HIV counselling doesn’t adequately address mental health issues

“The drop-in centres and other AIDS-related healthcare service centres are providing counselling for HIV to MSM and transgender people, but counselling for mental health issues is not being looked upon adequately” said Aniruddh Vasudevan, Director of The Shakti Centre in Chennai. Aniruddh was speaking at the plenary of the State Consultation for MSM and Transgender on “Confronting Crises: The Situation Today.” Read more

“Many transgender people in Tamil Nadu are school drop-outs. Many transgender activists who went for sex reassignment surgeries in Tamil Nadu broke down, cried, due to the trauma and insult they had to face while going through the psychiatric counselling process” said Aniruddh Vasudevan.

However a Kolkata-based psychological counsellor has another opinion. In AIDS related clinics, by integrating mental health in general healthcare has not only reduced stigma-related to mental health but also increased access to mental and general health services for the men-who-have-sex-with-men (MSM) and transgender communities. “Clubbing medical practitioner and counsellor together in the drop-in centre and other clinics has put off the mental-health related stigma” said Mou Bhattacharyya, Psychological Counsellor with PLUS (partner of MANAS Bangla).

There is no denying to the fact that mental health issues are unique to transgender and MSM people, and are not adequately being addressed.

“Mental health needs are huge for transgender as they are neglected and maltreated by the society, and their own family friends or family in some cases who are source of trauma” said Mou Bhattacharyya. “Earlier experience of trauma comes from your own family and friends. Maltreatment includes teasing, humiliation coming from very closed ones, not even given the minimum respect or importance of what you expect from your family members” adds Mou.

“From the very inception of MANAS Bangla, Mental health issues are very much integrated. In each of the drop-in centres, the main agenda is to let people come in and talk and share things with each other. Every drop-in centre, has one doctor and one counsellor along with other team members like peer counsellors” shares Mou Bhattacharyya.

Are MSM and transgender people who come to these clinics willing to access counselling services? “People who come to these drop-in centres are more than keen to access these services. Every day they are going through several traumatic experiences, when they travel for work or travel for other reasons, or at home or from their partners with whom they may interact sexually or otherwise. Mainly the ongoing problems are with their male partners, family members and other closed relatives and their own confusion and frustration regarding their identity, sexual preferences and other issues” says Mou Bhattacharyya.

“People who have opened up regarding their sexual identities are coming to these drop-in centres. There are lot of people who are not yet open regarding their sexual identity and are difficult to reach. With rising HIV awareness, people are more keen to come in for services” says Mou Bhattacharyya.

Counselling is the main coping strategy counsellors at these clinics resort to. “If the person needs mental health medicines we refer to the doctors. Doctor who comes to drop-in centre is not a psychiatrist, so if we need psychiatric help, we need to refer to psychiatrists. We have a pool of psychiatrists who are sensitive to issues and people can access services with care without any stigma or discrimination at these healthcare settings” says Mou Bhattacharyya.

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