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Social Distance and Community Attitudes Towards People with Psycho-Social Disabilities in Uttarakhand, India

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Abstract

Stigma is an important contributor to the large treatment gap for people with mental and psycho-social disabilities (PPSD) in India. Social distance as assessed by willingness to engage in relationships with PPSD is a proxy measure of stigma and potential discrimination. In North India, investigations of community attitudes towards PPSD have been limited. To describe attitudes towards people with depression and psychosis, a community sample of 960 adults in Dehradun district, India from 30 randomised clusters, was surveyed using a validated tool to assess social distance, beliefs and attitudes related to mental illness. Participants preferred greater social distance from a person with psychosis than a person with depression. Beliefs and attitudes around mental illness were diverse reflecting a wide spread of belief frameworks. After controlling for confounding, there was increased social distance among people who believed PPSD were dangerous. Factors that reduced social distance included familiarity with PPSD, and belief that PPSD can recover. Attitudes to PPSD, stigma and social distance are complex and likely to require complex responses that include promoting awareness of mental health and illness, direct contact with PPSD and increasing access to care for PPSD.

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Acknowledgements

We are thankful to the hard-working Burans teams of OPEN, LCH, Sneha and HOPE for surveying/ data collection in a very wet monsoon. Appreciation also goes to Kezia Chand, Gabriella Ailstock, Lawrence Singh and Suraj Chetri for their support in data collection and entry.

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Authors and Affiliations

  1. Emmanuel Hospital Association, New Delhi, India

    K. Mathias

  2. Department of Epidemiology and Global Health, Umea University, Förvaltningshuset, Universitetstorget 16, 901 87, Umeå, Sweden

    K. Mathias, I. Goicolea & M. San Sebastian

  3. Landour community hospital, Mussoorie, Uttarakhand, 248 179, India

    K. Mathias

  4. Nossal Institute of Global Health, University of Melbourne, 161 Barry Street, Melbourne, Australia

    M. Kermode

  5. Woodstock School, Upper Tehri Road, Mussoorie, Uttarakhand, 248 179, India

    L. Seefeldt

  6. Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area Gurgaon, New Delhi, 122002, India

    R. Shidhaye

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  1. K. Mathias
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  2. M. Kermode
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  3. I. Goicolea
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  6. M. San Sebastian
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Correspondence to K. Mathias.

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All authors declare that they have no conflict of interest in their participation in this study and written report.

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Mathias, K., Kermode, M., Goicolea, I. et al. Social Distance and Community Attitudes Towards People with Psycho-Social Disabilities in Uttarakhand, India. Community Ment Health J 54, 343–353 (2018). https://doi.org/10.1007/s10597-017-0211-y

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  • DOI: https://doi.org/10.1007/s10597-017-0211-y

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