By Sakuni Weerasinghe This week we’re in conversation with Dr. Kanthi Hettigoda, a licensed clinical psychologist currently working in the Sri Lanka Navy, on the topic of mental health in Sri Lanka. Below are excerpts of the interview. To start off, could you please tell us about yourself? I am a chartered clinical psychologist. I work both as an academic as well as a practitioner. My interest in psychology emerged soon after my A/Ls (Advanced Levels). I saw psychology as a means to reach the vision and mission of my life which can give a meaning to my existence. I have my Bachelor’s in Psychology (Hons) from the University of Peradeniya (2000) and an MSc in Organisational Management (2005) from the same university. I gained my MPhil in Clinical Psychology from the Faculty of Graduate Studies at the University of Colombo (2010) as a member of the first batch of that programme. In 2013, I made a critical decision to join the Sri Lanka Navy Regular Force to serve as a clinical psychologist where I had to complete three months of military training. In 2014, I was awarded the Commonwealth full scholarship to pursue my PhD in the UK. Upon completion of my PhD, I resumed duties at the Navy. I am currently deployed in the General Sir John Kotelawala Defence University (KDU) Hospital as a clinical psychologist. I am a chartered clinical psychologist in the British Psychological Society and a foreign affiliate of the American Psychological Association (APA). Furthermore, I am the current President of the Sri Lanka Psychological Association and represent the country in several international psychological alliances. I’m a also a participant in the National Mental Health Steering Committee. As a renowned clinical psychologist in Sri Lanka, what do you find to be most rewarding when it comes to the work you do? For me, it is the improvement of the clients I work with; this is not about just reducing their symptoms. Rather, it is about the overall improvement of their lives. Seeing them reaching their full potential is rewarding to me. There seems to be a notion in society that psychotherapy is only for those with mental disorders. Could you reflect on this? This is a very wrong notion and a leading factor for the stigma towards mental health and for not seeking help. Psychotherapy offers diverse options to ensure mental health wellbeing for any healthy person. It has three functions: curative, preventive, and developmental. Only the curative aspect helps people with mental health issues. You must be meeting clients with varying dimensions of psychosocial concerns. What are the noticeable signs that could indicate that someone might benefit from psychotherapy? We as mental health professionals look at a mental health issue through the biopsychosocial model, and any patient would benefit from psychological interventions. However, most importantly, when we observe that the main predisposing factor is psychological and not genetic, we have a big role to play. Also, when there are factors that maintain the disorder, psychologists can help to overcome them. When the disorder is mild and there is no need for medication, psychologists have a vital role to play. Psychotherapy has been proven to be very effective for most of the personality disorders. Evidence-based practice encourages combining psychotherapy with pharmacotherapy even for psychotic and mood disorders. If the (psychotic) problem recurs and relapses occur frequently, it is an indication that there is a need for psychological support. For any disorder of a mild to moderate level, psychologists can help even without administering medicine. When it comes to experiencing psychological distress, it is apparent that most people tend to wait it out until the distress builds up and daily life is affected. Could we dive into how important early intervention is when it comes to managing mental health? This is one of the main issues related to mental health in Sri Lanka. Yes, early intervention is vital to prevent further development of the problem – that is, when an individual notices changes in his/her sleeping/appetite, feels sad most of the time, feels hopeless and helpless, that person should seek help. These are symptoms of depression which may be mild to moderate. If they are not addressed early on, they can lead to severe depression which may require anti-depressants to balance the chemicals in the body. If we could all implement one practice in our lives for the betterment of our mental health, what would it be? Practise mindfulness. What is the most challenging aspect of working in the field of mental health in Sri Lanka? The lack of co-ordination among the different parties in the mental health field. The lack of trust and perceived threat to each other are very crucial. Where are we as a country in terms of fighting the stigma against mental illness? We are progressing slowly. There are a lot of indicators for this. Now, parents bring their young children for early intervention (examples in cases of autism, ADHD [Attention Deficit Hyperactivity Disorder]) and there is an increase in seeking help from psychologists on their own. We need to increase the mental health literacy of the citizens. What changes do you wish to see in this field within the next five years? Every mental health unit works with a multidisciplinary team to help patients. To eradicate the stigma, general psychology and life skills should be included in the school and university curricula, which will thereby increase mental health literacy. The Government and other interested parties can also take a rights-based approach rather than a welfare approach. You have been a mentor to so many inspiring practitioners in Sri Lanka. What piece of advice would you give to someone interested in joining the field? Be genuine. Have compassion.