Mental Health In Rural Areas vs Urban

Mental health awareness has been on the rise in India, especially after the COVID-19 pandemic, with more and more people opting for mental health consultations. However, mental health care remains a major challenge across the country, in both urban and rural areas. Thus, both urban and rural India grapple with mental health challenges, and the nature of these differs significantly. This article will explore the major mental health challenges faced in rural and urban India.

Mental Health in Rural Areas

Almost 65% of India’s population lives in rural areas, making it a vast majority. However, there are many challenges when it comes to mental health care in rural areas. They are:

• Lack of Awareness

Lack of mental health education and awareness is one of the major barriers to help-seeking in rural areas. Most people do not know whom to approach for mental health issues or how to identify the symptoms of any mental illness. Thus, people often visit tombs and religious places to seek help.

According to a Lancet study published in 2023, many people in rural areas attribute mental health issues to black magic and seek treatment at religious institutions, Some people even reported stopping medication as they believed they could get better only through faith healing.  

These practices put patients at a high risk of misdiagnosis, leading to ineffective treatment and the aggravation of mental health conditions. 

• Treatment Gap

Research in 2018 found that almost 5.3% of the rural population was at risk of developing common mental health disorders such as anxiety or depression but only a few of them sought help. A high treatment gap is one of the reasons for this trend. Even if people want to seek help for mental health issues, there aren’t enough psychologists or psychiatrists available to support the large number. This leaves many people no option but to rely on faith healers or general practitioners for help

• Stigma

Another challenge in rural mental health is the stigma associated with mental health issues. Thus, many people experiencing mental health issues face social exclusion. Such practices discourage people from seeking help for mental health.

Considering the above-mentioned challenges, India needs stronger mental health awareness and infrastructure in rural areas, which can be achieved by strengthening the District Mental Health Programme and careful implementation of the Mental Healthcare Act of 2017.

Mental Health In Urban Areas

Increased Awareness And Help-Seeking

The mental health situation in urban areas seems to be improving with increased awareness and help-seeking, especially after the COVID-19 pandemic. According to a Practo survey conducted in 2022, the number of mental health consultations sought on their app increased by 66% year on year. The same survey reported that the majority of mental health consultations were sought by women under the age of 35.

Another survey published by Practo in 2023 found a 29% year-on-year increase in offline consultations booked through the app. The same survey also reported that men generally opt for in-person consultations, while women prefer online appointments. In the same data, it was found that the majority of the mental health consultations came from Tier 1 cities such as Delhi, Bangalore, Mumbai, Hyderabad, Chennai and Pune, and the majority of the help-seeking population was aged between 18-44 suggesting high mental-health awareness among young adults and middle-aged population.

Increased Mental-Health Start-Ups

The rise in demand for mental health services has led to multiple mental-health start-ups. As per a report in 2023, there are almost 280 mental health startups in India. Many of these startups have received funding as well, which is likely to encourage more mental-health startups soon. Increasing mental-health start-ups might lead to increased affordability and accessibility of services as well.

Quality of Care- A Major Challange

While increased awareness and help-seeking are positives, there is still a long way to go when it comes to ensuring the quality of mental health care in urban areas. Due to a lack of government regulations, there has been a rise in people giving mental health advice over the Internet, without appropriate qualifications. People are providing mental health services without appropriate qualifications as well.

This has led to a spread of misinformation, which only fuels the pre-existing stigma. Stricter Government regulation is a necessity to ensure, there is no misinformation and that people can access the right and qualified professionals for help,

Conclusion:

While mental health awareness and mental health startups are rising in urban areas, there is still a treatment gap, with a limited number of psychologists and psychiatrists serving the large population, A similar treatment gap exists in rural areas as well. In conclusion, both urban and rural areas need better mental health infrastructures and stricter regulations to curb misinformation

References:

1. Bawaskar, H. S., Sapkal, G. H., & Bawaskar, P. H. (2024). The complexities of mental health in rural India. The Lancet, 403(10435), 1444–1445. https://doi.org/10.1016/S0140-6736(23)01911-6
2. FE Mental Health Series | How apps are changing consultation landscape amid drought of experts in India. (2024, May 27). Financialexpress. https://www.financialexpress.com/business/healthcare-fe-mental-health-series-how-apps-are-changing-consultation-landscape-amid-drought-of-experts-in-india-3502372/
3. Gupta, R. (2024). Rural–Urban Divide in Mental Health Care in India: Bridging the Gaps. Indian Journal of Social Psychiatry, 40(1), 7. https://doi.org/10.4103/ijsp.ijsp_41_24
4. Kallakuri, S., Devarapalli, S., Tripathi, A. P., Patel, A., & Maulik, P. K. (2018). Common mental disorders and risk factors in rural India: Baseline data from the SMART mental health project. BJPsych Open, 4(4), 192–198. https://doi.org/10.1192/bjo.2018.28
5. Kumar, A. (2011). Mental health services in rural India: Challenges and prospects. Health, 03(12), Article 12. https://doi.org/10.4236/health.2011.312126
6. Matharu, S. (2023, July 5). Everyone’s a therapist in India—Influencers, dentists, homeopaths. It’s the new epidemic. ThePrint. https://theprint.in/ground-reports/everyones-a-therapist-in-india-influencers-dentists-homeopaths-its-the-new-epidemic/1655337/
7. Standard, B. (2023a, October 10). Mental health: Women opt for teleconsultations, while men prefer in-person. https://www.business-standard.com/health/mental-health-women-opt-for-teleconsultations-while-men-prefer-in-person-123101000213_1.html
8. Standard, B. (2023b, October 11). Four-fold surge in mental health consultations: How much does insurance cover? https://www.business-standard.com/finance/personal-finance/four-fold-surge-in-mental-health-consultations-how-much-does-insurance-cover-123101100202_1.html
9. Surge in consultations for Oncology and Mental Health among Indian women in 2022: Practo Insights – Practo Digest. (n.d.). Retrieved June 26, 2024, from https://blog.practo.com/womens-day-health-medical-consultation-trends-mental-health-oncology-press-release-pract/