Coronavirus has been called the ‘black swan’ moment, indicating that it is regarded as a paradigm-changing event for all things under the sun, and has accelerated the transition to all things online. This has also made technology-delivered psychological interventions a thriving reality in these unprecedented times. This digital revolution in mental healthcare was long overdue and was being discussed for several decades by scholars. However, the wide research-to-practice gap has resulted in failed implementation of these strategies over the years. Therefore, both mental health professionals and patients have welcomed the advent of teletherapy owing to the unpredictability of the ‘black swan virus,’ coupled with social distancing precautionary norms.
It is important to note that teletherapy includes, but is not limited to, psychotherapy through video conferencing. It can cater to heterogeneous populations by emphasizing prevention-based approaches, and extends to people at risk. Teletherapy, in a nutshell, is seen as the future of mental healthcare because it is accessible, available, and cost-effective. However, this cannot truly be generalized across the globe since most of the teletherapy research, much like other research, exists in a vacuum made up of WEIRD (Western, Educated, Industrialized, Rich, and Democratic) populations. Therefore, these studies’ results cannot be blindly applied to all contexts. Hence, it is important to consider that teletherapy can prove to be beneficial only in certain settings but not in all environments.
In developing countries, an uneven distribution of resources leads to disparities in mental healthcare accessibility. India’s present socio-cultural context (the rich-poor gap, gender inequality, religious differences, and the caste system) and its inability to view mental health as a priority, combined with the internet access gap, makes it difficult to view teletherapy as a viable option for all, even during these dire times. The mental health needs of the country have only grown owing to the pandemic. Research has shown that the lockdown has affected people in India differently, with its implications varying across people’s sex, occupation, place of residence, and socio-economic status. India imposed a lockdown as a response to the pandemic two weeks after WHO’s declaration of COVID-19 as a pandemic. It was a needed shift, but came with various mental health consequences. Moreover, a positive correlation between the duration of the lockdown period and diminishing mental well-being of the individual was observed. More than two-fifths of the population admitted to experiencing anxiety and depression owing to the lockdown, making it necessary to expand mental health services in the country.
There are certain challenges pertaining to mental health care in developing nations that cannot be overlooked. For example, India still battles with destigmatizing mental illness. Mr. Ajay Gulzar, a psychologist, observes that there is a certain hollowness to the whole ‘reach out to a mental health professional’ narrative in India. In view of teletherapy, on one hand, there is a population that uses technology like it is a second language to them. Hence, social media awareness is helpful for this target audience as it initiates a dialogue about mental health and reaches a considerable amount of people in need. Social networking services such as Twitter, Facebook, and Whatsapp provide room for socially relevant discussions and various online activities (example, classes and workshops) to increase awareness of, and provide ease in access to mental health services. These online sources are advantageous for learning about positive health outcomes relating to one’s mental health issues. However, on the other hand, an underprivileged population does not have such easy access to technology and thus, lacks access to social media. This proves to be a barrier for poor and marginalized people, instead of acting as a medium that makes it easier to reach out for help. Therefore, the issue of mental healthcare accessibility in India does not have its solution in social media campaigns when only 24% of India’s population enjoys total access to the internet. Therefore, the question of digital inequality in India is one that should be at the forefront during this pandemic.
Mental healthcare is not only for a select few, and should not exist in a vacuum only for the privileged sections of the society. Therefore, teletherapy is indeed a step forward in the field of mental healthcare; however, it does not serve as the most inclusive option for a diverse nation like ours. Coming up with innovative ways to make mental health resources accessible to the most vulnerable sections of the society should be treated as a priority by both the government and mental health professionals. Awareness raising campaigns need to be done from the bottom to the top of the prevailing social class, through mediums that can be accessed by all populations in India. Moreover, funds need to be allocated at the grassroot level, to towns and villages to promote the narrative that mental healthcare is for all.
For effective application of teletherapy, progressive mental health policies need to be implemented. A more realistic, tailored, and inclusive approach needs to be adapted in order to truly take a step forward that reaches and benefits us all as equals.
Priyal Khade
