Dalits and mental health: investigating perceptions, stigma and barriers to support in Kathmandu, Nepal

French, Amber N

doi:10.29392/001c.12136

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…We found that rural healthcare providers had a high level of awareness and understanding of the cultural, educational and socioeconomic factors behind inequalities in healthcare usage. The lack of awareness, knowledge and education among Dalits and other low castes, their preference for traditional healers, deep-rooted and internalised stigma, and differential parental attitudes towards male and female children, were all commonly identified, and were in accordance with findings in the existing literature from Nepal6 7 10 11 13 25 26 and elsewhere in South Asia 8–10 12 15 16 27 28…”

Section: Discussionsupporting

confidence: 82%

Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias

et al. 2023

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ObjectiveThis study explored provider perspectives on: (1) why inequalities in health service usage persist; and (2) their knowledge and understanding of the role of patient experience and implicit bias (also referred to as unconscious bias).DesignA three stage, iterative qualitative study was conducted involving two rounds of in-depth interviews and a training session with healthcare staff. Interview transcripts were analysed using a reflexive thematic approach in relation to the study’s aims.SettingParticipants were recruited from rural hill districts (Mugu, Humla, Bajura, Gorkha and Sindhupalchok) of Nepal.ParticipantsClinical staff from 22 rural health posts.ResultsHealthcare providers had high levels of understanding of the cultural, educational and socioeconomic factors behind inequalities in healthcare usage in their communities. However, there was less knowledge and understanding of the role of patient experience—and no recognition at all of the concept of implicit bias.ConclusionIt is highly likely that implicit bias affects provider behaviours in Nepal, just as it does in other countries. However, there is currently not a culture of thinking about the patient experience and how that might impact on future usage of health services. Implicit bias training for health students and workers would help create greater awareness of unintended discriminatory behaviours. This in turn may play a part in improving patient experience and future healthcare usage, particularly among disadvantaged groups.

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Section: Discussionsupporting

confidence: 82%

Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias

et al. 2023

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“…Studies on caste‐based exclusion and mental health report anxiety and depression (French, 2020); social isolation, low self‐esteem, low self‐confidence, withdrawal, and anger (Pal, 2015); and confused self‐identity, hypertension, and neuroticism (Ramaiah, 2007) among respondents. Psychosocial and emotional responses to social exclusion include feelings of disempowerment (Barnes, 1999), trauma (Barnes, 2004; Krishnan, 2015), poor psychological well‐being and self‐harm as a coping strategy (Cleary et al, 2014; Friedli & WHO, 2009; Smith, 2013).…”

Section: Marginalization and Mental Healthmentioning

confidence: 99%

Mental health at the intersections of marginalization: A conceptual model to explore the mental health concerns of women sanitation workers in India

Monteiro

Nalini

2021

Asian Soc Wrk & Pol Rev

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In India, sanitation work is predominantly undertaken by persons from oppressed castes whose customary roles relegate them to stigmatized occupations. Women sanitation workers, comprising nearly half of the urban workforce, grapple with multiply marginalized identities and social positions. Marginalized at the intersections of caste, gender, and occupation, they contend with violence and socio‐economic discrimination. The literature on the occupational and psychosocial risks of sanitation workers indicates that the mental health concerns of women sanitation workers remain largely unaddressed in research and public policy. This paper draws on an analytical review of research on women sanitation workers’ occupational and psychosocial risks with the objective of conceptualizing the relationship between marginalization and mental health. Utilizing intersectionality and social systems theories to present women sanitation workers as a critical case, their experiences of marginalization at the intersections of caste, gender, and occupation are analyzed. Consequently, a conceptual model of mental health outcomes at the intersections of multiply marginalized identities and social positions is developed to analyze the implications of marginalization for mental health. Guidelines for action to inform public policy and social work practice are suggested, emphasizing the need for intersectional interventions and a social justice framework in mental health care for marginalized groups.

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“…Not only in Indian society, but caste also shows its presence in other South Asian countries (Thapa et al, 2021), making the caste system a global issue. Researchers have also revealed the prominence of caste discrimination in the UK (Dhanda, 2017;Gorringe et al, 2017), Kuwait and the UAE (Leonard, 2005). Studies have revealed that caste discrimination is a major issue in the USA and the Dalit diaspora in the US faces severe workplace discrimination (Dutt, 2020;Zwick-Maitreyi et al, 2017).…”

Section: The Caste Systemmentioning

confidence: 99%

“…In terms of life satisfaction, the castes at the top are more satisfied than the lower and middle castes (Fontaine & Yamada, 2014;Landeghem & Vandeplas, 2018;Spears, 2016). In Nepal, a country that follows a caste system similar to India, youth from low caste groups reported more anxiety, depression, and low selfesteem than their counterparts from other caste groups (French, 2020;Kiang et al, 2020).…”

Section: Caste Gender and Well-beingmentioning

confidence: 99%

Life Satisfaction and Well-Being at the Intersections of Caste and Gender in India

Johri

Anand

2022

Psychol Stud

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Psychological research has a paucity of studies on caste and well-being. Existing literature on caste has extensively focused on pathological conditions in rural areas. In contrast, individuals who experience vulnerabilities in urban areas at the intersections of caste and gender identities are still underrepresented in the research literature on the psychology of well-being. The present study recognises this gap in research and explores the interaction of caste and gender on life satisfaction and well-being in urban areas. On administering the Satisfaction with Life Scale and Mental Health Continuum-short form to a sample of 465 young adults, the results revealed significant caste differences in both life satisfaction and well-being. The findings highlight that general caste individuals have higher life satisfaction and well-being than scheduled caste individuals. The findings also indicate significant gender differences in life satisfaction, with women having higher life satisfaction than men across caste groups. Results revealed no interaction effect between caste and gender. Consistent with earlier studies, the results on caste suggest that despite its discourses of diminishing importance, especially in urban areas, caste does play a significant role in an individual's well-being and life satisfaction. Hence, the findings have implications for policy-making, education, and training to understand caste-based experiences better.

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Dalits and mental health: investigating perceptions, stigma and barriers to support in Kathmandu, Nepal

Cited by 5 publications

References 17 publications

Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias

Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias

Mental health at the intersections of marginalization: A conceptual model to explore the mental health concerns of women sanitation workers in India

Life Satisfaction and Well-Being at the Intersections of Caste and Gender in India

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