This week, I found an article on how stigma around poverty and the caste system affects people with mental illnesses in India. The article is called “Mental illness, poverty and stigma in India: a case-control study”.  Their research question or statement, while not stated directly, was “how does discrimination and stigma affect people with mental illness in regards to their status as impoverished or not?”.  They hypothesize that in India, the social-stigma and exclusion towards people with serious mental illnesses leads to low self esteem and worse life conditions over time, hindering their ability to receive help or treatment. For example, people with mental illnesses may be treated a burden to the family and unable to fulfill their prescribed duties under cultural/social norms, leading to low self esteem, learned helplessness, etc. They may be discriminated against by others due to stigma around mental illness and denied job opportunities or a proper social life (exclusion). Education, health, shelter, and food were also taken into consideration when evaluating the lifestyles and poverty status of individuals. Their method of choice was to do a case study, comparing mentally ill people to a non-mentally ill control group through the Department of Psychiatry of the Dr Ram Manohar Lohia Hospital in New Delhi. The ill participants were recruited through the hospital by being told about the study and choosing whether or not to participate, and then be referred to a researcher for informed consent. They were matched to randomly selected non-ill people who were around the same age as them and lived in the same area. Participants were interviewed on demographics, health, accessibility, employment, education, food security, socioeconomic factors, income,  physical safety (measured through perception), material well-being, social life. One-way analyses were used to look for significance in discrimination and poverty levels between the two groups, as well as adjusting for gender, age, and caste. Difference in access to employment, income, food security, and house ownership were high when comparing the two main groups, with the patients experiencing these dimensions of their lives negatively. When controlling for gender, women were more deprived and experienced more poverty, especially if they were from the hospital group. When controlling for caste, ‘scheduled castes’, ‘scheduled tribes’, and ‘other backward castes’ were more likely to be poor.  When it came to the relationship between poverty and stigma, the p value was always < .0001 regardless of gender, caste, and age controls.

Trani, J., Bakhshi, P., Kuhlberg, J., Narayanan, S., Venkataraman, H., Mishra, N., Groce, N., Jadhav, S., Deshpande, S. (2015). Mental illness, poverty and stigma in India: a case-control study. BMJ Open. doi:10.1136/bmjopen-2014-006355