MONICA KUMAR

India,

Through multimedia awareness campaigns, policy advocacy, and partnerships with citizen organizations, corporate entities, and schools, Monica Kumar is fostering a social market for mental health care in India. She is also creating new venues for treatment outside traditional medical settings. 

This profile below was prepared when Monica Kumar was elected to the Ashoka Fellowship in 2007.

INTRODUCTION

Through multimedia awareness campaigns, policy advocacy, and partnerships with citizen organizations, corporate entities, and schools, Monica Kumar is fostering a social market for mental health care in India. She is also creating new venues for treatment outside traditional medical settings. 




THE NEW IDEA

A trained clinical psychologist, Monica aims to increase both the demand and the supply for mental health care. To encourage people to seek help for psychological problems, Monica has created imaginative awareness campaigns and social forums that destigmatize mental health concerns and help people see treatment as a normal part of life. At the same time, she meets treatment needs with a system of accessible mental health support within existing institutions.

Monica is countering common perceptions of mental health in India, where the disgrace and ignorance associated with psychological problems are a major barrier to treatment. Because people are generally so reluctant to seek care, mental illnesses often progress to a stage where treatment in formal medical institutions is the best option; unfortunately, this phenomenon further feeds the stigma around psychiatric illness. Monica seeks to change this by creating new possibilities for people to pursue psychological well-being outside structured clinical settings. She works closely with citizen organizations (COs), which recognize that greater awareness of mental health within their institutions will reduce stress and increase productivity among their employees. In the long-term, she is committed to spreading the central concepts in her training programs to government health ministries so that they will become part of India’s healthcare policy.




THE PROBLEM

It is estimated that up to 2 percent of India’s population suffers from severe mental illness, such as psychosis, depression, or drug addiction. Schizophrenia alone affects an estimated 7 million people in India, out of a population over 1.12 billion. Urbanization, globalization, growing economic disparities, and increasing work-related pressures all contribute to the rise in the number of Indians with chronic depression, anxiety, and other mood and personality disorders, which affect around 6 percent of the population.

The decline in productivity, breakdown of family and community ties, and even loss of life that can be attributed to mental illness far exceeds the impact of other medical disorders. Yet recognition of these diseases is sorely lacking. This lack of awareness, along with the widespread stigmatization of the mentally ill, is among the many barriers that keep people from seeking mental health treatment. Furthermore, the fact that India, as a developing country, faces a host of other pressing challenges, means mental health is rarely seen as a priority. Psychological problems tend to take a back seat to issues of survival and livelihood, in terms of both government and civil society priorities. Nonetheless, a growing economy presents an opportunity to focus individual and institutional attention on the link between productivity and mental health. In addition to the need for accessible mental health care, there is a pressing need for increased understanding of mental health challenges and an appreciation for the fact that they are common and treatable.




THE STRATEGY

Monica works to provide mental health care and shift public perceptions about the importance of mental health. Her strategy is informed by her clinical experience as well as her collaborations with schools, corporations, and COs. She envisions a mental health care system that takes treatment outside the confines of hospitals and integrates it into larger public institutions. She believes that going outside familiar clinical facilities will help bring about a shift in public attitudes. She hopes to do for mental health awareness what large-scale campaigns have done for HIV/AIDS awareness.

Monica began her work in the citizen sector by moving her clinical practice outside the medical institution where she first worked. As her practice began to expand, she established a lab school for children with learning and behavior disorders that schools couldn’t handle. Building upon her experience, she started running training programs in other institutional settings. In 2000 she founded Manas as a way to spread her work into the broader community. Manas soon established programs in five Delhi schools and began to run mental health awareness programs in association with corporate human resources departments. Though her corporate clients found her mental health awareness trainings to be valuable, Monica decided to shift her focus to the citizen sector, whose goals are more closely aligned with her own and who can support the systemic change she hopes to achieve. She has recently begun working with several COs and is currently developing a mental health program with Youthreach, a national support organization for young people.

Central to her work with COs are the training programs she designs based on the specific needs of each group. She helps organizations identify how well they function—she regards this as the “mental health” of the institution—then develops a structured training that allows staff members to examine the stresses and concerns affecting them and their constituents and explore alternatives. She teaches them the skills they need to identify and diagnose problems within the scope of their ability and to refer people to professionals when needed. Monica and the staff of Manas work with client organizations for many months to design appropriate training programs. The organizations pay Manas for the service.

In addition to providing these services, Manas runs a vibrant awareness campaign that includes renowned artists, photographers, and Bollywood actors, who engage in public dialogue and events around mental health. Monica has discovered that having well-known film personalities speak publicly about emotional well-being is a particularly effective strategy. In another successful campaign, Manas posted life-sized images of daily activities around Delhi. Each of the images was accompanied by a thought-provoking caption and information on mental health services in the city. The posters proved to be quite popular, and during the campaign, Manas noted a marked increase in the number of clients seeking help.

Finally, Manas lobbies governmental institutions and funding agencies to make mental health a priority. Creating a lasting, functional, and diversified public mental health infrastructure requires Monica to build alliances with other COs and to engage in continuous dialogue with government agencies.




THE PERSON

Born to a lower middle-class family in Delhi, Monica attended the city’s best boarding school on a government scholarship. Her transition from a public school forced her to quickly catch up with her peers, who were already proficient in English. In the process, she read everything she could put her hands on, which helped her develop her English language skills and gave her a rich knowledge base. The majority of the students in Monica’s school came from very affluent families. Seeing her peers’ emotional problems made her realize that neither money nor academic performance could guarantee happiness. She saw that emotional security plays a large role in maintaining mental health. This marked the beginning of Monica’s interest in psychology.

During her third year in college, she rented vacant garages in her neighborhood, where she ran a small business designing and sewing clothing. This provided employment for seven destitute women, helped Monica finance her education, and taught her about entrepreneurship.

In 1991, her father died in a traffic accident. Tragedy struck her family again the following year, when her sister was killed in a similar accident. During that time, she found support among friends, one of whom took time off work to be with Monica as she grieved. These personal losses gave her further insight into the importance of mental health care.

In 1995, Monica completed her undergraduate degree in Psychology at Delhi University. She went on to earn an M.Phil in Medical and Social Psychology from the prestigious National Institute of Mental Health and Neurosciences in Bangalore.

After moving back to Delhi, Monica joined the Vidyasagar Institute of Mental Health and Neurosciences, a private organization. Her experiences there helped her to understand that outpatient facilities can only provide limited mental health care. Equally important are outreach and the promotion of the idea that mental health is as important as physical health. With that in mind, Monica and a colleague started a counseling center in her home in 1999. When the volume of people needing counseling grew beyond their capacity, they rented a facility that would accommodate a learning center, a play-based school for children, and space for workshops. She founded the Manas Foundation in 2000.

Monica and her husband Naveen Kumar live in Delhi with their eight-year-old daughter. Naveen recently joined Manas Foundation as a trustee.