By Natasha Rasaratnam 

I was lucky. I was lucky that my grandparents left Sri Lanka to seek a better, more hopeful future for their children. I was lucky that I did not have to grow up in a war-torn country whose scars are only beginning to heal. Yet for those who lived through the 25-year civil war, the trauma is everlasting, hiding under the facade of a country that wants to forget the legacy of its conflicts. It is no surprise that after these decades of violence, mental health issues have risen dramatically in Sri Lanka. Yet this spike has not been adequately met with appropriate treatment and education. At its core, this crisis is underpinned by an entrenched cultural stigma towards mental health conditions.

Stigma is when there is a negative perception of someone based soley on them experiencing a mental health issue. More often than not, stigmas aren’t born from malicious intent rather due to a lack of understanding yet nonetheless they create a barrier for people to seek help. In Sri Lanka, it can sometimes be thought that having a mental illness or being associated with someone who does, negatively affects your employment and marital opportunities. This is exacerbated by a lack of mental health workers and information that is not readily available to the public. As a result, particularly in rural areas, it is more common to take people to faith healers or temples rather than seeking professional help. There are also cultural associations that link these illnesses with the notion of ‘karma’ and resulting in them being considered as fate with blame being laid on the person themselves. There are also some views that mental illness simply doesn’t exist and people “just need to get on with it”. This dismissive perception associated with mental illness is deep-rooted and spreads beyond South Asia to immigrant communities worldwide.

Closer to home, despite all the ‘R U OK days’ and mental health awareness events, there are still communities in Australia in which mental health is a stigma. Although we’ve made vast improvement to tackling the stigma surrounding mental health conditions, we must not be complacent in thinking we have completely solved the problem.

Growing up in a migrant community has its ups and downs. Everyone is friendly and wants to know about you… maybe too much at times. Coming from a Sri Lankan background, it is not unusual to hear older members of the community dismiss depression as a weakness of character and not a valid health condition. Similarly, suicide is often mentioned in hushed tones, more a source of shame rather than the tragedy it is. Of course, these attitudes cannot be generalised to all members of the community and I am lucky to be surrounded by a family that understands and values the importance of mental wellbeing.

Yet the consequence of this underlying stigma can have devastating effects on those already isolated due to their mental health. A friend was told to “just pray it away” by family members as a cure for her severe depression. Although faith can be a healing force, the dismissiveness of these comments resulted in a toxic environment at home of further isolation and distrust. Mental health stigmas not only stop people from speaking out about their health but can also worsen the situation perpetuating a vicious cycle.

These perceptions are so ingrained in the older generations of migrant communities it’s difficult to weed them out. Unlike Sri Lanka, Australia has the resources and educational tools to reform and erode taboos such as these. However, despite their admirable aims events run by organisations such as Beyond Blue and Headspace can have little reach to address older members of the community.

To an extent this is also a generational problem rather than a cultural one. Hence, it falls upon us as the next generation to strive to engage in a conversation with our parents, grandparents, aunts and uncles about mental health.  For all their flaws, migrant communities are tight knit, and it is this support which can be utilised to help those struggling the most rather than demonising them. Cultural leaders have the power to make change and it is only through our conversations with them that we can start to see this stigma being overcome. We’re the lucky ones – we have resources and information at our fingertips. Our communities’ ignorance can no longer be an excuse.

By Kit Ming Foo

March: the time of year when footy fans around Australia rejoice after 6 months in the wilderness finding creative ways to spend their weekend. However, when the first bounce occurs, all eyes are on the players. Every little thing that they do is examined under a microscope. Every goal is celebrated but also every dropped mark or skewed kick is met with sighs of disgust and for some, even boos. Such is the life of an AFL player, where everything they do is in the spotlight, good or bad. Everything gets scrutinised and what the fans and media fail to realise is that at the end of the day, there is still a human being behind these athletes, someone who has put in so much to end up where they are now.

On the 17^thof December 2018, news broke that one of North Melbourne’s players Majak Daw, had an incident on the Bolte bridge where he fell and sustained serious injuries. Suddenly there was an immense focus on not only Majak’s well-being but also that of the wider AFL population. In the months leading up to this incident, many other players such as Richmond superstar Dustin Martin discussed their battles with mental health, yet many felt that not enough was being done by the central administrative body to look after the wellbeing of the players. This all changed in the aftermath of Majak’s bridge fall as the CEO Gillion McLachlan introduced a mental health manager for the league and highlighted that mental health was the “No 1 issue for the playing groups”.  Whilst the AFL has taken some encouraging steps in addressing this issue, it is unfortunate that the catalyst for change from the status quo was such a devastating event.

Now some of you may be thinking, this is the Auricle, a medical student journal so why is AFL being mentioned? Taking a closer look, you can draw many similarities between being a player in the AFL and a member of the medical profession. Many of the things that were mentioned above apply to medicine too. Both professions require high levels of dedication to be successful. Both come under heavy scrutiny when things go wrong. Both have the capacity to place massive amounts of pressure on players and practitioners alike. Finally, both have started the long journey to make mental health a priority.

In recent years, prominent doctors have started social movements such as Crazy Socks for Docs. With this, medical student mental wellbeing has also been brought into the spotlight and this is something that needs to be taken seriously. For many of us, this is a topic that we have all heard about but until we personally have to confront it, either through our own                    experiences or a friend’s, it is in a way something that is hard to relate to. Problems with mental health are actually more common than we think. A study published by BeyondBlue in 2013 involved the responses of 1,811 medical students and revealed that around 10% had very high levels of psychological distress. This is three times as much as the general population, so why do we not hear more people in the medical profession talking about their struggles with mental health?

Much like AFL players, few medical students ever share their stories publicly, meaning that countless more go through these battles in secret. Admitting to one’s own mental health struggles to the world is not easy, let alone telling the people closest to you. As a result, like many footy players, medical students try to hold it together whilst they are in the eye of the public, whether it is on the hospital wards or in tutorials. Because of this, a facade is put up, tricking everyone into thinking that everything is fine, when in reality the opposite is true. If a star player like Dustin Martin can do it, so can many medical students.

The aim of piece is not to say everyone should have the courage to tell the world everything, but rather to try and make having a conversation with trusted friends easier. We as a profession need to improve the way that we all think about mental health. We need to accept that it is a problem that all of us have a responsibility to deal with. Breaking down the barriers to seeking help is one way to start and to do so we need to remove the stigma that many of us associate with doctors asking for help. Our profession is built on being empathetic towards our patients but why are we not the same towards our colleagues when they are in times of need? If we do not change our response to this, the topic of talking about mental health will never be made easier. People will continue to avoid seeking help and this problem will continue to grow. Such changes in mentality obviously take time to transpire and it is unrealistic to expect a change overnight amongst the medical profession. However, much like how we have begun to see shifts against bullying in the workplace and safer working conditions, everything needs to start somewhere and we all can have a role in championing a change to make talking about mental health easier.

Medicine is a team game and much like being on the footy field, we need to look out for our mates. Battling issues with mental health can make a person feel isolated and often the onus is on them to make the first move and talk to someone about it. At the end of the day there is truth to this as it really is up to the individual and whether they want to share their experiences. Sometimes though, people are just waiting for an opportunity to open up. Simple questions such as “are you alright” or “is there something that you want to talk about” may be all they need. Let’s all make sure that we look after our friends and get through this season together.