To mark World Mental Health Day, Parami is sharing an essay on mental health issues in the Myanmar context written by Khin Phyu Cyn Kyi. She is a Parami student from the 2021 Parami summer course, Writing for Social Change, taught by Dr. Frances O'Morchoe. World Mental Health Day is celebrated on October 10th every year, marking global mental health education and awareness. This year's World Mental Health Day theme is 'Mental health in an unequal world.'

Introduction

"You'll get over it." We've all said this to somebody at some time. But have we ever thought they or we really would get over it? The truth is, we don't. But why do we assume we will? This is not about heartbreak, but it is about our mental health. The topic of mental health has become much more of a topic discussed among young people nowadays, but the question is, is the mental health stigma really gone? The answer is no.1

Mental health conditions are increasing worldwide, with 20% of the world's children and adolescents having a mental health condition and even resulting in the second leading cause of the deaths of 15-29 years old.2 However, many people, especially in our Southeast Asian countries, do not treat mental health as a medical issue.3 They tend to rule someone as sick only if they are 'physically' ill, i.e., having a fever, sneezing, or coughing. But we rarely consider it serious when someone has depression or any other mental health issue. We let the fragile mental health of people be shattered without bothering to handle it with care or put the pieces back together.  

Mental health and culture

When addressing mental health issues, we often find the causes of the illness among personal problems such as work, family, and relationships. What we often overlook is the role culture plays in mental health. Though it may not be direct, cultural and societal factors do still influence a person's mental health.4 From the perspectives of Myanmar culture, mental health issues can be caused due to various old notions that have been rooted in our society for more than hundreds of years, including the idea that mental health is 'a sin' or is caused by 'past life's bad deeds'.5 Moreover, Burmese society believes that medical issues can only be solved with medicines, thus the hindrance to accepting mental health issues and treatments such as psychotherapy. Despite Myanmar getting advanced in these past few years, there are very few people working as psychologists and psychiatrists for their main career as the majority of the society does not think paying money to the doctor to talk will solve our health problems.5

Mental health and gender norms

There are different kinds of mental illness: depression, anxiety, bipolar, post-traumatic stress disorder, etc. These mental health issues may be triggered by any kind of factor, regardless of age, gender, and other demographics.6 But the thing is that whoever has mental health problems is ruled as 'weak' or 'exaggerating' due to gender stereotypes. If a woman has mental health issues, society calls them, 'dramatic,' "she is  just having her menstruation." Women with mental illness have been condemned as witches and burnt alive throughout history, especially in European countries. If men have mental health problems, society calls them 'weak' and 'effeminate.' It has been proved in a study made by Rosval and Nillson in 2016 that these gendered stereotypes linked with mental health result in adolescent-masculine boys not opening up about their mental health condition so as not to risk their expressions of manliness by society.7 

Mental health and government

Despite culture and gender norms being significant barriers themselves, people still try to look out for ways to treat their mental health issues. However, the governments of the countries that we live in are also one of the barriers. As aforementioned, not just the citizens of Southeast Asian countries do not take mental health seriously, but the governments do not prioritize it either.7 This can be reflected in a local context how there are only a mere number of 0.016 psychiatrists per 100,000 people in Myanmar.8 

Conclusion
When we are scared of diabetes, we try to maintain our sugar intake. When we are afraid of COVID-19, we wear masks and use hand-gels. But have we ever taken precautionary measures for our mental health? Or have we taken the topic of mental health into our daily conversations? Just like how our immune systems are all different from one another, our levels of mental strength are also varied. While some can stay stress-free, others may break down easily. In reality, mental health is equally important as physical health. As fragile as it is, we tend to forget the importance of it. As the World Health Organization states, "There is no health without mental health.". That is why we are in need of mental health awareness more than ever. If not now, when will we fight this prevailing mental health stigma and start normalizing mental health issues? 

Citation

1. Stigma and Serious Mental Health, Treatment Advocacy Center (2016, June)
   https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3631
2. Mental Health, World Health Organisation
   https://www.who.int/health-topics/mental-health#tab=tab_2
3. Raj Kaur Bilkhu, (2016, September). Why do many South Asians regard mental illness as taboo? BBC News.
   https://www.bbc.com/news/uk-england-36489893
4. U.S. Department of Health and Human Services. (2001). Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. Chapter 2. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
   https://www.ncbi.nlm.nih.gov/books/NBK44243/
5. Way, RT (1996). Culture and mental health in Burma. Australasian Psychiatry 4(4), 184–186. doi: 10.1017/CBO9781107415324.004. https://journals.sagepub.com/doi/abs/10.3109/00048678509158832
6. Fusco, Julianna (2017) "How Gender Differences Affect Mental Health Outcomes," Perspectives: Vol. 9 : Iss. 1 , Article 6. Available at: https://scholars.unh.edu/perspectives/vol9/iss1/6
7. Rosvall, Per-Åke and Stefan Nilsson. 2016. "Gender-Based Generalisations in School Nurses' Appraisals of and Interventions Addressing Students' Mental Health."Students' BMC Health Services Research 16:1-8 doi: 10.1186/s12913-016-1710-1.
8. Policy Brief on Mental Health in ASEAN Endorsed by the 12th AHMM https://asean.org/wp-content/uploads/2012/09/AMT-Policy-Brief_Endorsed-by-12th-AHMM.pdf
9. World Health Organization, Ministry of Health, WHO-AIMS Report on Mental Health System in Myanmar, (2006) https://www.who.int/mental_health/evidence/myanmar_who_aims_report.pdf