Kintsugi for mental health

‘I am still trying to figure out what ‘okay’ is, particularly whether there exists a normal version of myself beneath the disorder, in the way, a person with cancer is a healthy person first and foremost. In the language of cancer, people describe a thing that ‘invades’ them so that they can then ‘battle’ the cancer. No one ever says that a person is cancer, or that they have become cancer, but they do say that a person is manic-depressive or schizophrenic once those illnesses have taken hold.’^[1]

Esmé Weijun Wang, The Collected Schizophrenias: Essays

The above statements by award winning American author Esmé Wang in her wonderful book – The Collected Schizophrenias – sum up the global mental health scenario. Despite increasing awareness in the mainstream media, mental health remains a neglected topic; discussing the same is considered a stigma.

Recently on Twitter, a huge debate occurred among the Indian medical community about mental health and its importance. What was shocking was the way numerous reputed physicians disregarded mental health and its importance – and the way the older generation of physicians dismissed mental illness as signs of weak will power and lack of determination. This outraged the younger set of physicians and there were renewed demands to take mental health more seriously, especially in light of the ongoing pandemic.

Scientific studies as well as popular news outlets have reported substantial neurological and psychiatric morbidity in as many as one in five patients, 6 months after the COVID-19 pandemic began.^[2,3]

There is no doubt that health is incomplete without mental health. The World Mental Health Federation has declared the theme for 2021: Mental Health in an Unequal World. Our world is becoming increasingly unequal, which is mirrored by the increasing inequality in mental health across all sections of society. Basic access to mental health resources, few support structures and doubts over accessing the right help are significant matters of concern in present times. From this, our thought process naturally turns to this: Does a homoeopath have a role in mental health? Homoeopathy has always been a holistic science. How much can homoeopathy help in improving mental health in society? In this issue, we have a policy paper by Dhawale that presents a roadmap to understand the role a homoeopathic psychiatrist can play in restoring mental health in an unequal world. This paper will surely help policy-makers, homoeopathic educational institutions, hospitals, practitioners and students to explore how homoeopathy can be a vital part in improving mental health in society.^[4]

Rural mental health services, especially in India, are a neglected area that needs immediate attention considering the burden of disease and the treatment gap. There is a great difficulty in getting correct professional help for complex psychiatric disorders; needless to say, simpler disorders are even more neglected. In such a scenario, one can imagine that hardly any resources would be allocated for the preventive aspects of mental health. Schools, colleges, universities, offices and elderly care institutions are the places where mental healthcare professionals and their services are urgently needed. Despite the high demand, the supply falls short.

We need better planning for delivering community-based mental health. While the policies have been designed and formulated, we need to go the last mile so that their intended outcomes can be achieved. The need of the hour is to ensure a grassroots approach; community ownership is vitally important to achieve universal mental health services, care and support in rural areas.^[5]

In this issue, we have two papers focusing on two vital areas of mental health. The first paper by Surti et al. demonstrates how homoeopathic teaching institutions can team up with NGOs and plan and implement mental health services; the study describes one such project undertaken at an old age home. The paper lays down a multidisciplinary approach in evolving effective strategies to formulate models for geriatric mental well-being. The findings from this paper will help all those who wish to plan interventions in elderly care centres.^[6]

The second paper, by Yadav et al., focuses on the application of homoeopathy in school mental health. The paper demonstrates the role of homoeopathy in the management of psychological stresses and somatic illnesses in high school students from rural India. The paper narrates how homoeopathy, along with stress management skills, helped the children in rural schools to overcome psychological stresses and reduce the burden of somatic illnesses.^[7]

Psychosomatic medicine is a multidisciplinary speciality that studies the relationships between social, psychological and behavioural factors and their effects on an individual’s health. Homoeopathy studies the individual and his illness through the bio-psycho-social model; it is, therefore, a holistic science and can play an important role in psychosomatic medicine.^[8] In this issue, we have two case reports that demonstrate the role of homoeopathy in psychosomatic medicine. A case report by Jain et al. demonstrates the application of homoeopathy in a case of dysthymia with carpal tunnel syndrome;^[9] the second case report by Patil demonstrates the importance of studying suppressed and repressed emotions in homoeopathy.^[10]

Creating the portrait of disease is a process very relevant to homoeopathy; it requires the synthesis of a clinical picture of the disease as well as the person in whom the disease is present. This process is very similar to how an artist creates a portrait. In this issue, Dr. Kapse reviews a book by the renowned sculptor Shri Sadashiv Sathe.^[11] The review draws parallels between the perceiving of the totality of an individual by a sculptor and by a homoeopathic physician. Understanding the process through such a comparison promises to be an enriching experience.

Despite all our progress as a society, mental illness is still considered a stigma, something that needs to be hushed up and not discussed freely. The need of the hour by all mental health professionals is to go much further than just prescribing medicines and taking sessions. What we really need is to have a humane approach toward mental illness and all those experiencing the same.

To this effect, the song Help performed by The Beatles, written by John Lennon/Paul McCartney, contains these beautifully expressive lines:

I recently read a beautiful book written by the Japanese-British author Erin Niimi Longhurst titled Japonisme. A chapter of this book, titled Kintsugi, appealed tremendously to me. Kintsugi is the traditional Japanese art of repairing broken pottery with golden lacquer. When the shattered pieces are put back together, the article becomes even more beautiful than it was originally, as it is laced with gold. The idea behind Kintsugi is finding beauty in imperfections. Rather than discarding a damaged object or lamenting its flaws, it becomes more treasured; its defects add to its beauty and become its strengths.^[13] People with mental ailments need help; this will allow them to heal, recover and get back on their feet without any prejudices. We believe homoeopathy can be the Kintsugi that is so desperately needed in mental health.

(On behalf of the editorial board of JISH, I thank all our readers, reviewers, publishers and contributors for their constant support, help and encouragement. Wishing all a Happy and Healthy New Year!)