Ayurvedic Psychiatry and the Moral Physiology of Depression in Kerala

Author(s):  
Claudia Lang

The GMH movement has not considered psychiatric traditions outside mainstream psychiatry. By highlighting the existence and significance of Ayurvedic mental health care, I challenge the notion of a “treatment gap” in India. At the same time, focusing on Ayurvedic psychiatry as an alternative to globalised biomedical psychiatry and highly dynamic field, I go beyond the usual dichotomy of global psychiatry and local traditional healing by showing how a (re)invented tradition assembles local bio-moral embodied minds, classic texts, vernacular practices, and globalised psychiatric and psychological knowledge to recognise and treat distressed, embodied minds. Against the narrative of traditional medicine as the epistemic “other” to Western psychiatry, I will describe how Ayurvedic psychiatrists engage elements of globalised psychiatry and psychology while stressing Ayurveda’s epistemic difference and embodied alterities.

2018 ◽  
Vol 9 (3) ◽  
pp. 388-407 ◽  
Author(s):  
Sirry M. Alang ◽  
Donna D. McAlpine

The gap between need and effective treatment for mental health problems continues to be a challenge for researchers and policymakers. Much of the attention has been on differences in treatment rates, with insufficient attention to variation in pathways that people take into treatment. Individuals may choose to seek help but may also be substantially influenced by others or coerced into care. The chances of each type of pathway are influenced by social characteristics and may shape perceptions of effectiveness of care. This paper investigates variation in pathways into care and perceived effectiveness of care. We also examine whether choice or coercion into care are associated with whether individuals perceive care as effective and if severity of illness moderates this relationship. We use data from the 2010–2014 National Survey on Drug Use and Health (N = 10,020). Persons who independently sought mental health care were more likely to rate treatment as effective compared to persons ordered into care. Among people with severe mental illnesses, the probability of rating treatment as effective is lowest among those who were ordered into care. Entry into mental health care is not sufficient for closing the treatment gap if coerced care leads to poorer quality outcomes.


Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D C Fuhr ◽  
C Ataturk ◽  
M McGrath ◽  
Z Ilkkursun ◽  
A Woodward ◽  
...  

Abstract Introduction Turkey hosts the highest number of Syrian refugees in Europe. Refugees are often vulnerable to situational forms of psychosocial distress as a consequence of exposure to war and violence which may result in more profound mental health problems if no treatment is sought. The aim of this study is to report evidence on mental health and psychosocial support (MHPSS) needs, access and barriers to MHPSS care among Syrians refugees living in Istanbul, Turkey. Methods A cross-sectional survey was conducted among Syrian refugees aged 18 years or over in Istanbul (Sultanbeyli) between February and May 2018. Data among 1’678 Syrian refugees were collected on mental health outcomes using the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) and the Hopkins Symptoms Checklist (HSCL-25) for depression and anxiety. We also collected data on health care utilization, barriers to seeking and continuing care as well as knowledge and attitudes towards mental health. Descriptive analyses were used. Results The prevalence of PTSD, depression and anxiety was 19.6%, 34.7% and 36.1% respectively. The treatment gap was 89% for PTSD, 90% for anxiety and 88% for depression. 249 respondents (15%) screened positive for either PTSD, depression or anxiety in our survey and self-reported emotional/behavioural problems since arriving in Sultanbeyli. Several structural and attitudinal barriers for not seeking care were reported. Conclusions To overcome the treatment gap, mental health care programmes need to be more responsive to the needs of Syrian refugees. Barriers to seeking and continuing care can be overcome by providing MHPSS services in the community which facilitate access to care. Community-based programmes of care should be supported by activities which increase awareness about mental health issues and tackle negative attitudes towards mental illness. Key messages This study provides the first nationally representative data on the mental health of Syrian refugees in Turkey, and shows that refugees have high mental health needs. Syrian refugees do not seek mental health care despite availability of mental health services in the community.


2018 ◽  
Vol 64 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Lily Kpobi ◽  
Leslie Swartz

Background: Traditional healing methods are considered central to mental health care in low-income countries such as Ghana, because they are perceived to be more easily accessible, more affordable and generally ascribe similar causal beliefs to those of the patients. However, not much is known about the work of traditional healers largely because their methods are shrouded in mysticism and secrecy. There is a need to understand the ideology and beliefs of traditional healers surrounding mental disorders, including knowledge about their practices in mental health care. Aims: In this article, we discuss the causal beliefs and treatment methods of traditional medicine-men from Accra, Ghana. We also describe their diagnostic and treatment methods for mental disorders. Methods: Eight medicine-men, indigenous to the Greater Accra Region, were interviewed through individual semi-structured interviews. The data were analysed through thematic analysis. Results: The medicine-men’s beliefs about mental illness were dominated by supernatural ideas. Mental illness was also seen as a form of punishment or resulting from envy, and there was a strong reliance on spiritual direction from the gods for diagnosis and treatment. Conclusion: These themes are discussed with emphasis on their potential implications for patients, as well as for collaborative efforts.


2021 ◽  
Vol 10 (11) ◽  
pp. 803-808
Author(s):  
Prakasha Amin ◽  
Mohan A.K

BACKGROUND In many rural communities, the cause of mental illness is attributed to black magic, spirit possession of past sin and the coastal region of Karnataka is not exempted from it. The natives of this region ascribe the cause of mental illness to the spirit or demigod, and they seek the help of traditional healers such as spirit dancers for the recovery. This help-seeking behaviour of the people results in delay in seeking psychiatry care and affects the recovery of the person with mental health problems. Therefore, this study explores the opinion of clients undergone traditional healing for mental health problems and the results of the study could contribute to planning an appropriate health promotion activity to promote community mental health. METHODS The present study was explorative, undertaken in the Udupi district of Karnataka state, which explores the views of the respondents about the cause of mental health problem and the outcome of traditional healing for their problems. Altogether 200 clients visiting traditional healers for mental health care were interviewed based on the snowball sampling technique and the interview schedule was used as a tool to gather the data. RESULTS Of the 200 respondents interviewed, 27.5 percent were adults (31 to 40 years), while 43.1 percent were unemployed. Black magic was found to be the major cause for mental health problems among 25.5 percent of the respondents; whereas, 26 percent of the respondents felt recovered completely after undergoing traditional healing for mental health problems. CONCLUSIONS The recognition of mental health problems is very much essential for people with mental health problems to seek professional help. This could help mental health professionals to diagnose illness at the very beginning and provide better mental health care. However, the explanatory model of the patients needs to be taken into consideration while providing modern medical care. KEY WORDS Black Magic, Mental Illness, Serpent Worship, Spirt Dancer, Traditional Healers


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dung Ezekiel Jidong ◽  
Di Bailey ◽  
Tholene Sodi ◽  
Linda Gibson ◽  
Natéwindé Sawadogo ◽  
...  

Purpose This study aims to explore how cultural beliefs and traditions are integral to understanding indigenous mental health conditions (MHCs) and traditional healing (TH). However, Nigerian cultural beliefs about MHCs and TH are under-researched. Design/methodology/approach This study adopted a qualitative design using critical realist and social constructionist perspectives to explore Nigerian mental health-care practitioners (MHCPs) and lay participants’ (LPs) views regarding MHCs and TH. Purposive and snowball sampling techniques were used to select 53 participants (MHCPs = 26; LPs = 27; male = 32; female = 21) in four Nigerian cities (Ado-Ekiti, Enugu, Jos and Zaria). Data were collected using semi-structured interviews and analysed through thematic analyses. Findings The data sets revealed three overarching themes, namely, existing cultural beliefs about MHCs as spiritual curse; description of TH as the first treatment modality for MHCs; and perceived stigma associated with MHCs and help-seeking behaviours. Originality/value A study on Nigerian cultural beliefs and TH contributes meaningfully to mental health systems. Future research and policy initiatives could explore ways of optimising TH practices and community awareness programmes to increase access to mental health care in Nigeria.


2017 ◽  
Vol 28 (1) ◽  
pp. 100-111 ◽  
Author(s):  
B. Roberts ◽  
N. Makhashvili ◽  
J. Javakhishvili ◽  
A. Karachevskyy ◽  
N. Kharchenko ◽  
...  

AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.


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