Where are the grief counsellors?
CHENNAI: Seventy-two-year-old Meenakshi Kumar* lost her husband to cardiac arrest eight years ago. Her life turned upside down. “No one teaches you to deal with grief,” she said wistfully. “It took me years to overcome what I was feeling and I did it on my own primarily. Our children live abroad so it was just the two of us. After his death, I was lonely. I did not know what to do with my time because I would spend so much time fussing over his food or hounding him to take his medication or pushing him to go for his evening walk or even just fighting over the television at night. It was the darkest phase of my life. I have relatives in the city who were extremely supportive but beyond a point, one feels that one should not trouble them any longer.”
Meenakshi suffered in silence. She got a dog and kept herself busy which she felt helped her a lot to divert her attention and get over the loss.
Grief is considered a natural response to any significant loss in life, a process that helps people come to terms with the situations of sudden change. And it is to deal with this emotion that there are dedicated Grief and Bereavement Counselling sessions offered by a few hospitals.
However, the concept is a relatively alien term in most parts of India. Some hospitals in other cities have taken the lead to provide caregivers and family members with grief counselling upon the death of a loved one. In Chennai, this facility is provided by less than a handful of hospitals, doctors said. The Cancer Institute in Chennai is one of the institutions that has a dedicated Psycho-Oncology department that conducts counselling for patients and caregivers.
“Having psychologists who are trained in oncology is the need of the hour,” said Dr V Surendran, head of the Psycho-Oncology department at the institute. “There are more than 400 cancer centres in the country with more than 10 lakh patients every year and it is important to have dedicated psychologists for this purpose. And this is only cancer, we need psychologists who will handle patients and caregivers for other diseases too.”
According to WHO, the mental health workforce in India (per 1,00,000 population) include psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07). Adding to the problem is the resistance of patients and families to take medication for mental health conditions.
“One of the biggest issues we face is the huge shortage of trained professionals,” Dr Surendran said. “We are a 550-bed hospital and have seven trained staff, which is possibly the highest number of trained professionals in an institute. But, this is nowhere near adequate. I see at least five patients a day and can stretch it to about eight patients but, that is far more than the global average of three patients a day.”
Traditionally, family, friends and relatives are considered the go-to people for support after the death of a loved one. However, psychologists and psychiatrists advocated the need for grief counselling with disintegrating family units and the lack of a safety net of relatives and so on, especially in urban areas.
“Most people live in nuclear families and do not have a strong support system of relatives and family in cities. There is an element of alienation, too. In this set-up, it is easy to let grief slip into depression, which can be very dangerous and that is why seeking professional help is important,” said a counsellor working for a private hospital on the condition of anonymity.
Dr Sangeetha Makesh of Psycafe echoes this sentiment. “Not all hospitals have psychologists and psychiatrists because it is not mandated, and getting counselling for grief is not something that people even think of because awareness about mental health is inadequate. Most people don’t seek professional; They fail to realise that while a relative could be a person they can speak to, the level of objectivity, rationality and confidentiality that they could get from a psychologist is unparalleled,” she said.
*Name changed on request
Is grief the same for everyone
Grief for every person is unique, as they have their own distinctive way of dealing with loss. The time taken to adjust to the new situation is also specific to every individual, regardless of the type of loss
Common experiences seen in grieving people
Lack of interest or apathy, anger, guilt, disturbance in sleep, difficulty in concentrating, loss of appetite, irritability, intense sadness, withdrawal numbness, loss of life’s meaning, loneliness
What are the common stages of grief
Denial or disbelief Blaming others or situations for the loss
Sadness or depression
Acceptance
Experiencing the pain
Trying to adjust to life
Trying to move on in life
When should one look at seeking help
If the grieving symptoms persist, and the person is not able to cope with
grief, they need external help.
What are some common factors to look out for
Drinks a lot, has suicidal thoughts, tempted to try illegal drugs, acts
recklessly, behaves violently