Premier League

The Premier League's six-way battle for the title sets up a dramatic second half of the season

In the middle of January, only 10 points separate Chelsea at the top and Manchester United at sixth.

January hasn’t been kind so far to Chelsea Football Club. The Premier League’s form team and previously runaway leaders were on a 13-game winning run, a record that cannot be overstated given the immense competition for places in the league and Chelsea’s own catastrophic start. However, London neighbours Tottenham, under Mauricio Pochettino, are more than just the pushovers they have been for most of the new century, and they had no interest in adding their name to Chelsea’s record books. A swift return to Earth followed for Antonio Conte and his men as they lost to two Delle Alli headers.

And then the January transfer window and the newly minted Chinese super clubs happened.

Poor spunky, self-sustaining Chelsea. Success against all odds and on a shoestring budget has come at a price for the London outfit, with big, bad, disruptive China training their money on their club-honed and nurtured stars. Club legend John Obi Mikel had his head turned after 10 years with the club, the Brazilian Oscar threw away the chance to stay and compete for the Premier League title, and now the catalyst for their strong showing this season, Diego Costa, is eyeing money enough to satisfy all retirement plans.

While the irony of Chelsea complaining about the influence of sugar daddies and money in the sport in palpable, it doesn’t take away from the fact that the club would be severely impacted if the want-away Costa did leave. A bust-up at the training ground with Conte and the club fitness coach over a supposed phantom niggle might have hastened the process, with Conte refusing to include him in the squad to face Leicester on the weekend.

All this is music to the ears of Messrs Klopp, Guardiola, Pochettino, Mourinho and Wenger, as they’ve been reduced to silent observers as the Chelsea juggernaut rolled on. They and their players must have been praying for a slip or three from Chelsea, as it was looking like the daylight between them and the leaders might prove insurmountable before long. And suddenly, most, if not all, are right back in with a chance.

In the middle of January, 10 points separate the club at the top to the one at sixth, and suddenly the five-point gap between toppers Chelsea and Liverpool at second looks easier to make up.

Key strengths for the challengers

Chelsea and Manchester United, at the two ends of the top-six table, have been obdurate in defence and relatively stingy with the goals this season. Conte revolutionised Chelsea’s tactical system by making them play with three at the back and that move proved to be the key factor for their resurgence. Costa with 14 goals has been the standout attacker, with Hazard chipping in as usual.

At United, Mourinho has been impressive in his focus on defence and the old warhorse Zlatan Ibrahimovic has proved quite a few doubters wrong with an impressive 13-goal haul already. Henrikh Mkhitaryan has grabbed the opportunities provided to him with both feet and has proved his credentials to an initially sceptical manager. Mourinho himself looks like he’s enjoying the sport again, although he will be hoping the rest of his team can discover their scoring edge.

Jurgen Klopp's Liverpool and Pep Guardiola's Manchester City are the strongest challengers to Chelsea's early surge (Image credit: Reuters)
Jurgen Klopp's Liverpool and Pep Guardiola's Manchester City are the strongest challengers to Chelsea's early surge (Image credit: Reuters)

Manchester City, Tottenham, Arsenal and, in particular, Liverpoool, have had an excellent season. Liverpool have scored 48 goals this season, playing some scintillating football along the way. Adam Lallana has provided the star turn for the Merseysiders, with his excellent runs into the box and great technical ability fashioning chances and goals seemingly at will. Sadio Mane’s departure for the African Cup of Nations will leave a big slot to fill, although Philippe Coutinho’s imminent return should soften that blow.

Manchester City have had a chastening time in the league with some consistent runs followed by massive downs. Sergio Aguero, David Silva and Kevin De Bruyne would light up any side in world football. Their experience and ability will help City as they step up their challenge in the league and Europe.

Arsenal and Tottenham are locked in an interminable battle for North-London supremacy, but each will have their sights on a solid title challenge as well, backed by an impressive attacking line-up.

Weaknesses abound

Chelsea, seemingly with little or no weakness after Conte’s restructuring, will have fresh doubts placed in their minds. Their depth in the strikers position isn’t outstanding, and the 3-4-3 formation isn’t impenetrable, as Tottenham have proved.

Liverpool’s defence remains their biggest liability, with uncertainty starting from the goalkeeper’s position. Mane’s absence could remove some of the sting from their counter-attacks as well.

Manchester City have had an up-and-down season so far, as Guardiola still adjusts to a frantic, high-pitched battlefield. Disciplinary issues have been troublesome, and with captain Vincent Kompany’s playing future up in the air due to injury setbacks, the first-choice centre-backs inspire no confidence as such.

Will Arsenal and Tottenham rise above the battle of North London? (Image credit: Reuters)
Will Arsenal and Tottenham rise above the battle of North London? (Image credit: Reuters)

Spurs have the experience of having challenged for the title last season, although they also have the experience of wilting under pressure from then. Pochettino will goad his men to produce that much extra effort this season to prevent a sequel.

Arsenal’s weaknesses remain in their mind. Having led against City and Everton in the recent past, they conspired to completely capitulate and lose against both. No clean sheets for long stretches will be a cause for concern as well.

United will continue to chip away, but a lot depends on young Marcus Rashford and Anthony Martial producing the goods up front. There is a sense that they might be a confidence team, which wouldn’t augur well for tougher tests ahead.

No Europe could be the deciding factor

Manchester City and Arsenal are currently set to face Monaco and Bayern Munich in the round of 16 of the Champions League, while Thursday nights beckon for Tottenham and Manchester City. With little or no distraction for Chelsea and Liverpool, they seem best placed to take their title challenge forward.

Arsenal have historically dropped off towards the business end of the season, and might do so around February, while United’s challenge is entirely dependent on them keeping a genuinely excellent run going for almost the entire season hence. A slip-up or two could mean curtains. Manchester City look too disjointed to pose a credible threat on both fronts, and Europe could prove to be their undoing.

There are multiple twists and turns yet in a Premier League which has seen the moneyed clubs back in the thick of it this season. Experience, consistency at the back and the density of the playing schedules will be key factors.

The Premier League six-shooter is ready to fire in the remainder of the season.

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Removing the layers of complexity that weigh down mental health in rural India

Patients in rural areas of the country face several obstacles to get to treatment.

Two individuals, with sombre faces, are immersed in conversation in a sunlit classroom. This image is the theme across WHO’s 2017 campaign ‘Depression: let’s talk’ that aims to encourage people suffering from depression or anxiety to seek help and get assistance. The fact that depression is the theme of World Health Day 2017 indicates the growing global awareness of mental health. This intensification of the discourse on mental health unfortunately coincides with the global rise in mental illness. According to the latest estimates from WHO, more than 300 million people across the globe are suffering from depression, an increase of 18% between 2005 and 2015.

In India, the National Mental Health Survey of India, 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed the prevalence of mental disorders in 13.7% of the surveyed population. The survey also highlighted that common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. Perhaps the most crucial finding from this survey is the disclosure of a huge treatment gap that remains very high in our country and even worse in rural areas.

According to the National Mental Health Programme, basic psychiatric care is mandated to be provided in every primary health centre – the state run rural healthcare clinics that are the most basic units of India’s public health system. The government provides basic training for all primary health centre doctors, and pays for psychiatric medication to be stocked and available to patients. Despite this mandate, the implementation of mental health services in rural parts of the country continues to be riddled with difficulties:

Attitudinal barriers

In some rural parts of the country, a heavy social stigma exists against mental illness – this has been documented in many studies including the NIMHANS study mentioned earlier. Mental illness is considered to be the “possession of an evil spirit in an individual”. To rid the individual of this evil spirit, patients or family members rely on traditional healers or religious practitioners. Lack of awareness on mental disorders has led to further strengthening of this stigma. Most families refuse to acknowledge the presence of a mental disorder to save themselves from the discrimination in the community.

Lack of healthcare services

The average national deficit of trained psychiatrists in India is estimated to be 77% (0.2 psychiatrists per 1,00,000 population) – this shows the scale of the problem across rural and urban India. The absence of mental healthcare infrastructure compounds the public health problem as many individuals living with mental disorders remain untreated.

Economic burden

The scarcity of healthcare services also means that poor families have to travel great distances to get good mental healthcare. They are often unable to afford the cost of transportation to medical centres that provide treatment.

After focussed efforts towards awareness building on mental health in India, The Live Love Laugh Foundation (TLLLF), founded by Deepika Padukone, is steering its cause towards understanding mental health of rural India. TLLLF has joined forces with The Association of People with Disability (APD), a non-governmental organisation working in the field of disability for the last 57 years to work towards ensuring quality treatment for the rural population living with mental disorders.

APD’s intervention strategy starts with surveys to identify individuals suffering from mental illnesses. The identified individuals and families are then directed to the local Primary Healthcare Centres. In the background, APD capacity building programs work simultaneously to create awareness about mental illnesses amongst community workers (ASHA workers, Village Rehabilitation Workers and General Physicians) in the area. The whole complex process involves creating the social acceptance of mental health conditions and motivating them to approach healthcare specialists.

Participants of the program.
Participants of the program.

When mental health patients are finally free of social barriers and seeking help, APD also mobilises its network to make treatments accessible and affordable. The organisation coordinates psychiatrists’ visits to camps and local healthcare centres and ensures that the necessary medicines are well stocked and free medicines are available to the patients.

We spent a lot of money for treatment and travel. We visited Shivamogha Manasa and Dharwad Hospital for getting treatment. We were not able to continue the treatment for long as we are poor. We suffered economic burden because of the long- distance travel required for the treatment. Now we are getting quality psychiatric service near our village. We are getting free medication in taluk and Primary Healthcare Centres resulting in less economic stress.

— A parent's experience at an APD treatment camp.

In the two years TLLLF has partnered with APD, 892 and individuals with mental health concerns have been treated in the districts of Kolar, Davangere, Chikkaballapur and Bijapur in Karnataka. Over 4620 students participated in awareness building sessions. TLLLF and APD have also secured the participation of 810 community health workers including ASHA workers in the mental health awareness projects - a crucial victory as these workers play an important role in spreading awareness about health. Post treatment, 155 patients have resumed their previous occupations.

To mark World Mental Health Day, 2017, a team from TLLLF lead by Deepika Padukone visited program participants in the Davengere district.

Sessions on World Mental Health Day, 2017.
Sessions on World Mental Health Day, 2017.

In the face of a mental health crisis, it is essential to overcome the treatment gap present across the country, rural and urban. While awareness campaigns attempt to destigmatise mental disorders, policymakers need to make treatment accessible and cost effective. Until then, organisations like TLLLF and APD are doing what they can to create an environment that acknowledges and supports people who live with mental disorders. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.