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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Under the banyan tree - exclusion and inclusion of people with mental disorders in rural North India

Authors: Kaaren Mathias, Michelle Kermode, Miguel San Sebastian, Mirja Koschorke, Isabel Goicolea

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Social exclusion is both cause and consequence of mental disorders. People with mental disorders (PWMD) are among the most socially excluded in all societies yet little is known about their experiences in North India. This qualitative study aims to describe experiences of exclusion and inclusion of PWMD in two rural communities in Uttar Pradesh, India.

Methods

In-depth interviews with 20 PWMD and eight caregivers were carried out in May 2013. Interviews probed experiences of help-seeking, stigma, discrimination, exclusion, participation, agency and inclusion in their households and communities. Qualitative content analysis was used to generate codes, categories and finally 12 key themes.

Results

A continuum of exclusion was the dominant experience for participants, ranging from nuanced distancing, negative judgements and social isolation, and self-stigma to overt acts of exclusion such as ridicule, disinheritance and physical violence. Mixed in with this however, some participants described a sense of belonging, opportunity for participation and support from both family and community members.

Conclusions

These findings underline the urgent need for initiatives that increase mental health literacy, access to services and social inclusion of PWMD in North India, and highlight the possibilities of using human rights frameworks in situations of physical and economic violence. The findings also highlight the urgent need to reduce stigma and take actions in policy and at all levels in society to increase inclusion of people with mental distress and disorders.
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Metadata
Title
Under the banyan tree - exclusion and inclusion of people with mental disorders in rural North India
Authors
Kaaren Mathias
Michelle Kermode
Miguel San Sebastian
Mirja Koschorke
Isabel Goicolea
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1778-2

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