“ It is important to have safe spaces for children to see that the system doesn’t define their worth, dignity and humanity.”

By Saransh Bisht

Interview with Arushi Ralli, a counsellor

Arushi Ralli is a mental health counsellor who intends to bring her human-ness into every relationship in her life. Since a child, she has seen value in deep and authentic conversations. Coming from a family of three women has shaped her identity in questioning the deep-rooted system of patriarchy. A lot of times, she enjoys doing nothing as quoted from Christopher Robin (movie), “Doing nothing often leads to the very best something”.

In this interview, Arushi talks about her thoughts on the need for intersectional mental health services for children and youth. Through her practice, she aims to stitch together the personal, the political and the social. She recognises the need to acknowledge the importance of psycho-social perspective in the therapeutic room, especially while working with adolescents and young adults.

Introducing Arushi Ralli

Q. Tell us a little about your work.

My name is Arushi (she/her) and I work as an independent Mental Health Practitioner in Delhi. I constantly demystify the traditional view of therapy which sees a therapist as a “healer”. I honour my clients as co-travellers with them and I, both humans co-travelling together.

With 4 years of experience in working with individuals with trauma, grief, loss, and other emotional challenges, I see all of us as work in progress, working through.

I’ve also worked as a Psychology teacher and high school counsellor for two years. Holding safe spaces for adolescents encouraged me to see how there is so much for us to learn, unlearn, co-create and revise with them.

I draw my practice from a trauma informed lens with an integrative approach, because it is important to see what works for my clients. I also work as a facilitator for awareness and create spaces for holding, stillness and reflection.

Q. What impact is your work making in the mental health sector?

I’m affirmed by the belief that there’s so much that is invisible to the eye, but known to the heart. With that, the impact has been with the little yet powerful breakthroughs that my clients share in therapy. Impact looks different for different people. For me, even the act of acknowledging “I’m not okay” is a breakthrough in itself.

One of the work that I can see and value draws back from my work with adolescents. We used to hold reflection/inner circles, spaces for debate and discussions in classes with experiential activities, and I have seen them grow, question, advocate, and challenge the system and their own beliefs. That gives me hope.

I’m engaged in research work, updating myself, introspecting to create safe and inclusive spaces with marginalized communities. I’m being more vocal and committed towards a more inclusive Mental Health framework in my practice.

Q. Tell us a little bit about the young population you have worked with in the past or are currently working with?

In the past, I’ve worked with adolescents dealing with understanding their identity, working through childhood trauma, neglect, grief, loss, abuse, self-harm and relationship with self and others. Due to my personal narratives around loss, most of my clients are womxn who’ve lost a loved one.

Q. What is the end goal of your initiative/collective work?

My end goal in the field of mental health would be to not reach a particular goal but rather stay in the process. My constant work would be to engage in mental health advocacy especially in making mental health services more accessible, affordable, safe, inclusive, and intersectional. I wish to work more with different identities to value the embedded nature of mental health challenges being personal, interpersonal and most importantly, systemic.

Understanding intersectional mental health

Q. How would you define ‘Intersectional Mental Health’?

The term “intersectionality” was coined by Professor Kimberle Crenshaw to describe the overlap between different identity markers and the way they shape one’s lived experiences.

For mental health to be inclusive, diverse and person-centred, we, as a society, need to acknowledge that ‘mental health is intersectional’. For that, we need to break the monopoly on the definitions of ‘abnormal’ and ‘normal’ as signs of productivity and distress to be a personal and individual phenomenon.

The way to see it as a collective phenomenon with an “intersection” is by considering the center of the narrative to be the person and their lived experiences which is not bound by the walls of an institution, or pillars of established systems.

To question the very system that shows us rigid parameters of having a ‘good’ mental health, to be dependent on who conforms to the social standards of behaviour, or who are able to participate in economic systems.

Intersectionality in Mental Health means to look at the series of oppression on marginalized communities who are excluded from the ‘mainstream’ society on the basis of caste, religion, sexual orientation, gender, race, ability/disability, those who undertake sex work, those who dissent, or those who’re simply considered as “immoral”. For example, Dalits work doubly hard to achieve what a Savarna (“those who fall within the caste system”) has by the virtue of systemic privilege.

Q. When did you first realise the importance of an intersectional approach to Children and/or Youth Mental health? How did that realisation change your method or practice?

The first time I realized the importance of an intersectional approach to children and adolescents was when they started asking pertinent questions regarding their own identity, values, and the way it impacts their mental health. Asking questions and creating the space to not just acknowledge, but shift the discourse of intersectionality having multiple dimensions and multiple meanings really supported my work with children.

It changed my method/practice by seeing therapy not happening in a vacuum. I remember the incident when an adolescent who started identifying as queer spoke about the distress created by the existing political climate in our country, or even about the homo-negative and problematic comments made by politicians.

When working with youth for whom knowing and unknowing their identity can seem alien, it is important to also deconstruct the power (in therapy) of working from a “know-it-all” stance. We need to constantly update ourselves about different identities and work on our own biases.

The question is to regard that identities are not the problem. Identifying with gender, sexuality, religion, race, ethnicity, and caste is not a problem. You are not the problem. It is the systems, practices, associations that collectively contribute to one’s well-being.

This therapeutic alliance opened the space for them and I to create change – believe in their truth, believe in it so much and constantly break the notion of “othering” that acceptance of one’s own identity feels safe.

Q. Have you worked with disadvantaged children/youth?

Yes, I’ve worked with disadvantaged children/youth which has only affirmed my work from a psycho-social approach. It is imperative to critically look at the power hierarchies to locate distress not within the child, rather in the societal fabric. We need to re-vision and reimagine with our children what feels right to them, what feels safe, and what it means to own up to their reality and challenge the oppressive systems.

Q. How does that social identity of these individuals affect their access to mental health?

The social identity of these individuals affect their access to mental health due to the years of discrimination and stigma – the legacy of marking, removing, confining leads for people belonging from a marginalized community to be excluded from the society. This exclusion impacts their access to education, mental health services, employment, transport, etc.

However, creating a community of different identities can create a space of comfort as it is here that there is a sense of collective belongingness, solidarity, support, and advocacy. This shared space of different identities (trans/queer, marginalized religious identities, etc) reveals the power dynamic that affect their mental health thereby making it a rights-based approach. It helps to question whether the most visible mental health services are also the most exclusive ones.

Identifying with a social identity means acknowledging and understand the histories and the power structure propagating the “normal”. What is “normal” anyway? Who decides for you, me and us?

A possible solution?

Q. According to you, how can one achieve the goal of understanding and implementing intersectional mental health services, specifically with regard to children and adolescents?

With children and adolescents, the goal of implementing mental health has to be in not silencing them, not hushing them, and not pathologizing their valid response to the society asking them to fit in social standards when they don’t want to “fit”. In the face of ideologies that prioritize the privileged, being in a therapeutic relationship that validates existence is a radical act; it’s liberation in itself. It is important to have safe spaces for children to see that the system doesn’t define their worth, dignity and humanity. A feedback-informed framework helps where both are co-creating by developing a vision for change. For example, what do they value? Does that align with what the system is asking them to do? If not, what would it mean to stay true to ourselves?

Q. What is the first step towards building an inclusive mental health mechanism within school spaces as well as outside?

I believe the first step in creating inclusive mental health within and beyond school spaces is to be vocal about anti-oppressive systems and values in order to become allies in the fight for freedom and inclusivity. We need to touch upon the socio-political-emotional within the personal and school space. Intersectional and inclusive mental health mechanisms in schools mean to focus on strengths based lenses to celebrate resilience and prioritize on creating a sense of agency that the system devoid us of.

Q. How has your personal practice enriched from an intersectional approach? What are some of the ways in which others can achieve inclusivity in their work?

One of the most needed practices enriched from an intersectional and inclusive approach is deconstructing the therapist’s “expert” position which clearly demarcates “us” and “them”. I believe the people I work with are the experts in their lives. I invite my fellow MHPs to be more vocal about injustices rather than taking a position of being “objective”. This would require introspection, reflection, unlearning and learning. Each identity needs to be considered as a valid identity, and not diagnosed. We need to also highlight the histories of marginalization which have critically impacted their mental health. It is not decontextualized from their social reality, it is embedded and webbed. For example, poverty and low living standards are all risk factors for mental health.

Q. What is your future course of action vis-a-vis the social population you are currently working with? Do you have any plans to further inclusive mental health initiatives?

My future course of action as a Mental Health Practitioner would be to continue working with a person-centred approach and learn from marginalized communities about their experiences and struggles. My way forward would be creating community mental health systems which question the systemic privileges of caste, class, gender, sexuality and ability. I, also, wish to hold counselling training for future psychologists to create spaces for learning about different identities and marginalizations. In its truest form, mental health needs to be intersectional, inclusive, safe, accessible, affordable, and for all.