Severity of Mental Health Issues in the students
Being home to two premiere institutions: Central Institute of Psychiatry (CIP) and Ranchi Institute of Neuro Psychiatry and Allied Sciences (RINPAS), Jharkhand is well-known in the Indian Map of Mental Health. But when we look at the statistics, they are very alarming. As per the National Mental Health Survey of India (2015-16) conducted by Union Ministry of Health and Family Welfare and NIMHANS, at least 11.1% population of Jharkhand suffers from mental disorders, a shade higher than the national average of 10.6%. This study also revealed that there was higher prevalence of "neurotic and stress related disorders" in Jharkhand as compared to other states. This issue of mental health issues becomes more problematic as on a national level, 12% children between 4 and 16 years of age in the country suffer from mental health issues. Globally 10–20% of adolescents experience mental health conditions which remain under-diagnosed and under-treated according to (WHO 2019).
As reported by WHO (2019), suicide is the third leading cause of death and depression is the fourth leading cause of illness in older adolescents (15–19 years). Similarly, in young adolescents aged 10–14 years, anxiety is one of the leading causes for emotional disorders along with prevalence of childhood behavioural disorders. While these mental illnesses are so common, awareness regarding them is found rather rarely. This is substantiated by another survey (2019) conducted in India, where around 65% counsellors believed that students are not aware of the common mental illnesses. Due to this lack of awareness, students are unable to recognise the issues they are dealing with and dismiss the alarming signs as usual anxiety and sadness. Resultantly, they don't seek help at the right time and become more susceptible to mental disorders. Therefore, during completion of elementary education (6-14 age group), students should be taught about mental health so that they are better equipped to deal with them.
On similar lines, Dr. Samir Parikh, Director, Mental Health and Behavioural Sciences, has also stated that: "Mental health related information, or providing reliable and adequate sources of information to the students within the school setting seems to be majorly neglected." While the issue is grave and taking so many lives, mental health is hardly given any importance in the schools and therefore as many as 96% professionals in a study (2019) have emphasized the need to incorporate a mental health curriculum within schools. Therefore, compulsory mental health curriculum should be introduced in the schools.
Introduction of mandatory Mental Health Curriculum by Academic Authority
Section 29(1) of the Right of Children to Free and Compulsory Education Act, 2009 (Central Act) empowers the 'Academic Authority' as specified by the appropriate State Governments to lay down the curriculum and evaluation procedure for elementary education (6-14 age group). Section 17(2)(b) of Jharkhand Right of Children to Free and Compulsory Education Rules, 2011, vests this responsibility of laying down curriculum, formulating relevant textbooks and other learning materials in the Jharkhand State Council of Educational Research and Training (JSCERT), the academic authority. Furthermore, Section 29(2)(g) of the Central Act also states that while laying down the curriculum, the academic authority should consider 'making the child free of fear, trauma and anxiety and helping the child to express views freely'.
The conjoint reading of the above specified provisions makes it clear that that by exercising these powers, the academic authority i.e. JSCERT could introduce 'Mental Health Curriculum' which will include importance of positive mental health, common psychological problems, knowledge about illness accompanied by experiences, examples and stories, effects of stress, successful coping strategy, fostering tolerance for disability, destigmatizing mental illness, seeking help and finding support at right time. By this introduction, it will be legally binding on the schools since recognition to the school is granted only after fulfilment of all the conditions mentioned in Form 2 under section 12 of Jharkhand Rules, including the 8th condition i.e. "The School shall follow the syllabus on the basis of curriculum laid down by the State Authority."
Increasing suicides necessitate inclusion of mental health education in schools at an early age. Here, it is interesting to note that when the National Crime Records Bureau (NCRB) data showed that Jharkhand was witnessing the maximum number of witch-hunting cases in India and widespread human trafficking from 2013 to 2016; to curb the same, the Jharkhand Government decided to introduce chapters on witch-hunting and human trafficking in the school syllabi.
Can Supreme Court issue directions to Government on inclusion of such a Curriculum?
In Santosh Singh v. Union of India (2016), a petition was filed for inclusion of moral science as a compulsory subject in the school syllabus in order to inculcate fading moral values and national character. The Court refused to allow the petition stating that question such as 'whether a particular subject should be included in the school curriculum' is beyond the scope of judicial review and it being a matter of public policy, is left to the executive.
Two years later, in S.Rajakeeran v. Union of India (2018), a petition was filed for enforcement of road safety norms. After looking at the increasing number of road accidents and considering the recommendations put forth by K.S. Radhakrishnan Committee, Ministry of Road Transport & Highways and Amicus Curiae, the Court directed the State Governments to ensure that 'Road Safety Education and Counselling' should be incorporated into the curriculum of the State Boards.
In Bachpan Bachao Andolan v. Union of India (2017), petition was filed for implementation of national action plan on the issue of drugs, alcohol and substance abuse amongst children. Ministry of Social Justice and Empowerment had also recommended tobacco and education on drug abuse to be included in the curriculum. The recommendation was accepted by Committee on New Education Policy (2015) too, after which the Court also issued the direction to adopt specific content in the school curriculum under the aegis of NEP.
In the first case, the Supreme Court had refrained from issuing direction for inclusion of specific curriculum and laying down policy while exercising judicial review. However in subsequent cases, after considering suggestions from different Committees and Ministry, it did issue directions to the Government on inclusion of different curricula stating that it is merely directing the Government to enforce obligations which were already existing under the legislative and administrative framework. Similarly, the below mentioned policies also put an obligation on the Government to introduce mental health curriculum.
Analysing the existing Government Policies on Education and Mental Health:
The objective of National Mental Health Policy launched in 2014, is to reduce stigma associated with mental health problems because lack of knowledge is accompanied by fear and hostility. Since mental health is neglected both in policy and practice, there is need to promote it. Some of the recommendations mentioned in the policy are: 1. Designing appropriate curricula and pedagogy, teacher student relationship; 2. Reliable mental health information should be readily available; 3. Life Skills Education (LSE) Programme should be offered to school going children; 4. Individual attention should be given to students by teachers trained in mental health promotion and distress alleviation.
Draft National Education Policy 2019 submitted by Dr.K.Kasturirangan has also emphasized that 'mind-and-body wellness' lessons should be incorporated into the curriculum starting at the Foundational stage. The policy talks about introduction of socio-emotional learning which will lead to improved cognitive and emotional resilience and promote constructive social engagement. It also mentions that counsellors should be made available in the school who will 'support and provide counselling on mental health issues, including stress and mood disorders' to the students. The counsellors should be capable of identifying cases requiring clinical mental health support. Facilities for medical care, strong mentoring programmes by faculty along with peer support programmes (e.g. buddy systems and student support groups), therapy, and treatment in cases of illness or distress should be made available. For ensuring this, collaboration between the State departments of education and health is imperative.
National Curriculum Framework 2005 has adopted a holistic definition of health including physical, social, emotional and mental development of a child. One of the guiding principles of the framework is "enriching the curriculum to provide for overall development of children rather than remain textbook centric" and this can be achieved only if mental health education is given equal importance as physical health education.
School Health Programme (2018) recommends that special attention should be paid to psycho-social and mental aspects based on the developmental stages of the child. It suggests that the ideal time to teach students about mental health is Middle School. It also recommends that data regarding the following should be collected: Percentage of school-conducted session on mental health (Annually) and no. of students recognised and referred by teachers to Adolescent Friendly Clinic (AFHCs) for counselling for mental health issues (Biannually).
National Focus Group on Health and Physical Education has stated that a comprehensive mental health programme should be part of the school health programme since it will strengthen the children's coping abilities to counter environmental stress and disadvantages with which they have had to cope in growing up. There is a need to enhance skills for psycho-social competence at different stages of the child's development.
World Health Organisation (1994) has also recommended that mental health education should be included in the school health education at regional and national levels. UNICEF has also given guidelines that all adolescents between the age group of 10-19 years should receive at least 20 hours of structured experienced life skill educational training in school levels.
Steps taken by Government of other States and Countries:
To address the issues of mental health and wellbeing among the students, Delhi Government had launched 'Happiness Curriculum' for classes Nursery to VIII in 2018. The curriculum is designed on the basis of the Happiness Triad. The purpose is to engage students in meaningful and reflective stories and activities with a focus on positive emotions, healthy relationships etc. Kerala SCERT has also introduced 'Ullasaparavakal', a modular life skills based mental health promotive intervention into the school curriculum. Haryana Education Department has collaborated with OneKeyCare (OKC) where workshops are conducted as a part of the curriculum to increase awareness about mental health issues like depression, anxiety, eating disorders, bullying etc.
Shortly, Tamil Nadu is also going to introduce a structured health and wellness programme which will cover several aspects ranging from emotional well-being to gender sensitivity. Even the Central Government is now planning to consider mental health lessons in the syllabus as per Prakash Javadekar, former Union Human Resource Development Minister.
In 2018, New York Government introduced a new law which makes mental health education mandatory in schools; this is done by updating the health curriculum and including mental health in its definition and purview. Virginia's law also mandates that mental health education should be incorporated into physical education and health curricula for 9th and 10th graders. England is also planning to make it compulsory in all schools in England following growing concerns about mental health problems among young people.
In the nutshell, when the students are educated about mental health, the likelihood of effectively recognizing signs and symptoms in themselves and others increases, they will know when and where to turn for help. Health education that respects the importance of mental health, as well as the challenges of mental illness, will help in ending the stigma and make students, their families and communities feel more comfortable seeking help.
There is an ongoing campaign in Ranchi initiated by psychiatrists of RINPAS focusing on inclusion of mental health paper in school curriculum. They are of the view that since witchcraft and superstitious beliefs in black magic is prevalent in poor tribal families, understanding the difference between treatment of mental disorders by Ojhas/Sorceres and medical professionals is need of hour for the students.
According to professionals, every mental health curriculum should incorporate the following characteristics:
Studies (2015) show that the schools with such curriculum demonstrate the best result. School-based mental health education improves academic performance, reduces behavior problems, improve school climate and, most importantly, saves lives.
Views are personal only.
(Ritika Goyal is a student at National University of Study and Research in Law (NUSRL), Ranchi, Jharkhand)