How has the rural population reacted to mental health issues due to the pandemic?
According to a study published by The Lancet Psychiatry in 2019, 197.3 million people in India had mental disorders in 2017. However, only 12 per cent of them sought help for their mental health issues.
Mental health has perhaps been one of the most common health issues that have been talked about during the COVID-19 pandemic. Even as the pandemic continues to wreak havoc around the world, people have suffered from chronic stress, anxiety, depression and other major health factors during this time. The only up-side, if one looks for it, is that awareness about mental health disorders have increased, with more people talking about their issues in the open, understanding its effects, and diagnosis and treatment. However, such trends of awareness have only been seen in urban areas, while access and awareness of mental healthcare in rural parts is still a cause of major concern.
According to a study published by The Lancet Psychiatry in 2019, 197.3 million people in India had mental disorders in 2017, of which 45.7 million people had depressive disorders and 44.9 million people had anxiety disorders. “The concerning part is that while 20 per cent of the country’s population suffers from some sort of mental health problem, only 12 per cent seek help for their mental health issues. The situation is even grimmer in the rural parts of the country where lack of awareness, facilities, and resources makes it even more complex and challenging to address this rising epidemic,” said Dr Prakriti Poddar, Global Head for Mental Health at Round Glass, Managing Trustee Poddar Foundation.
Mental health is a factor that contributes to our health in all ways, and therefore, is likely to affect anyone, irrespective of where they live, and the type of lifestyle they lead. “While mental health continues to be a tabooed and shunned subject in rural India, it is important to spread the word about mental well-being to accelerate awareness in the remote corners of the country,” added Dr Poddar. She said, “The best way to promote mental health awareness is by training and educating children at the grassroots to eradicate the myths and challenges surrounding mental health. Misinformation of mental disorders is rampant in the remote corners of the country from where perpetuates a vicious cycle of stigmatised behaviour towards mental health,” even as she shares insights on the lack of awareness about mental health in rural India and the stigma that still surrounds it.
Lack of awareness and stigma — A big concern
Rural India faces significant challenges when it comes to addressing mental health issues. The Mental Health Survey (NMHS) report of 2015–2106 showed that every other state of the country except Kerala fell short of the WHO’s requirement of at least 1 psychiatrist for every 100,000 persons. Other than that, quality mental health facilities are often out of reach of rural people. According to the NMHS, on average, patients travel between twenty and forty kilometres to access mental health facilities, and the median out-of-pocket monthly expenditure on travel and medicine is about one thousand rupees.
Due to lack of access to better care and facilities, patients mostly are unaware of the mental disorders they are suffering from. Also, the majority of these patients shy away from seeking professional help because of the high cost of treatment involved and instead seek the help of community healers or priests. Needless to say, it deepens the stigma around mental illness in villages. Patients are often labelled as cursed by ‘God’ or ‘possessed by the devil’ when they exhibit any symptoms of mental illness. They are often asked to adhere to certain locally believed rituals to get rid of the curse or the ‘devil’ possessing them.
Awareness through education holds the key
Proper mental health education during childhood is especially important if awareness is to be spread about the subject. As children grow up, the absence of proper education on mental health propagates them to believe the long-held beliefs of society. The deep roots of a lifetime of stigma are laid in a child that perpetuates a vicious cycle of stigmatized attitudes towards mental health.
Other than including subjects in the syllabus that educate children at a school level, it is important to make discussions on mental health relatable. Activity based-approach can be adopted by schools to go beyond the mere delivery of facts and invoke a unique insight into mental health. Such an approach should be designed by the schools keeping in mind the developmental needs of children that would provide fertile grounds for them to engage rather than just receive information.
A mixed-method approach of education, engagement, and activities can nip the malicious self-perpetuation of stigma around mental health from the bud. Also, the focus should be paid to the training of teachers to ensure the delivery of long-term interventions as they are the primary caretakers and agents of socialisation.
The need to facilitate engagement with knowledge in the classroom becomes evident from the obvious lack of awareness of mental health issues in rural India. By allowing students to develop an enhanced perception of fundamental ethics and a clear idea about mental well-being, the mental health crisis plaguing our villages and rural towns can be seriously challenged.