Enhancing mental health literacy in India to reduce stigma: the fountainhead to improve help-seeking behaviour
| Date | 09 September 2014 |
| Pages | 146-158 |
| Published date | 09 September 2014 |
| DOI | https://doi.org/10.1108/JPMH-06-2013-0043 |
| Author | Shivani Mathur Gaiha,Greeshma Ann Sunil,Rajeev Kumar,Subhadra Menon |
| Subject Matter | Health & social care,Mental health,Public mental health |
Enhancing mental health literacy in India
to reduce stigma: the fountainhead to
improve help-seeking behaviour
Shivani Mathur Gaiha, Greeshma Ann Sunil, Rajeev Kumar and Subhadra Menon
Shivani Mathur Gaiha is a
Research Associate, Health
Communication and
Dr Subhadra Menon is
the Director, Health
Communication at the Public
Health Foundation of India,
New Delhi, India. Greeshma
Ann Sunil, a former consultant
in mental health and Rajeev
Kumar,Co-ordinator, Research
at Innovators in Health, Jaipur,
have closely participated in this
research.
Abstract
Purpose – Lack of understanding around mental illness and stigma are an overwhelming barrier in help-
seeking behaviour for mental health concerns. The purpose of this paper is to examine mental health literacy
and social attitudes as instrumental factors in building capacity of the demand-side to support and access
mental health care at the community level in India.
Design/methodology/approach – Knowledge, Attitude and Practice surveys were administered to 521
persons from the general population, distributed equally in the age range of 15-60 years. The study
included 52 respondents per district from ten districts across five states in India, namely Andhra Pradesh,
Assam, Delhi, Gujarat and Uttar Pradesh. The responses were collected and analysed thematically,
keeping in mind the relevance of these findings as contributors to knowledge of mental health and to the
construct of stigma.
Findings – Pervasive socio-cultural factors, especially stigma inhibit access to basic mental health
information and care, despite knowledge that mental illness is treatable. Degrading treatment, loss of
personal liberty and social exclusion, i.e. compromised human rights at the community level are
widespread. Self-reported attitudes when encountering a person with mental illness show that respondents
act out of fear and are guided by misinformation and myths. Extant knowledge on mental health is attributed
predominantly to informal networks, as a potential resource to be strengthened.
Practical implications – Realising mental health care, including help-seeking behaviour calls for greater
knowledge-sharing, sensitisation and community engagement.
Originality/value – This paper fulfils an identified need to study current levels of mental health literacy and
underlying perceptions that contribute to the persistent treatment gap.
Keywords Mental health, Knowledge, Behaviour, Stigma, Health communication, Health literacy
Paper type Research paper
Background
The burden of mental illness in India is massive and growing, with over 61 million people
suffering from mental and behavioural disorders recorded in 2002 (Central Bureau of Health
Intelligence, 2011). These cases do not tell the complete story and highlight the first and most
profound denial of human rights; when a large magnitude of persons live with mental illness, but
are unable to recognise, accept and take appropriate action. By and large, in low and middle
income countries (LAMICs), 75-90 per cent of people with mental disorders do not receive
medical treatment (Bruckner et al., 2011; Patel et al., 2011). Estimates indicate the presence of
a noteworthy “treatment gap” in India; with 80 per cent of 20 million persons requiring mental
health care outside the purview of psychiatric treatment (Demyttenaere et al., 2002; Kohn et al.,
2004; Nagaraja and Pratima, 2008).
Despite economic advances by India, among LAMICs, community mental health services
and resources (such as mental health specialists) are scarce and unevenly distributed
This research was led by the Health
Communication Division at the
Public Health Foundation of India
with financial support from the
National Mental Health
Programme, Ministry of Health and
Family Welfare, Government of
India. The authors are grateful to
the TechnicalAdvisory Group of the
“Maanavta Se Anmol Mann Tak”
(Humanity for Precious Minds) pilot
communication campaign for
feedback on survey methodology
and instruments. The eminent
group included Dr A.K. Agarwal,
Dr B. Anand, Dr Vivek Benegal,
Dr Achal Bhagat,
Dr Sanjiv Jain, Dr K.N. Kalita,
Dr Sudhir Khandelwal, Professor
Vikram Patel, Dr Alka Pawar,
Dr C. Ramasubramanian,
Dr M. Ranganathan, Dr Sudipta
Roy and Dr R. Thara. The authors
would like to acknowledge the
efforts of community-based
organisations and volunteers
who facilitated this research.
PAGE 146
j
JOURNAL OF PUBLIC MENTAL HEALTH
j
VOL. 13 NO. 3 2014, pp. 146-158, CEmerald Group Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-06-2013-0043
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