A Sonali’s Choice: The Effect of Globalization-Based Acculturation on Mental Health Treatment Attitudes in Indian Young Adults Anuj Dhaval Gandhi
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rom 1990 to 2017, it is estimated that one in seven Indians were affected by mental illnesses of varying severity (India State-Level Disease Burden Initiative Mental Disorders Collaborators, 2020). Even more damaging, this statistic likely is a grand understatement of those facing mental health issues in India, as there is a harmful stigma against mental health (Gaiha et al., 2020). One-third of young Indian people display poor knowledge of mental health problems and hold negative views against them. They are less able to recognize the causes and symptoms of mental health problems even if Indian young adults face such issues (Gaiha et al., 2020). Additionally, mental health resources are inadequate, with less than 1% of the national Indian healthcare budget allocated to mental health as influenced by previous British legislation regarding mental health policy (Patel et al., 2017). India’s attitude towards mental health treatment (MHT) remains complicated due to shifting powers and Western cultural influences. History of Mental Health Care in India Mental health and its treatment have always been a cornerstone of health in India, with one of the firstever practices of psychotherapy recorded in the Bhagavad Gita, a part of the significant Hindu epic, the Mahabharata, written approximately two thousand years ago (Bhatia et al., 2013). In this text, Krishna counsels Arjuna using psychotherapeutic principles akin to cognitive behavioral therapy while maintaining an ethical client-practitioner relationship (Reddy, 2012). Additionally, MHT in India has been integrated into holistic health practices to care for the body, soul, spirit, and mind through traditional practices, including Yoga and Ayurveda. Many Yoga practices borrow heavily from the psychotherapeutic principles in the Bhagavad Gita, including addressing cognitive distortions (Sankhya Yoga) and placing trust in one’s healer (Bhakti Yoga) (Reddy, 2012). Sattvavajaya is one of the three main principles in Ayurveda, and it translates to “conquest of mind” which incorporates psychotherapeutic principles, including emotional regulation and coping habits (Behere et al., 2013). All of these practices have existed in Indian culture for thousands of years, demonstrating the Indian culture’s great emphasis on mental health and the treatment of
mental ailments. MHT, traditionally practiced in India, has aligned with psychotherapeutic practices to better care for the Indian psyche, defined as the human soul, spirit, and mind cultivated through individual and community experiences (Gogineni et al., 2018). However, due to invasions, globalization, and urbanization, the Indian psyche has evolved drastically (Gogineni et al., 2018). Over three thousand years, India has faced several invaders, from the Persians to the Mughals. Most recently and prominently, the British Empire occupied India from 1858 to 1947, initiating many cultural changes to align with Western norms and values. This occupation created a dissonance of culture as Indian culture differs immensely from Western culture. Specifically, India is the birthplace of many Dharmic religions, which inform many norms, customs, and traditions in Indian households, including the philosophy of nonviolence, the importance of family structures, and an emphasis on healthy relationships with the mind, body, spirit, and Earth. Nonetheless, even after Indian independence, the Westernization of India became widespread, affecting industry, technology, politics, economics, lifestyle, law, norms, customs, and traditions (Nair & Johri, 2019). Through the changing societal and cultural values, the Indian psyche has had to adjust and adapt several times to survive. However, Indians have continued to hold on to their collectivist roots in a world of individualistic pursuits (Gogineni et al., 2018). As a result, strictly Western psychiatric and psychotherapeutic principles, specifically ones based on individualism, cannot always be applied to Indian clients (Avasthi, 2011). Nonetheless, due to the longstanding presence of the British Empire, mental health care in India was not tailored to its population and the changing culture. The evolution of formalized mental health care in India began in the late Indian colonial period with a growth in mental asylums instituted by the British. The First Lunacy Act changed the administration and healthcare system as it pertained to treating mental illness (Dey & Prashanth, 2019). In 1987, the Indian Mental Health Act recognized the crucial role of treatment and care of mentally ill persons. It proposed many changes to