In rural India, mental healthcare remains limited due to scant state services and incongruence between provider- and patient-framing distress. Help-seeking by people with mental health problems is related to how meanings of distress are understood differently by individuals, based on their interaction with various actors in the community and the available cultural explanation within their local ecologies.
This qualitative study builds on six in-depth interviews with people with severe mental health issues and one person with epilepsy, referred to as people with psychosocial disability (PPSD) in the study. The data analysis was iterative and followed a thematic approach.
The study found that personal beliefs based on one's experience, such as negative self-judgement and wider cultural explanations, such as supernatural beliefs, as well as gender roles, impacted the way people address their mental health problems, in turn shaping their help-seeking behaviour. Participants lost hope for a cure after years of trying to find an effective solution. Moreover, the lack of access to care and the remoteness of the mountainous area made help-seeking and recovery feel impossible.
This study underscores the need for researchers and policy professionals to explore the local context and culture to improve care and treatment quality. The study also explains that personal explanations of psychosocial problems and help-seeking are not unidirectional. It is a complex phenomenon layered with the local contexts which should be addressed in clinical practice, as well as future research. Finally, clinicians' training should address the local cultural language of distress to identify the problem and suggest an effective solution.
This study puts in place a rigorous understanding of how marginalised communities navigate mental health systems in a rural and community-centred environment. The study provides a critical analysis of the different ways mental health is perceived and cared for.
