Preprint / Version 1

Factors influencing care-seeking behaviour for mental illness in India: a situational analysis in Tamil Nadu

Authors

  • Anant Jani Oxford Martin School, University of Oxford, Oxford, OX1 3BD, UK
  • Sindhu Ravishankar Oxford Department of International Development, University of Oxford, Oxford, OX1 3TB, UK
  • Naresh Kumar JSS Institute of Naturopathy and Yogic Sciences, Coimbatore, Tamil Nadu 641105, India
  • J Vimitha South India Aids Action programme, Chennai, Tamil Nadu, 600041, India
  • Soleil Shah Stanford University Medical School, Stanford, CA, 94305, USA
  • Anees Pari East of England and Midlands, Public Health England, Nottingham, NG2 4UU, UK
  • C Ramasubramaniam Tamil Nadu Ministry of Health, Chennai, Tamil Nadu, 600 009, India

Keywords:

health services, management and policy, mental health

Abstract

ABSTRACT The contribution of mental illness to the total burden of disease in India nearly doubled from 1990 to 2017, increasing from 2.5% of the total disability-adjusted life years in 1990 to 4.7% in 2017. Despite efforts by the Indian government, a treatment gap of 75–85%, with heterogeneity across multiple dimensions, exists across India. We conducted a qualitative study in Tamil Nadu, India, to better understand the contextual factors affecting the care-seeking behaviour for mental illness. Methods Qualitative methods, including semi-structured interviews and focus groups (FGs), were conducted with stakeholders involved in the mental health care pathway in Tamil Nadu. Ten semi-structured interviews and five FGs were conducted and analysed using an inductive approach to identify codes, using Dedoose v7, related to the emerging themes and categories. Results Our analyses identified three key areas that influence care-seeking: views on what causes and/or constitutes mental illness, stigma and discrimination associated with mental illness and broader factors influencing decision-making. Conclusions The specific contextual factors identified by our study can be used to design and implement approaches that can help to address some of the issues that influence the care-seeking behaviour and manifest in the treatment gaps seen in Tamil Nadu and in India, more generally. Keywords: health services, management and policy, mental health

Author Biography

Anant Jani, Oxford Martin School, University of Oxford, Oxford, OX1 3BD, UK

Oxford India Centre for Sustainable Development, Somerville College, University of Oxford, Oxford, OX2 6HD, UK

Downloads