• Users Online: 862
  • Print this page
  • Email this page

ORIGINAL ARTICLE Table of Contents  
Ahead of print publication
Community perceptions with regard to mental illness in urban, rural, and tribal areas in Mysuru


1 Post Graduate, Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India
2 Assistant professor, Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India
3 Professor and Head, Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India

Click here for correspondence address and email

Date of Submission20-Jul-2021
Date of Acceptance09-Oct-2021
Date of Web Publication23-Nov-2021
 

  Abstract 


Background: Mental illness is multifactorial in its occurrence varying from place to place, thereby listing different opinions among communities. Religious, cultural beliefs play an important role in the perception of mental illness. This study aims to understand the community perceptions of urban, rural, and tribal areas and associate with sociodemographic factors.
Aims: (1) To explore the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural, and tribal population of Mysuru. (2) To compare the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural and tribal population of Mysuru.
Materials and Methods: Study design: It was a cross-sectional study conducted between January 2021 and March 2021 in urban (n = 100), Rural (n = 100), and Tribal (n = 100) field practise areas in Mysuru district among participants aged >18 years. A semi-structured questionnaire regarding their attitude, beliefs, and understanding about mental illness was drafted, and data were obtained from participants after taking their informed consent. Ethical clearance was obtained from the institute.
Statistics: Chi-square analysis was done to see the association between sociodemographic variables and perceptions.
Results: Participants held different opinions across three different zones. A significant association was seen between their age, place, education, occupation, and type of family with their perception about mental illness.
Conclusion: We can conclude that age, place, education, and occupation play an important role in the varied perception regarding mental illness. Continuous and focused interventions have to be done among the community for a positive acceptance and reducing stigma toward mental illness.

Keywords: Community perceptions, mental illness, Mysuru, rural, tribal, urban


How to cite this URL:
Hegde S, Chandrashekarappa SM, Akbar S, Narayana Murthy M R. Community perceptions with regard to mental illness in urban, rural, and tribal areas in Mysuru. Arch Ment Health [Epub ahead of print] [cited 2021 Dec 7]. Available from: https://www.amhonline.org/preprintarticle.asp?id=330920





  Introduction Top


Mental illness is a complex and multifactorial occurrence in its very outset, presenting itself as signs and symptoms but varying from case to case, becoming very abstract for the individual or community observing it as a third party thereby catapulting diverse beliefs among different communities.[1]

Studies have shown that mental illnesses are an important contributor to the rise of noncommunicable diseases with 60 million suffering from bipolar depression and 21 million suffering from schizophrenia, and an estimated 350 million are suffering from depression. In India, like other parts of the world prevalence of mental illness is high, with 58 per 1000 suffering from mental illness and 10 million with severe mental illness.[2],[3]

Religious and cultural beliefs seem to positively correlate in the perception and healing of mental health. Many accounts of religious healing have been found in a variety of historical contexts, commonly involving techniques such as prayer, ritual, reading of religious texts, and terms like “Faith” or “spiritual” are freely exchanged.[4] In India, people in rural more than urban believed mental illness was God's punishment for their sins or past misdeeds, and remedies like fasting or a faith healer could cure them mental illness.[5]

A lack of awareness regarding mental illness is very evident in India and other developing countries. There is prejudice and discrimination against mentally ill people in the society and this has contributed more to the incidence of mental illness.[6] Throughout history, patients have been stigmatized and are perceived as frightening, shameful, imaginary, dangerous, unstable, and worthless in the community which is a major impediment to help seeking for mental disorders.[7]

Culture impacts health in diverse ways so there is a need to delve deeper into how culture impacts the presentation of mental illness and understanding the needs of the individuals to enforce policies on culture-specific policies.[8] Hence, this study focuses on understanding the community perceptions, their beliefs regarding treatment and practices in three different areas of urban, rural, and tribal areas of Mysuru district.

Objectives of the study

The primary objective of the study was to explore the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural, and tribal population of Mysuru.

The secondary objective was to compare the knowledge, attitude, cultural beliefs, and practices with regard to mental illness among urban, rural and tribal population of Mysuru district.


  Materials and Methods Top


Ethics

Ethical clearance was obtained from the Institutional Ethical Committee and informed consent was obtained from study participants before data collection.

Study design

Study settings

This was a community based study conducted in Bannimantap (urban), suttur (rural) and Sargur (tribal) as shown in [Figure 1]. field practice areas in Mysuru. A population of 40,000, 5000, and 11,000 were found to be in Bannimantap, Suttur, and Sargur, respectively.
Figure 1: Study conduct flowchart

Click here to view


Study duration

The research was largely done independently by the researchers with the help of local primary health centers and volunteers over a duration of 3 months (January 2021 to March 2021).

Sampling technique and participants

Line listing of houses in Bannimantap, Suttur, and Sargur areas were done, and simple random sampling by lottery method was adopted to select the households from which participants had to be interviewed.

Inclusion criteria

In the selected household, any individual who was >18 years of age and consented to participate in the study were interviewed till a sample size of 100 in each urban, rural, and tribal areas was reached.

Exclusion criteria

No specific exclusion criteria except people who were suffering from psychiatric disorders or were on psychiatric therapy.

Data acquisition

The questionnaire for interviews included details about their sociodemographic variables, their understanding about mental illness, attitudes and beliefs of mental illness, its treatment and practices. A one-on-one interview was done with the participants, and data were obtained.

Statistical analysis: Data were entered into Microsoft excel, and data analysis was done using IBM SPSS statistics software version 25.0 (licensed to JSSAHER, Mysore)(licensed to the institution). Descriptive statistics such as proportion, mean, Standard deviation was used to represent data variables and graphs were used wherever appropriate. Chi-square analysis was used to see the association of socio-demographic variables with the perceptions of mental illness.


  Results Top


The mean age of the sample population was 42.937+-14.12. Majority of the participants were male (52.66%). The largest number of study participants were Hindus (80%) and lived in nuclear family (69%). With regards to education and occupation, majority of the participants in all three areas were illiterate (urban = 29.2% rural = 51%, tribal = 72.5%) with no formal schooling and remained unemployed (urban = 55.2, rural = 32.4, tribal = 59.8). There was no past (97.33%) or present history (99.33%) of mental illness in most of the respondents.

There was significant statistical association seen between age [Table 1], place of residence [Table 2], level of education [Table 3], occupation [Table 4], and type of family [Table 5] with the perception of mental illness.
Table 1: Perception of participants of different age groups towards mental illness

Click here to view
Table 2: Perception of participants residing in urban, rural and tribal areas towards mental illness

Click here to view
Table 3: Perceptions of study participants of various levels of education towards mental illness

Click here to view
Table 4: Perception of participants of varied occupation towards mental illness

Click here to view
Table 5: Perception of participants belonging to different types of family towards mental illness

Click here to view


Significant statistical association was seen between age and the participants perception on mental illness (P < 0.001), causes of mental illness (P < 0.001), symptoms of mental illness (P < 0.001), social implications on individual and family (P < 0.001), its treatment ((P < 0.001), their preferences of treatment (P < 0.001), and reasons for hesitancy in seeking treatment for mental illness (P < 0.001).

Significant statistical association was seen between place of residence and the participants perception on mental illness (P < 0.001), causes of mental illness (P < 0.001), symptoms of mental illness (P < 0.001), social implications on individual and family (P < 0.001), its treatment((P < 0.001), their preferences of treatment (P < 0.001), and reasons for hesitancy in seeking treatment for mental illness (P < 0.001).

Significant statistical association was seen between levels of education and the participants perception on mental illness (P < 0.001), causes of mental illness (P < 0.001), symptoms of mental illness (P < 0.001), social implications on individual and family (P < 0.001), its treatment((P < 0.001), their preferences of treatment (P < 0.001), and reasons for hesitancy in seeking treatment for mental illness (P < 0.001).

Significant statistical association was seen between occupation and the participants perception on mental illness (P < 0.001), causes of mental illness (P < 0.001), symptoms of mental illness (P < 0.001), social implications on individual and family (P < 0.001), its treatment((P < 0.001), their preferences of treatment (P < 0.001), and reasons for hesitancy in seeking treatment for mental illness (P < 0.001).

A significant association was seen between the type of family and participant perception on mental illness (P < 0.001) and causes of mental illness (P < 0.001).


  Discussion Top


It is seen from this study that place, education, occupation, age, and family had a significant association with the community perceptions regarding mental illness while gender had no significant association.

We can conclude from the study that people have a varied opinion about mental illness in their understanding. In this study, majority cited abnormal thinking as their understanding of mental illness, and the maximum number of participants (42%) did not know or were unaware of the answer. This finding is relatively at par with a study done by Sangeeta et al. highlighting the lack of knowledge regarding mental illness.[1] When it came to causes of mental illness, among the participants, family disputes, financial problems and stressful life events as the main reason and very few believed in supernatural occurring here as the main cause, which might be contrary to similar studies which shows that religious myths and beliefs play an important role in perceptions, this change in attitude can be attributed to the ongoing awareness regarding mental illness through various media outlets.[3]

People across urban, rural and tribal areas said that irrelevant behavior, social withdrawal, violence, and disobedience as the main symptoms which is also in line with previous studies saying irrelevant behavior and social withdrawal as the main reason, same with social implications on individual, general opinion in all three zones were that issues with marriage, jobs were the main implications of mental illness and when it came to family, they agreed MI was a family burden due to their unemployment, many did not know or were not aware of the implications, and social discrimination was a general implication which is not clearly highlighted in any of the previous studies. Among the participants, half of them who answered did not know whether metal illness is treatable, and for those who preferred treatment, majority preferred medical treatment, which may be contrary to some previous studies in which people were uncomfortable to visit a psychiatrist[5],[6] Social implications and stigma were the main reasons for hesitating to get themselves treated, and stigma was usually associated with other members of the commune in line with previous studies.[6]

The strength of the study is that it is conducted in urban, rural, and tribal areas in Mysuru with very few similar studies done along similar lines, and the limitations would be the smaller sample size that may not be totally representative of the population and our inability to include qualitative study methods to understand the perception.


  Conclusion Top


In this study, some of the important aspects of the community perceptions with regard to mental illness have been explored. We can conclude that there is a varied perception regarding knowledge of mental illness across the urban, rural and tribal population, and also education, occupation, and type of family that a person belongs to. Participants with better education, occupation seemed to be more knowledgeable about mental illness. This study tells that continuous efforts from healthcare workers, and community participation have to be bolstered to raise awareness of mental illness. Good education seems to play an important role in positively routing people to accept mental illness, reduce stigma and improve health-seeking behavior. Overall more research and awareness efforts have to be implemented to understand varied perceptions and reduce stigma towards mental illness.

Acknowledgments

Acknowledgment to primary urban health center Bannimantap; primary health center Suttur, for providing technical support throughout the project.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sangeeta SJ, Mathew KJ. Community perceptions of mental illness in Jharkhand, India. East Asian Arch Psychiatry 2017;27:97-105.  Back to cited text no. 1
    
2.
Tucci V, Moukaddam N. We are the hollow men: The worldwide epidemic of mental illness, psychiatric and behavioural emergencies, and its impact on patient ad providers. J Emerg Trauma Shock 2017;10:4-6.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Porreddi V, Ramachandra, Redamma K, Suresh BM. Attitude and response of rural population with regard person with mental illness. Acad J Psychiatry 2013;4:42-8.  Back to cited text no. 3
    
4.
Dien S. Religious healing and mental health. Ment Health Relig Cult 2020;23:657-65.  Back to cited text no. 4
    
5.
Kishore J, Gupta A, Bantman P. Myths, beliefs and perceptions about mental disorders and health seeking behaviour in Delhi, India. Indian J Psychiatry 2011;53:324-9.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Ganesh K. Knowledge and attitude of mental illness among general public of Southern India. Natl J Community Medicine 2011;2:175-8.  Back to cited text no. 6
    
7.
Salve H, Goswami K, Sagar R, Nongkyrih B, Sreenivas V. Perception and attitude towards mental illness in an urban community in South Delhi – A cross sectional study. Indian J Psychol Med 2013;35:154-8.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Sarkar S, Punnoose VP. Cultural diversity and mental health. Indian J Soc Psychiatry 2017;33:285-7.  Back to cited text no. 8
  [Full text]  

Top
Correspondence Address:
Saurish Hegde,
Door No. 19, Hanumanth Nagara, Bannimantap 3rdStage,OppositeSalafiMasjid,NexttoKrishnaMilkDairy. Mysuru - 570 015, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amh.amh_107_21



    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

Top
 
  Search
 
   Ahead Of Print
  
 Article in PDF
     Search Pubmed for
 
    -  Hegde S
    -  Chandrashekarappa SM
    -  Akbar S
    -  Narayana Murthy M R


   Abstract
  Introduction
   Materials and Me...
  Results
  Discussion
  Conclusion
   References
   Article Figures
   Article Tables

 Article Access Statistics
    Viewed37    
    PDF Downloaded4    

Recommend this journal