Mental health care in rural India: a study of existing patterns and their implications for future policy

Three separate studies were carried out to examine the patterns of mental health care in an Indian village. The first examined the conceptual frameworks of the various traditional and modern healers. The second was an attitude study inquiring about the type of healer favoured for psychiatric consultation. The third was a population survey in which every person with one or more symptoms was asked if he or she had consulted anyone for relief of distress. Besides the modern doctors there were three types of traditional healers: Vaids, practising an empirical system of indigenous medicine; Mantarwadis, curing through astrology and charms; and Patris, who acted as mediums for spirits and demons. It was found that a large majority (59 per cent) of those with symptoms had consulted someone. The consultation was determined more by the severity of illness than by socio-demographic factors. Modern doctors were more popular, but most people consulted both traditional and modern healers without regards to the latter's contradictory conceptual framework. Literacy and other socio-demographic factors had no influence on the type of consultation. A conclusion was reached that any scheme for introducing modern psychiatry into rural areas should make use of the locally popular healers, both traditional or modern.