Women's freedom of movement and participation in psychosocial support groups: Qualitative study in northern India

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Springer Science and Business Media LLC
Journal Title
Journal ISSN
Volume Title
Language
eng
Date
2019
Authors
Gailits N
Mathias, Kaaren
Nouvet E
Pillai P
Schwartz L
Abstract

Background: Depression, the world's leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study's objective was to examine the factors influencing women's participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community's mental health. Methods: This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. Results: The principal barrier to participating in psychosocial support groups was restrictions on women's freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community's attitude toward gender relations, the women's own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women's ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women's freedom of movement. Conclusions: Mental health access and gender inequality are inseparable in the context of Northern India, and women's mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women's freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women's freedom of movement.

Description
Citation
Gailits N, Mathias K, Nouvet E, Pillai P, Schwartz L (2019). Women's freedom of movement and participation in psychosocial support groups: Qualitative study in northern India. BMC Public Health. 19(1). 725-.
Keywords
Humans, Focus Groups, Attitude, Depression, Gender Identity, Family, Spouses, Interpersonal Relations, Mental Health, Decision Making, Mental Disorders, Community Mental Health Services, Qualitative Research, Freedom, Adult, Women's Health, Employment, Patient Participation, Self-Help Groups, Asia, India, Female, Social Participation
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
42 - Health sciences::4203 - Health services and systems::420313 - Mental health services
44 - Human society::4405 - Gender studies::440509 - Women's studies (incl. girls' studies)
42 - Health sciences::4206 - Public health::420606 - Social determinants of health
Rights
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.