STIGMA, ACCESS, AND TREATMENT GAPS IN WOMEN’S MENTAL HEALTH DURING COVID-19: A CRITICAL REVIEW OF THE INDIAN CONTEXT

Abstract

The COVID-19 pandemic creates a parallel mental health crisis in India and exacerbates the challenges faced by women who experience a disproportionate amount of psychological distress due to long-standing gender norms, stigma, and unequal access to services. Mental health issues are commonly seen through social judgment and moral frameworks in India and as a result, there is pressure on women, whose identities are inextricably linked to their roles as caregivers and representatives of their families to not disclose their illness or to seek help. The lockdowns resulting from the COVID-19 pandemic have increased these vulnerabilities by disrupting livelihoods, limiting mobility, increasing domestic responsibilities, and restricting access to mental health services. The paper examines how demand side barriers such as stigma and social judgement interact with structural barriers around access, cost, and knowledge of services to create and perpetuate gaps in treatment for women's mental health in India during the COVID-19 pandemic.

This research uses both qualitative and quantitative forms of research for a complete understanding of the impact the stigmatization of mental illness has on help-seeking behaviour as well as how specific areas disrupt access to care. Through utilising secondary data from peer-reviewed journals, governmental policy documents, and data from publicly avaiable resources there are four themes of emerging evidence from the literature identified: stigma and gender-specific barriers to help-seeking; structural barriers that disrupt access to care; widening gaps in treatment during public health emergencies; and possible intervention points. The analysis also highlights how the disruption of services as well as fear and restrictions of movement are increasing during crises which ultimately yields significant treatment gaps due to increased control of women's autonomy within the household. Finally, although several governmental initiatives exist regarding digital mental health care, their effectiveness is dependent on a number of factors (e.g., awareness, confidentiality, affordability, and cultural competence).

According to the research paper, circumstances leading to unmet mental health needs in female patients are not due to unpredictable service failures, but rather are due to systemic gender-based factors; thus, in order to address these gaps in service delivery and create more equitable outcomes for female patients, emergency mental health services must be gender sensitive and use a combination of expanding service availability, reducing stigma around mental health care, and improving practical access to those services.