Academic journal article East Asian Archives of Psychiatry

Community Perceptions of Mental Illness in Jharkhand, India

Academic journal article East Asian Archives of Psychiatry

Community Perceptions of Mental Illness in Jharkhand, India

Article excerpt


Mental illness is the result of many complex mechanisms. Presentation of symptoms, cause, treatment, progress, and prognosis vary from case to case. It is difficult for an individual to understand various aspects of mental illness when he / she have such disease, or when witnessing it in a relative or observing it as a third party. Based on their culture, education and experiences, different individuals view mental illness in different ways. They will offer various explanations for a mental illness such as brain disorder, psychological disturbance, weakness of mind, possession by a spirit / evil spirit, an illness, or a behavioural problem. Based on their belief the attribution differs and so does the model of illness that explains these phenomena, no matter these are due to internal or external forces. Previous studies have identified many common beliefs about the cause of mental illness including a curse or punishment by God, being possessed by a divine or evil spirit or ghost, black magic, evil eye, astrological problems, bad deeds in the previous life, and sexual problems. (1-14)

People often believe inappropriate conversation, hallucinatory behaviour, and wandering to be the symptoms of mental illness. Psychotic disorders are usually considered to be mental illness while non-psychotic mental illnesses often remain under-recognised by cultural explanations. When mental health practitioners are not sensitive to the explanatory models of the individual, there is a high chance that the illness will remain unrecognised. (15-18) An in-depth understanding of various sociocultural aspects and socio-economic scenarios is important to develop effective strategies to address mental health issues.

Individuals with mental illness often cannot understand what has happened to them. In cases of psychotic illness, denial prevails. Studies of common mental disorders, however, have reported different findings. Patients with depression, anxiety, and somatoform disorder attribute their illness to psychosocial and organic factors and have high levels of stigma. (7,16) In other studies, people were reported to be resistant to biomedical or psychological models and attributed mental illness to spiritual or supernatural causes. (19,20) Hence there is a need for more studies.

The relatives of an individual with mental illness are more concerned about the associated social stigma. They feel that the illness should remain a private matter for the sake of the family. The explanatory models and stigma have been found to be associated in many studies. Often, an individual will not wish to be identified as a relative of a family member with mental illness. This significantly affects treatment and help-seeking behaviour. Studies report high levels of psychological distress among the relatives of individuals with mental illness but help is not sought for fear of stigma and a lack of awareness. The relatives often consider mental illness as more severe than a chronic physical illness such as cancer and express feelings of loss and guilt. (4,10,13,21-26)

Among the general public there is a general fear of interaction with a mentally ill person whom they consider to be dangerous. Members of the general public rarely initiate any contact with the mentally ill individuals because of their abnormal behaviour; hence they fail to try and understand their problem. On the other hand, cultural beliefs and attributions play a significant role in forming an individual's beliefs and attitude towards mental illness in both developed and developing countries. (13,27,28)

Although many studies have been conducted to understand individuals with mental illness in different populations, the explanatory models of different sections of the same population were rarely reviewed and compared. Jharkhand is a state in the north of India with a population of around 33 millions. It is one of the least developed states in India. …

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