Mental Health an Urban Concern? Here’s How Rural India Fares
We need to fight the stigma and reluctance to discuss depression in rural India in order to treat it.
Sushant Singh Rajput's death in June this year brought up the discussion about mental health, but it kept getting derailed by uninformed viewpoints on social media. Bollywood actor and producer, Kamal R Khan, made one such claim on Twitter recently about how "people in rural India do not suffer from depression". Dr Soumitra Pathare, a consultant psychiatrist and Director of Centre for Mental Health Law and Policy at ILS, corrected Khan on his claims. Dr Pathare pointed out that although there are fewer cases reported, depression is present in rural India.
The tweet archive can be found here.
The National Mental Health Survey (NHMS) 2015-16 backs Dr Pathare claims. The report states that 4.48% of people in rural India had experienced depressive disorders in their lifetime, as compared to 8.23 in urban metros.
Further, Khan's tweet claimed, "So I can say with 100% guarantee that only drugs addicted people do face depression problem. Therefore people suffer from depression in the big cities and film industries only."
Are the Claims that Rural India Doesn't Have a Mental Health/Addiction Problem, Real?
The NMHS report suggests that alcohol and substance abuse was prevalent more in rural areas of the country as opposed to the urban metros. According to the report, "the rate of alcohol and substance use disorders was 24 % in rural India as compared to 18% in urban metros."
Both the claims made by Khan on his verified Twitter account were proven to be false. However, his tweet got over 4000 likes and close to 900 retweets. This showed that his ideas resonated with some of his followers. Therefore, it is not only crucial to debunk Khan’s claims but also provide people with some data about mental health in rural India so that they can be more informed.
Reasons Behind Mental Disorders
Mental health problems stem from a combination of biological, social, cultural and economic reasons. However, according to the report, the four primary reasons are:
- Substance use disorders
- Mood disorders
- Depressive disorders
- Neurotic and stress-related disorders
Access to Proper Healthcare Facilities
Only 1 in 10 people screened for mental disorders seek help from professionals, as per this report. A WHO-backed case study explains the problems faced by people in rural India when it comes to medical aid. On the other hand, India has 0.75 psychiatrists per 100,000 populations, while the desirable number is anything above 3 psychiatrists per 100,000, as per an NBCI report. Both factors combine to create a burden on healthcare in India and increase the gap in rural parts of the country.
Science vs Black Magic
Due to the state of education in rural India, people find it difficult to understand mental health problems. In the absence of science, one often equates mental illness as a form of karmic punishment or some form of black magic. This often leads to stigmatisation of the disease, and people are often shunned from society. An NCBI study conducted in rural settings showed that the feeling of stigmatisation was the highest when it came to rural manual labours.
The Role of Gender
An NCBI report suggested that symptoms of depression, anxiety, and unspecified psychological distress are 2–3 times more common among women than among men. The reasons for the same have been noted as physical/sexual abuse, postpartum depression, stress, and so on. While we see more cases of mental distress in women, the gap in receiving treatment is higher. Healthcare facilities are not equipped to accommodate female patients. There is also a higher risk of stigmatisation when it comes to women with mental illnesses.
Although the rate of healthcare issues in rural India is comparable to that of urban metros, mental healthcare for services need to be catered separately and have to be more rural-specific. Many government and non-governmental organisations are working on mobilising young people to create awareness about mental health. It is, therefore, essential to have a proper conversation about mental health in the rural parts so that more steps can be taken to remove the stigma and increase social acceptance.
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