting it to the ambit of physical health. I think framing mental health as a human right helps us understand that ‘good mental health’ is more than just the absence of a specific, medically-endorsed illness but rather stands for emotional well-being and the right to be free from discrimination, stigma, prejudice, social exclusion – all of which, to me, are ‘social’ symptoms faced by those struggling with mental health.

TNS: How important do you think it was to flesh out the link between mental health and human rights?

DK: I find that the relationship between mental health and human rights is three-fold: human rights violations lead to higher probability of mental health symptoms; malpractice and mistreatment in mental health can have severe, negative impacts on human rights; and greater protection of human rights can mutually benefit protections extended to those with mental health illnesses, who in some cases may be unable to successfully assert their human rights at a time when those rights are most vulnerable to being breached.

TNS: What should be the state’s response as mental health becomes more precarious with complex challenges ranging from economic woes to climate change?

DK: Mental health research has rarely shown interest in the political – but in recent years, it is coming to acknowledge that the current “us vs them” zero-sum politics is intrinsically linked to the personal. Partisanship drives much of our lives; where we live, who we interact with, where our children go to school. The way politics represents itself determines our day-to-day difficulties. When stakes are high and outcomes are uncertain, levels of stress are easily diffused in communities. There is a sense of dread lingering about what will happen next; sometimes coupled with a sense of powerlessness and hopelessness. Turbulence on the streets can easily make its way into our homes, creating a loop between personal and political anxiety. The way we respond to fluctuations in the economy, high rates of inflation and climate change is influenced not just by our personal resilience but also that of our societal networks and communities. In Pakistan, mental health has never enjoyed parity with physical health — not in terms of financial budgeting, laws, education or practice, despite increased levels of mental well-being having been internationally acknowledged as a prerequisite for individuals to reach their full potential- ultimately enabling greater social development.

TNS: Would you concede though that mental health has become a part of public discourse now?

DK: Internationally, perhaps. Locally, far from it. The way that I see it, the right to mental health has two equally important components – the individual and the public. The former focuses on each government’s responsibility to ensure that it is not implementing policies or practices that are harmful to the mental health of individuals, and the State’s duty to provide services necessary to maintain good mental health. The latter looks at mental health through the prism of public health which is a more expansive portfolio, and goes beyond prescribing the State’s role in simply providing care or rehabilitation services. In addition, it focuses on the obligation that communities and society (as a whole) have to ensure public conditions foster good mental health. This is testament to the global shift away from mental health being simply a ‘moral’ claim, to becoming an inalienable human right that countries (governments and citizens alike) are obligated to respect, defend and promote.

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TNS: How important are community responses in fostering an environment conducive to mental wellness?

DK: In Pakistan, the interplay of religion, culture and patriarchy intensifies mental health stigma ten-fold. It causes people to battle mental illnesses in silence, isolate themselves and be reluctant to seek help. Step one, is to stop taking myths as fact. For example, it’s untrue to think mental illness is the result of a character or personality flaw, depression is not over-sensitivity or playing the victim, and acts of self-harm are not testament to attention-seeking. In times of arguments and abuse, it is common for stigmas to be used to discredit individuals through statements such as ‘her memory can’t be trusted because she is depressed.’ This can lead to those struggling with mental health to take on self-stigma and internalise negative associations. In worse cases, they can start doubting their perceptions of reality.

Enum Naseer

The writer is an assistant editor at The News on Sunday.

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