Something that is not very well appreciated in the world of psychiatry so far is how cultural context plays an important role on the psyche of each individual. India is a land of many cultures all of which are remarkably different from the culture of USA or Europe. It is important that we also adapt the tools and techniques that we use according to the cultural context we are going to use them in. It is with this in mind that I talk about the concept of Community Mental Health Interventions in an Indian context.
Community Mental Health
Indian society has been a collectivistic one for centuries. The main focus in our society is not on each individual but a group of individuals collectively. We often see people talking about the importance of collective action rather than individual efforts. It is hence pretty important that when we look into the possible treatments for disorders like major depressive disorder, PTSD or others; that we look into the possible role that the close community around the sufferer can play in their treatment.
Doctors Cannot Be Everywhere
India is a country of about 1.2 billion people as of 2011. The current estimate puts the population at somewhere around 1.35 billion. No matter how much the government tries, it is hard to believe that a time will come soon enough when every rural village would have access to high quality healthcare.
Mental health care hence, fares even worse than normal health care. It is hence important that to ensure mental well being of all individuals, we have grassroots programs that would lead to a trained counsellor in every village. One such effort was made in Maharashtra and later in Gujarat by the name Atmiyataa. I will discuss this program in great detail later in September.
The Role of Religious Figures
Another very important thing in the rural India setting is the prominence of religious figures and the influence they have over the locals. Many priests are often approached for life problems looking for a solution.
Many community intervention programmes which have been carried out have emphasised the importance of these religious figures. They are asked to listen to each person’s problem that approaches them and also encourage them to visit doctors or psychologists for additional help. We criticize the superstitions that some priests spread around but we must not ignore their power in rural settings.
India is a land of many cultures. We are different from the traditional roots from which clinical psychology emerges in the western world. If we want to make a more meaningful and deeper impact, we must try something different. Community interventions are the way ahead for me personally when it comes to treating mental disorders in rural India.
It is unrealistic to believe that the people in rural India will undergo a paradigm shift when it comes to mental illness quickly. It is also important to note that a society is more likely to change when it is brought about by someone from within the society. The responsible people of a community need to act as the connecting links between better health care and its access to the common man.
We can change the situation but none of us can do it alone.