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10 Feb 2019

Cultural barriers to seeking therapy in India

The World Health Organisation (WHO) has stated that India is the country with the highest prevalent rates of depression in the world (source). Over 56 million people suffer from depression and an additional 38 million suffer from anxiety related disorders. These numbers have deep implications and makes it very likely that someone you know is suffering from a depressive or anxiety related mental illness.

Apart from the fact that access to mental healthcare is limited, there is a cultural aspect as to why we, as Indians may be more hesitant to seek therapy.

The benefits of having a familial support system while dealing with mental illnesses cannot be overstated, however there is a possibility that an excessive reliance on the interdependent/collectivist framework of Indian families without the knowledge or awareness of mental health can have a negative impact.

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Reasons why Indians may be hesitant to seek therapy
  • Because mental health is misunderstood, the family views mental illness among its members as something that stain the family’s reputation or dignity. Due to this, added to heavy stigma attached to mental illness, an individual hesitates to seek outside help, as he/she may be viewed as ‘weak’ or ‘fundamentally flawed’
  • Most problems are attributed to individual behavior or outside interference. For example, someone suffering from depression may lose interest in their day to day activities, marriage or other commitments. A lack of discipline or familial ‘values’ and ‘ideals’ are attributed to this so called ‘bad behavior’.
  • Another example is that an excessive belief in concepts like ‘Karma’ leads people to believe that mental illness is an individuals’ way of atonement for past ‘sins’ or ‘misdeeds’, especially among the rural population. In some places people suffering from mental illness are often looked at as being possessed or evil, and spiritual advisors, folk doctors and the elders in the family are often sought after for ‘treatment’ instead of a medical intervention. Although religion is not to be blamed here, deep rooted religious beliefs and lack of awareness and information on mental illness is prevents Indians from seeking clinical help/therapy.
  • Since there is a culture of interdependence, the role of parents or adults in the family is not limited to providing an education and home till the age of eighteen, like in the west. Parents play the role of guides and advisors to their children and other youngsters within the family even in their adult life. There is a possibility that parents feel insecure and inadequate if their children seek help outside, since traditionally, older family members are always consulted in decision making and problem solving. Mental health is no exception to this. Therefore, the need of expertise and specialized intervention to effectively tackle depression or anxiety is discounted.
  • A lack of awareness leads people to believe that depression and anxiety can be resolved with the right kind of advice and guidance from adults within the family. This is because it does not always manifest with frenzied symptoms.

Diagnosis, treatment and management of depression and anxiety requires clinical intervention, along with family support. Cultural norms need to be broken sometimes in order to ensure the individual receives the help they need.

References

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