Mental health issues have emerged as a pressing concern in India, significantly impacting individuals, families, and communities. While the focus on mental health has gained momentum in urban areas, the challenges faced by rural India remain largely overlooked. This is primarily due to the fact that as opposed to urban areas, rural populations are still struggling to get their basic needs fulfilled.?
While awareness about mental health is undoubtedly getting attention, unfortunately, the understanding has still not reached the rural population as much as it should.?"When treating mental illness, rural India is a forgotten geography. Rural people go through a lot of turmoil and hardship. Young boys and girls of migrant labourers miss their fathers who come home once in six months. Likewise, farmer suicides leave entire families shattered and in dire need of medical intervention for mental disorders. In this backdrop, the outreach by NGOs in rural areas is appreciable," said Dr Vijay Arora, Senior Director, Max Super Speciality Hospital, Patparganj.
There are several different challenges that the rural areas of the country face. Here are a few of them:
Studies have consistently highlighted the scarcity of mental healthcare facilities in rural India. A survey conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed that only 10-12% of people in need of mental healthcare in rural areas had access to appropriate services. This limited access can be attributed to the shortage of mental health professionals, including psychiatrists and psychologists, who are primarily concentrated in urban areas.
The stigma surrounding mental health issues remains a significant barrier in rural India. Traditional beliefs, cultural norms, and societal attitudes often lead to the neglect and marginalization of individuals with mental health concerns. A study published in the Indian Journal of Psychiatry reported that nearly 80% of respondents in rural areas believed mental illness to be a result of supernatural causes rather than a medical condition. This stigma inhibits help-seeking behaviour and perpetuates a cycle of suffering and isolation.
Rural India faces numerous socioeconomic challenges that exacerbate mental health issues. Poverty, lack of education, unemployment, and limited access to basic amenities contribute to heightened stress levels and psychological distress among rural communities. A study conducted by the Public Health Foundation of India (PHFI) found that economic deprivation and low socioeconomic status were associated with an increased prevalence of mental health disorders in rural areas.
Rural women and children are particularly vulnerable to mental health problems. Gender-based discrimination, domestic violence, and lack of empowerment add to their psychological burden. A study published in the Journal of Mental Health and Human Behavior emphasized the high prevalence of depression among rural women, linking it to their lower social status and limited decision-making power.
Now that we have talked about the challenges faced in rural India regarding the mental health structure, there are some solutions that one can go forward with to resolve those challenges.?¡°While building awareness about mental health and normalizing mental illness is important, it is absolutely critical to create a sustainable model for the prevention and treatment of mental illness in rural India. Providing access to affordable psychiatric treatment and counselling, government-aided schemes, vocational training, psycho-social support, and rehabilitation can help those affected with mental illness, their carers & families,¡± said Anisha Padukone, CEO of LiveLoveLaugh.
There is an urgent need to strengthen mental healthcare infrastructure in rural India. This includes the establishment of mental health clinics, telepsychiatry services, and mobile mental health units to reach remote areas. Government initiatives like the National Mental Health Program (NMHP) need to be expanded and adequately funded to provide comprehensive mental health services in rural communities.
Efforts to destigmatize mental health issues through community-based awareness programs are crucial. Collaborations between healthcare providers, NGOs, and local leaders can promote understanding, dispel myths, and encourage early intervention. Integrating mental health education into school curricula can also help foster a more inclusive and empathetic society.
There should be a provision of specialized training for mental health professionals, including psychiatrists, psychologists, and counsellors, to address the unique needs and challenges of rural communities. Other than that, there should be an implementation of training programs to build the capacity of primary healthcare providers to identify, manage, and refer individuals with mental health concerns, ensuring a comprehensive and integrated approach to care. Last but not least, we should empower community health workers, such as Accredited Social Health Activists (ASHAs), to provide basic mental health support, psychoeducation, and referral services.
Support and establishment of self-help groups for individuals with mental health concerns, providing a platform for sharing experiences, peer support, and promoting self-care practices. In addition to that, there should be a formation of community support networks, where community members come together to support individuals with mental health challenges, organize awareness campaigns, and advocate for better mental health services. There should also be partnerships with?non-governmental organizations (NGOs) and volunteers to extend mental health support, conduct outreach programs, and provide counselling services in rural areas.
It is extremely important to integrate mental health services within the existing primary healthcare system to ensure a holistic approach to healthcare, with mental health being an integral component of overall well-being. More than that, there should be a provision of training and workshops for primary healthcare providers to enhance their understanding of mental health, enabling early identification, and basic management of mental health conditions.
¡°Mental health services were always needed across the whole country. These services were unavailable to rural people for a long time. Growing access to traditional and social media in rural India has made people aware of the existence and importance of mental health services. Organizations that are taking mental health to such unserved areas are doing appreciable work. More help must be provided to people dealing with mental disorders, and these illnesses must be destigmatized,¡± said Dr. Akshay Kumar, Head of Clinical Psychology Department at Artemis Hospital Gurugram.
It requires collaboration between government agencies, healthcare providers, NGOs, community organizations, and individuals themselves to create a supportive ecosystem that prioritizes mental health