A Chat Over a Cuppa on Mental Health Awareness Issues with Prof. Romesh Jayasinghe – 18 Mins

This transcript was created automatically from the audio and checked for names. Minor errors may remain.

Join this episode of Over a Cuppa with Dilhan C. Fernando, tea grower and CEO of Dilmah Tea. In conversation with Professor Romesh Jayasinghe, a psychologist and hypnotherapist with over 14 years of clinical and professional experience. The start of the pandemic has brought on physical and mental hardships worldwide. Listen as Professor Jayasinghe elaborates on a few pointers on spotting the early signs of deteriorating mental health and how to simply assist the individual as an empathetic family member, friend or colleague. Dr. Romesh Jayasinghe, thank you for joining us on the program. We have a really a very serious topic that we are discussing today and that is mental health. Mental health is something that has been exacerbated by the pandemic. Every cloud has a silver lining and I suppose the only silver lining that we are seeing is the fact that as a result, there is greater awareness of what's happening in relation to mental health and its traumatic effects on people. So I would really like to get your professional perspective,

Dr. Jayasinghe, on what the pandemic has done and what you believe to be the way forward. Yes, the pandemic has aggravated mental health conditions of all people irrespective of their age, including children, teenagers, adults and the older population. So especially I would say anxiety. You know, anxiety is a condition that we all have from time to time, you know, our anxiety levels keep fluctuating. So I guess the pandemic has really elevated anxiety levels, not really of children, but particularly of adults and the older population. When it comes to children, of course, I would say the school closures and the online schoolings have contributed to some level of anxiety and frustration. And of course, we see the addictions now to the screen, like to laptops and tabs and smartphones, the devices. So that's increasing at a rate globally with regard to school children who are doing online schooling.

So yes, I would definitely say it's anxiety. And you know, when anxiety increases, you can get other complications like you have OCD, obsessive compulsive disorders have increased, particularly health related like hygiene related conditions. Anger has aggravated in people, you know, anger is another emotion that is always hard to manage, especially when you have anxiety and frustration and things like that. And I guess the people who have lost their jobs or who, you know, had to do working from home online working, I think were also affected because, you know, online working and you can work online from home for a couple of weeks or a month or two.

But if that extends to six months or a year or more, I think that has impacts on mental health and even physical health. I think we are seeing increases in domestic violence where that's reported. But we're also seeing a worrying increase in levels of depression and suicide rates. Now, I guess in many cases, these are sometimes undiagnosed, hidden and perhaps unacknowledged. Is there something you have to say on that? Yes. So, you know, mental illnesses are called invisible illnesses. So as you said, most of them are not diagnosed. They are not even priority, even by the health ministry, the government of a lot of countries and including Sri Lanka, of course. And then I feel that, yes, so people who have been having mild depression, of course, their depression levels have kind of aggravated or increased. And as you said, suicide is another problem.

We see that as a major problem in a lot of countries and even Sri Lanka. You look at the statistics for the last 10 years, youth suicides have increased in Sri Lanka in the last 10 years. So youth suicides are suicides between the age of 14 and 27 among both boys and girls. But always, you know, the boys have a higher rate. The men have a higher rate of completing suicide or actually dying. So that also has been happening in a lot of countries, including Sri Lanka in the past 10 to 15 years. We see an increase and then, of course, you get the addictions, like the drug addictions has been increasing as alcohol addiction has decreased in the last 25 years in Sri Lanka, according to statistics. And globally, we see a decrease in alcoholism. But the disturbing trend is an increase in drugs like ice, for example, crystal meth, you know, that's a problem particularly in Sri Lanka and even globally. And as you said, domestic violence, child abuse are the problems that

come with lockdowns, working from home, you know, homeschooling can lead to these types of things, as you mentioned. So we see an increase of those in Sri Lanka as well in the last one and a half years. Yeah, almost two years. Dr. Jashank, you know, particularly when you cite this really troubling indicators concerning youth mental health. Is there something, I know it's a complex topic, but is there something at a simple level that a carer, a co-worker, family member could do to try to ease at least in the preliminary stages to help somebody who might be going through this? Yes. So I think the family has to be educated. That's very important. You know, the public family has to be educated, even school teachers, you know, at the grassroot levels, like even school children, like all of the lay level students have to be educated about suicide prevention. So that's something important at a community level, it has to be done. And suicides are preventable, you know, a majority of suicides are preventable, including youth

suicides, but fight to be preventable, action has to be taken, timely action will have to be taken, starting from the family and the school, the community, friends, and, you know, even the community health organizations, the public health organizations have to take timely action. And if such action is taken, these suicides, youth suicides can be prevented, you know, and I think that's something that Sri Lankan government and governments in a lot of countries, the NGO sector, even the private sector can contribute in some way in terms of corporate social responsibility to create this awareness among the public, the community about suicide prevention. Dr. Johnson, at a very simple level, if I might just explore that a little bit more, is there something through the therapeutic effects of nature, the therapeutic effects of companionship that we could do that we could advise people at a very simple level to be doing this? Of course, I'm not talking about medical, simple.

Yes. So so we see that youth today are, you know, moving away from nature, they are kind of disengaging from nature, from spirituality, from religious beliefs, you know, they're moving away, withdrawing from family bonds and getting hooked on to the Internet, you know, technology, smartphones, social media. So all these things are contributing factors. And I think even, you know, having a pet, there's something called animal assisted therapy, which is good for youth and for children and even for adults. And I think all these things can contribute. And I think that awareness should should be created to get you to, you know, get closer to nature, to become more interested in protecting the environment, to become more aware of, you know, environmental impacts, influences.

And I think those things, yes, at the school level, from families at the community level, it has to be propagated. Thank you, Dr. Justing earlier, you mentioned the SDG, the Sustainable Development Goals as a framework for mental health and so on. Perhaps you might like to comment further. Right. So there are 17 SDGs that were launched in 2015. And the goal was by 2030, by 2030, so in a 15-year period, to achieve most of these SDGs, 17 SDGs, and particularly the SDG3, which is about good health and well-being, promoting good health and well-being, talks about both physical and mental health, and of course, it looks at child health, maternal health, HIV, AIDS, malaria, and other infectious diseases, as well as the non-communicable diseases.

So I believe that from 2015 to 2019, the world and a lot of countries, including Asia and African countries, were making quite good progress in those four years on trying to achieve the targets set by the SDGs. But of course, last year, you know, things really changed. In 2020, and even this year, I think a lot of countries, including Sri Lanka, have had a huge challenge in trying to work towards achieving these targets, the SDG targets, particularly not just the third SDG, which is on health, but all the others, you know, eliminating poverty, hunger, they're providing quality education, gender equality, and all the other SDGs have been a huge challenge during the last two years for a lot of the developing countries, including Sri Lanka.

And I suppose the pandemic has affected a lot of countries economically and when it comes to financially and in terms of tourism, now if you look at Sri Lanka, Sri Lanka has been badly hit in terms of tourism. So I guess by next year, hopefully by the end of next year, so 2022, and I think things should recover, get back to progress, and so we will then have roughly another 8 more years to go up to, you know, 7 to 8 years to go up to the 2030 goal of achieving a majority of these SDG targets. And a lot of public health experts claim that even though we might not achieve all these targets, at least some of them, we might be able to achieve by 2030.

If there was a simple thing coming to a conclusion, if there were a simple suggestion you might make for people in offices, homes, etc., to try to understand if they're seeing someone, a colleague or a friend who may be looking a little disturbed or a little too quiet, what would you suggest? Right, I think, so friends, you know, family and work colleagues, including superiors or supervisors, managers, have this obligation. I think they have a responsibility to identify the warning signs among their other work colleagues or friends or even family. If there are any warning signs, they should be able to identify and, you know, provide assistance or support immediately to such a person because, as we discussed earlier, mental illness is something invisible, it's not seen, it's not clearly visible, and we will have to infer by their behavioral patterns or changes in their habits or behaviors, and we can identify some warning signs and, you know, kind of talk to, listen to this person, ask him whether everything is all right.

Is there any way that, you know, you can help this person and maybe you might have to talk even to the family members or the others in this person's life and see whether any support should be provided because stigma is a problem, you know, when it comes to mental health, social stigma. And even in Sri Lanka, we do have still quite a lot of stigma when it comes to, you know, mental illnesses and depression and suicide, there's a lot of stigma around it. So sometimes people don't want to talk about it, they don't want to disclose it, they don't want to address it. And I think listening, being a caring listener, being a supportive empathetic listener is the best way to, you know, get somebody to speak up, to talk about whatever issue they are facing or going through and to get the necessary help, the timely help before it's too late.

I think this is something and I think today, well, the internet also has contributed to creating more awareness about this, you know, people Google up so much that I think if you take Sri Lanka in Colombo, the Western province, people are more aware of mental health, but I guess in the rural areas and not just in Sri Lanka, but worldwide in rural communities, this knowledge is hard to come by and I think people are really, they are clueless about mental health and I think, so therefore, I think the government has a major role to play to create this awareness, even in the, you know, suburban and the rural areas where people may not be so educated, they may not be so knowledgeable.

So this awareness, the only way we can do this is by creating awareness, either through mouse media or the, you know, the internet or the media or the community, through the community health centers, this awareness has to be created and there is no other way. Yes, that's the best way. Dr. Jayasinghe, I think, whilst of course awareness is critical, you believe that in the early stages before, if you see somebody being dragged down by their mental health and related conditions, that love and kindness could help bring that person out of it and always, I mean, it's not a medical condition as such, is it or what is your opinion there?

Yes, so we say that, you know, love and care is the best medicine when it comes to mental health. There's no doubt about it. So that can come from the family members, it can come from our colleagues, it can come from friends, it can come from your neighbors or anybody basically. So yes, I think that's very important, you know, that compassion, that compassion that has to be shown towards a person struggling with mental illness, whatever the illness, even if it's an addiction, then an addiction is considered to be a mental illness today. So that love and care can go a long way in, you know, helping the person to turn around, to talk about his problem, to seek for assistance or help to get the necessary medical care or the psychological care treatment, whether it's counseling or psychological therapy, whatever, you have to get that.

I think that's definitely important. And as you said, or you asked this question that yes, a lot of these conditions do become illnesses or diseases, you know, which are very much biological and neurochemical and then they might require proper, proper, you know, treatment, proper medication and even, you know, proper psychotherapy support is essential for them to have a speedy recovery. Early intervention is the key, you know, early intervention is always better than late intervention. So I think that could be provided through this love and care that you mentioned at the beginning, but later on medications might have to be prescribed. Yeah. Dr. Romesh Jayasinghe, you are a world authority on the subject.

We are really honored and humbled that you agreed to have a chat with us. The purpose of this conversation is really to do exactly as you suggested, to share awareness and to do it through whatever channel possible, because the more people know, the more we can show that love, care and kindness that you talked about and help avoid a more chronic or critical situation where mental health is concerned. Thank you very much for joining us today. We will do everything possible to spread the word and we really appreciate your sharing your knowledge and wisdom with us. Is there any final comment that you would like to make?

Yes, just one more thing. So, World Mental Health Day on October 10th, that's the whole purpose of this session today. I think that, you know, mental health starts with parenting. Personally, that's what I believe, it's parenting. So, we need to, I think, really educate the parents, get this message across to all parents worldwide, not just in Sri Lanka, that, you know, parents have a tremendous, a tremendous contribution or role to play in improving the mental health of their children and has to become teenagers and young adults. I think parents need to be educated. So, the problem is a lot of parents are not aware, you know, they are ignorant about these things.

I think we need to get this message across to parents worldwide, globally, because mental health begins at home. It starts at home in the family. That's the root of mental health. It's very disturbing to note that about 50% of mental disorders begin before the age of 14 years, according to research statistics. 50% of mental illnesses, half of mental illnesses begins before the age of 14. So, then the question arises, where does it begin? Well, it begins at home. It begins in the schools. So, I would say the home is the first institution, social institution, and the second institution is the school that has to also take responsibility for contributing to positive mental health with students, with children, pupils, you know, the school.

So, I think we need to really educate the teachers. So, first and foremost, I would say the parents and second, the teachers, all teachers in all schools should be educated about mental health. So, this is the grassroots. If we can address these two areas, we can make a real cost of impact in the future. Thank you for joining us today. Thank you very much.