The objective of this course was to analyze how gender intersects with cultural models of medicine, illness and health and the human body across the globe. Throughout the course we were able to see how the western biomedical model differs from others. These included traditional medication, healing, etc. In the first week, we went over the five theoretical models. These models were used to learn about the various gendered health issues that arise in our society. In this post, I will use the feminist theory to explain the high rate of mental illness in women in India. Along with this theory, I will explore how cultural and social determinates can influence how women receive treatment (or lack thereof), and the importance of education and awareness of mental health. How women are expected to carry themselves in Indian society can be major influences for the lack of treatment they receive. For social determinant, I will discuss how the lack of education on mental illness can account for many not receiving treatment. There are also various social, political, and economic determinants that can influence mental health in India.
India is located in southern Asia, bordering the Arabian Sea and the Bay of Bengal, between Burma and Pakistan. It is slightly more than one third the size of the United States with a population of 1,281,935911 (UNICEF 2013). 48.17% of that population consist of females and the other percent male. In India, people learn the essential themes of culture life through family. Family is very important in Indian families, and they tend to be very close knit (Hays 2015). Family is more important than the individual and the individual is nothing unless he or she is part of a family (Hays 2015). One important part of culture are rituals, rites of passage, etc. These can affect the lives of the men in women that are apart of that culture, and even determine what could happen to them. One important ritual in Indian culture is marriage, or, the Kanyadaan in Hindu tradition. It is necessary for the formation of a family and having a large family is significant. The male and the female play different roles in this family setting. The man is the one who is tasked with working. This work is typically the hard work, while the women is tasked with household work. Men have a very close relationship with the mother and the daughter and father typically have a strong bond. The oldest son is also the one to become the head of the household when the father dies.
Another important part of the culture is the birth of a child. Children are deeply desired, and often times there is a celebration for their arrival. One of these rituals include childhood Samskaras. The oldest form of the rituals is performed immediately after birth followed by the Namakarana (naming ceremony) and the proceeded by the exit for the birth room, eating their first solid food, the ear piercing, and then the first haircutting in the third year of life (Rites 2018). Rituals and rites of passage as the ones mentioned above all aim for protecting and nurturing the child. They are critical for one’s life journey and have an influence on how one lives their life. As the child grows, their role in society is dependent on whether they are male or female. Traditionally, the women have four roles in her life: the daughter, the wife, the housewife, and then the mother.
Religion also plays a very important role in Indian culture. Hinduism and Buddhism account for most of the religion. 84% of the identify as Hindus, with different variations of the religion. Another 13% of the population identity as Muslim, making it one of the largest Islamic nations in the world. The others include Christians, Sihks, Buddhist, and Jains (Zimmerman 2017). In India, the women have a very specific role that involves rituals in religions. From the book titled, “Women’s Lives, Women’s Rituals in the Hindu Tradition” by Tracy Pintchman, she talks about the various rituals that women go through in India. She states that, “in India, women are more religious than men and do the lion’s share of day to day religious work” (Pintchman 2007). Pinthcman discusses how the work performs parallels the work women do in the household. Religion, like Hinduism, plays a huge role in Indian culture and this can be seen in various rituals carried out in Indian culture.
Mental illness is a worldwide issue. We can see how it impacts an individual’s life and why. According to CNN, India is one of the most dangerous countries in the world for women. There are many things that contribute to the high occurrence of mental health disorders in women located in this region. These factors include the role of a women in society, domestic abuse, substance abuse, and others. There are others including the high risk of sexual violence and slave labor, along with forced marriage and other issues (Dewaan 2018). In an article by Savita Malhortra titled, “Women and Mental Health in India Overview”, the topic of how mental health affects women is discussed. She writes that, “Gender is a critical determinant of mental health and mental illness. The patterns of psychological distress and psychiatric disorder among women are different from those seen among men. Women have a higher mean level of internalizing disorders while men show a higher mean level of externalizing disorders…. Social factors and gender specific factors determine the prevalence and course of mental disorders in female sufferers. Low attendance in hospital settings is partly explained by the lack of availability of resources for women. Around two-thirds of married women in India were victims of domestic violence.” (Malhortra 2015). This issue is very important to identifying because it is so prevalent. As we can see, based on one’s gender, there can be a higher chance for mental illness. In India, it is important to determine what factors contribute to mental health. In research by Indira Sharma and Abhishek Pathak, we see that “the Indian culture is unique. Joint family system, patriarchy, marriage a must, especially women; marriage is a sacrosanct union, permanent union; subservient status of daughters-in-law at home, preference for the male child, practice of dowry, lower educational status of women, strict code of conduct for females, and primary roles of women being childbearing and child rearing, and the “Indian Paradox” (the married woman with severe mental illness, subjected to domestic violence…are all part of the Indian culture. These factors significantly affect the occurrence, manifestations, treatment, and outcome of mental disorders in women of India” (Sharma, Pathak 2015). The gender differences and their role in that culture have an effect on how the mental health of these women are affected, showing that depression is the most common of the mental disorders and more persistent in the women in India than in the men. This can come from risk factors including gender-based roles, stressors, and negative life experiences and events. We see that “Depression is widely prevalent in women in all age groups especially in India where 1.2 billion population lives. In the current scenario of underdiagnosed, untreated cases of females suffering from depression, the hurdles faced by Indian women include inadequate number of mental health professionals, lack of awareness, stigma, disadvantaged position of women, multiple roles, increased levels of stress, and domestic violence.” (Srivastava, Bhatia, Bohra 2015). Identifying such factors will be easier to determine how to deal with them.
By utilizing the feminist theory, we can look at what factors specifically can contribute to the high number of mental health issues in India. Feminist theory can be defined as the focus of the interaction and experiences of women and girls within society. They ask about the role of gender, the idea we as a society hold about gender, and our gender behaviors in all situations. Some of the questions asked by feminist theorist include, “how does gender impact the situation?” and, “is there inequality present due specifically gender?” along with others. Today, the theory uses intersectionality to analyze these inequalities in more depth (ANP 270 1.6). We can look at the inequalities that exist because of one’s gender, and how this has an effect on their lives and health. These inequalities that arise because of gender cause many negative effects on the individuals in society. An example is how these inequities can impact a women health, and more specifically, mental health. Gender is a critical determinant of mental health and mental illness. Gender determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status and treatment in society and their susceptibility and exposure to specific mental health risks (WHO 2013). Depression, anxiety, psychological distress, sexual violence, domestic violence and escalating rates of substance use affect women to a greater extent than men across different countries and different settings. Pressures created by their multiple roles, gender discrimination and associated factors of poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse, combine to account for women’s poor mental health. There is a positive relationship between the frequency and severity of such social factors and the frequency and severity of mental health problems in women. Severe life events that cause a sense of loss, inferiority, humiliation or entrapment can predict depression (WHO 2013).
As we have seen, there are many things that affect mental health. Education is an important aspect of a society and is also one that can influence mental health in a community. Being able to teach others the awareness and importance of certain things is vital for change within a community. In this case, it would be vital to educate on mental health and its importance. Starting out in schools can be very helpful. Researchers have found that school services delivered by teachers and professional can help reduce mental health problems in elementary aged children (Ians 2018). Being able to start out in schools lead to the chance of being able to allow other programs to happen. Implementing mental health awareness programs will significantly help communities. In the article titled, “Mental Health Awareness: The Indian Scenario”, it is stated that, “Mental health awareness campaigns have yielded positive outcomes. Some of the strategies undertaken to target awareness and address stigma around mental illness include participation by family members, sensitization to treatment and social inclusion. Lack of knowledge about the mental illnesses poses a challenge to the mental health care delivery system. Research has highlighted the role of community-based systems in low-income countries and has also yielded positive results in creating awareness, thereby impacting participation” (Srivastava, Chatterjee, Bhat 2016). In addition to bettering the community, it allows for conversation to happen about implementing mental health programs. Having policies and various programs be made that benefit mental health will also strengthen a community and help mental health awareness.
It is important to note that there are many things that can impact one’s mental health. Things like the living conditions of one’s community, culture, support (or lack of it), politics and others all can influence an individual’s mental health. Being able to identify the various determinants of health that contribute to mental illness will be very helpful in identifying a way to fix a worldwide issue. Factors such as adequate public education, health programs, and things of the sort will help alleviate such issues that arise for these women suffering from mental health disorders in India.
Dewan, Angela. (2018, June 26). India Most Dangerous Nation for Women, US Ranks 10th in Survey. CNN. https://www.cnn.com/2018/06/25/health/india-dangerous-country-women-survey-intl/index.html.
Hays, Jeffrey. (2015, June). Families and Gender Roles in India. factsanddetails.com/india/People_and_Life/sub7_3d/entry-4174.html.
Ians. (2018, March 3). Teachers may help reduce mental health problems in children, says study. Retrieved from https://www.indiatoday.in/lifestyle/health/story/teachers-may-help-reduce-mental-health-problems-in-children-says-study-1181063-2018-03-03
Malhotra, Savita, and Ruchita Shah. (2015, July). Women and Mental Health in India: An Overview. doi:10.4103/0019-5545.161479.
Pintchman, Tracy. (2007). Women’s Lives, Women’s Rituals in the Hindu Tradition. Oxford: Oxford University Press
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Sharma, Indira, and Abhishek Pathak. (2015, July). Women Mental Health in India. Indian Journal of Psychiatry
Srivastava, K., Chatterjee, K., & Bhat, P. (2016). Mental health awareness: The Indian scenario. Industrial Psychiatry Journal
Srivastava, Shruti, Ms Bhatia, and Neena Bohra. (2015, July). Depression in Women in Indian Context. Indian Journal of Psychiatry
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WHO (2013, June 24). Gender and Women’s Mental Health. World Health Organization. http://www.who.int/mental_health/prevention/genderwomen/en/.
Zimmermann, Kim Ann.(2017, July 20). “Indian Culture: Traditions and Customs of India.” LiveScience, www.livescience.com/28634-indian-culture.html.