Mental Health Stigma in Urban and Rural India Exploring Perceptions, Beliefs, and Impacts on Help-Seeking and Care System

Abstract

Mental health stigma remains a major barrier to accessing care in India, particularly in rural and underserved regions. Despite increasing awareness, stigma continues to be deeply rooted within cultural beliefs, social norms, and institutional practices. This study explores mental health stigma in both urban and rural contexts, with a specific focus on Madhya Pradesh. Employing a mixed-method approach—combining quantitative survey data (N=764) and qualitative interviews (N=6) with community members, students, caregivers, and NGO workers—the research examines how stigma is shaped, experienced, and internalized in varied settings.

Findings indicate that understandings of mental illness are shaped by dual belief systems, where traditional and spiritual explanations coexist with biomedical models. Rural participants were more likely to attribute mental illness to supernatural or religious causes, while urban respondents highlighted issues such as societal judgment, privacy concerns, and shame. Gender also emerged as a significant factor, with young women reporting higher levels of internalized stigma. Notably, exposure to psychiatry—whether through personal experience or educational settings—was associated with reduced negative attitudes and increased empathy, especially among medical students. By integrating experiences and perceptions from across diverse social groups, this study addresses key gaps in existing literature that often overlook comparative, lived realities. The findings emphasize the importance of culturally rooted, community-based anti-stigma initiatives that work within existing belief systems rather than disregarding them. This research contributes to both academic understanding and practical strategies for mental health planning within India’s complex socio-cultural landscape.