(6 September 2022 marks thefourth anniversary of the reading down of Section 377 of the IPC. In light of it, we're republishing this story from the Quint archives because the good fight for LGBTQIA+ rights, and liberation continues even four years on.)
"In our society, the LGBTQIA+ community is at the receiving end of a lot of prejudice and hostility all year round because of their gender and sexuality realities."Dr Shruti Chakravarty, Mental Health Practitioner to Quint FIT
Popular rhetoric laced with queer phobia, for instance, continues to permeate medical systems, including mental health practices and institutions, and can often do more harm than good.
Organisations like the Mariwala Health Initiative in Mumbai, with whom Dr Chakravarty works, have been working to bridge this gap for years.
On 30 June, MHI launched The Queer Affirmative Counselling Practice (QACP) Resource Book is for mental health practitioners in India — a first-of-its-kind book to be published that challenges the existing systems, and 'queering' mental health.
"The whole traction got accelerated during the pandemic when mental health really took the center stage," Harsh Mariwala, Founder of Mariwala Health Initiative, tells FIT.
So, how can mental health practitioners help people of the LGBTQA+ community find safe, affirmative mental health support?
Why Does Mental Health Need a Queer Lens?
The answer is simple, says Dr Chakravarty, it's a matter of 'social inequality'.
"Mental health practitioners (MHPs) need to know that LGBT people undergo higher levels of stress, not because there’s anything inherently different about them, but because of society’s negative response to them."Dr Shruti Chakravarty, Mental Health Practitioner to FIT
"You know, the world is currently designed to support those who are heterosexual and conform to gender rules. But a lot of people don’t live like that, and they face a lot of hostility, prejudice, hate, there’s isolation, loneliness, helplessness," she adds.
And, according to Dr Chakravarty, that’s the crucial difference.
The problem isn’t that somebody may be gay or lesbian, the problem is that society responds to them in a way that makes it difficult to accept themselves, and can give rise to a slew of mental health issues.
"I believe that this part of the society has a higher level of anxiety to be accepted into the society, and it's important that the society integrates each and every section," adds Harsh Mariwala.
"There is a lot of loneliness," he adds.
The Fault Lines Run Deep in Our Mental Health Systems
"Because we live in a world where heterosexuality is the default, first of all MHPs may miss that their clients may not all be heterosexual," says Dr Chakravarty.
"So in therapy when you’re supposed to center your client and see them for who they are, you may miss out on some very core aspects of their life because you haven't trained yourself in recognising that there are multiple sexualities and multiple ways of being."Dr Shruti Chakravarty, Mental Health Practitioner, to Quint FIT
She also says that a more dangerous outcome is when MHPs are led by their prejudice and may believe that it is possible to change someone’s sexuality, and you may believe that it is something that can be cured.
Writing the Wrongs
If mental health practitioners hope to tackle the disproportionate burden of mental health issues in the Queer community, they must first begin by unlearning.
"The mental health curriculum is not yet equipped or doesn't adequately represent how to work with a community that is marginalised," says Dr Chakravarty.
Mariwala Health Initiative has been conducting a Queer Affirmative Counselling Practice training course, for the last 3 three years to tackle the stigma that permeates mental health curriculums and to train practitioners to become better attuned to offer effective mental health support to people of the LGBTQ+ community.
"We have now decided to make it more accessible with a book," she says.
"This book is a much-needed resource for mental health practitioners so that they can learn how to engage with the struggles and issues of the community, and equip themselves with the knowledge and skills to respond appropriately."Harsh Mariwala, Founder of Mariwala Health Initiative
"Not only in terms of policy, but also how individuals are treated on a day-to-day basis," he adds.
The primary target of the book, they say, are mental health practitioners, counselors, psychologists, medical and psychiatric social workers.
Speaking of the bases the book covers, Dr Chakravarty lists them as,
Perspective building of how inequality impacts the lgbtq community. Knowledge — what are the unique stressors that impact the community.
Casework, skills, principals and tenets of how to do queer affirmative counselling so that it supports the community.
"All the senior leadership will have to make the effort to walk the extra mile to ensure that such individuals are included. The diversity agenda of organisations has to be very comprehensive and inclusive."Harsh Mariwala, Founder of Mariwala Health Initiative
Queer Friendly vs Queer Affirmative
Now what exactly is 'queer affirmative', and why isn't it enough to just be queer friendly?
"Queer friendly may simply be ‘I’m okay with your existence’," says Dr Chakravarty, "but affirmative is about ‘I’m okay with your existence, and I would like to do more to integrate you and make society more equal."
Being queer affirmative is doing that extra, she says.
"Queer affirmative means you do the extra in terms of you learning the knowledge from LGBTQ+ lives because the curriculum we have doesn't adequately cover what these lives face."Dr Shruti Chakravarty, Mental Health Practitioner to Quint FIT
"Queer affirmative also means taking into account that the field itself has historically damaged and pathologised this community, so taking some sort of an ethical responsibility for that as well," she adds.
"Mental health practitioners have also unfortunately given advice like get into heterosexual marriages and you will be okay. This is part of not understanding or having an affirmative lens."Harsh Mariwala, Founder of Mariwala Health Initiative
Essentially, queer affirmative therapy not only ensures a safe space for queer clients but also actively supports them and helps them tackle the unique stressors they experience simply because they are queer.
This resource book aims to arm mental health practitioners with all the know-how to do just that.
"Our job is to help them grow, share best practices, and give them funding, training, sharing of best practices and any other help," adds Harsh Mariwala.