Coping strategies and perceptions of mental health services among women in South India

Abstract

Objectives Lack of engagement with mental health services is a challenge for Global Mental Health research and intervention in lower- and middle-income settings. In India particularly, there is a significant treatment gap for people experiencing common mental disorders. This exploratory mixed-method study investigated women’s attitudes toward mental healthcare in Mysuru, India, and investigated what distress copings strategies they used in their everyday lives. Methods We conducted qualitative interviews and administered a depression symptom screener with a community-based sample of 54 adult women. Interviews asked women to comment on their own distress experiences and stress management techniques, as well as their dispositions toward seeking mental healthcare for themselves or others. Results Nearly 65 percent of the study sample screened for any level of depression risk, but only 5 had ever received mental healthcare. Around 20 percent of women stated that they would hypothetically be open to receiving such care. Yet, there was strong agreement across the study sample that mental healthcare was not an appropriate resource for addressing their own distress. Most women who rejected mental healthcare mentioned concerns about stigma and lack of perceived need or treatment inadequacy as their main reasons. Women described a broad range of coping strategies they used for dealing with distress, and which they reported as being effective. Many of these approaches resemble behavioral and talk therapies used in psychology and psychiatry. Conclusions Women in this study generally did not view clinical mental healthcare as an appropriate treatment for their distress. Many already had effective strategies for managing their distress and analogous to existing psychological behavioral and talk therapies. A better understanding of why people reject mental healthcare is necessary for increasing the success of mental health interventions, and for developing new intervention approaches that support coping outside of clinical encounters.