Indian Journal of PsychiatryIndian Journal of Psychiatry
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ORIGINAL ARTICLE
Year : 2007  |  Volume : 49  |  Issue : 3  |  Page : 189-194

Stigmatization of severe mental illness in India: Against the simple industrialization hypothesis


1 Centre for Behavioural and Social Sciences in Medicine, University College London, London, United Kingdom
2 University College London, London, United Kingdom
3 Department of Psychology, Concordia University, Montreal, Canada
4 University of Calcutta, Kolkata, West Bengal, India
5 Dibrugarh University, Dibrugarh, Assam, India

Correspondence Address:
Sushrut Jadhav
Centre for Behavioural and Social Sciences in Medicine, University College London, 48 Riding House Street, London W1W 7EY
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.37320

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Background: Major international studies on course and outcome of schizophrenia suggest a better prognosis in the rural world and in low-income nations. Industrialization is thought to result in increased stigma for mental illness, which in turn is thought to worsen prognosis. The lack of an ethnographically derived and cross-culturally valid measure of stigma has hampered investigation. The present study deploys such a scale and examines stigmatizing attitudes towards the severely mentally ill among rural and urban community dwellers in India. Aim: To test the hypothesis that there are fewer stigmatizing attitudes towards the mentally ill amongst rural compared to urban community dwellers in India. Materials and Methods: An ethnographically derived and vignette-based stigmatization scale was administered to a general community sample comprising two rural and one urban site in India. Responses were analyzed using univariate and multivariate statistical methods. Result: Rural Indians showed significantly higher stigma scores, especially those with a manual occupation. The overall pattern of differences between rural and urban samples suggests that the former deploy a punitive model towards the severely mentally ill, while the urban group expressed a liberal view of severe mental illness. Urban Indians showed a strong link between stigma and not wishing to work with a mentally ill individual, whereas no such link existed for rural Indians. Conclusion: This is the first study, using an ethnographically derived stigmatization scale, to report increased stigma amongst a rural Indian population. Findings from this study do not fully support the industrialization hypothesis to explain better outcome of severe mental illness in low-income nations. The lack of a link between stigma and work attitudes may partly explain this phenomenon.



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