Hinduism And Mental Health Assignment 11

7 page essay on how Hinduism view and treat mental illnesses. It should include 7 pages within the body of the paper with 3-5 references (at least two article/book references).

Paper MUST be in APA format 6th edition, and include title page, abstract, citation page and references.

I have done extensive research and uploaded files that could be used AND CITED on the paper. but you are free to use any reliable sources that you can find

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Background: Socio-cultural explanatory factors for mental health problems determine help seeking behaviors. The study aimed to understand the reasons mentally ill patients and their families in India choose to seek help from a religious site. Materials and methods: Persons with mental illness and their families were interviewed at religious sites using a guideline questionnaire. Issues such as significant life events, explanations for perceived abnormal behavior and reasons for choosing a specific religious site for ‘treatment’ were explored. Discussion: Seeking religious help for mental disorders is often a first step in the management of mental disorders as a result of cultural explanations for the ill- ness. This behavior also has social sanctions.

Key words: chronic mental illness, religious sites, qualitative study, ritualistic practices

INTRODUCTION

Religion and religious practices are significant in every aspect of life in India as in several communities all over the world. Seeking help in a religious setting or from faith healers is a common behavior pattern among those suffering from any kind of illness, including chronic mental illnesses (Sethi & Trivedi, 1979; Sathija &Nathawat, 1984; Campion & Bhugra, 1997). The variety and diversity of traditional health care practices is an indication of healing as a cultural preoccupation. There are several resources for seeking traditional and or religious help to alleviate mental problems. These include places of worship like temples, durghas and churches in the country as well as the indigenous faith healer. Hinduism And Mental Health Assignment 11

Construction of explanatory systems for changes in behavior is a norm in most cultures. Social, cultural and religious beliefs of the patients, their families and the community contri- bute significantly to the understanding of mental illnesses, assessment and diagnosis, help seeking and management (Sheehan et al., 1990; Suryani et al., 1995; Razali et al., 1996; Weiss, 1997). In a study of perceptions of and attitudes towards mental illness, Al Adawi et al. (2002) found that majority of students and the public felt that mental illness was

International Journal of Social Psychiatry. Copyright & 2005 Sage Publications (London, Thousand Oaks and

New Delhi) www.sagepublications.com Vol 51(2): 139–149. DOI: 10.1177/0020764005056761

caused by spirits. Investigating the cause of changes in behavior from the patient’s point of view, Jiloha et al. (1997) reported that over 56% of the subjects attributed their illness to supernatural agents like ghosts, evil spirits and witchcraft. A methodologically rigorous study conducted in a rural community in South India, demonstrated the ability of the impoverished illiterate rural population to recognise behavioral concomitants of mental ill- nesses (Thara et al., 1998). Epilepsy and mental retardation were seen as physical illnesses, nervous problems or due to heredity. The explanations offered for psychoses, depression or hysteria were possessions by evil spirits, devils or curse of gods. The main sources of infor- mation about the causes of mental illnesses have been the traditional healer, friends or rela- tives, astrologers, other significant persons in the community or the patients own personal knowledge (Kua et al., 1993; Razali et al., 1996; Jiloha et al., 1997).

Help seeking patterns are determined in part by the explanatory models that prevail in the community. Factors vital to resorting to religious treatment include the type of afflictions, the local interpretation of illness, the socio-economic status of the patient and the availability of healers. Kapur (1979) documented the co-existence of several kinds of healers treating mental illnesses in an Indian village. Healing methods included astrology, penance, a visit to a shrine, use of a holy object, or spirit possession to negotiate with the possessing spirit. He opined that most people chose a particular healer because the healer was known to be able to cure illnesses effectively. Jiloha et al. (1997) reported that consultation with faith healers was irrespective of level of education or the patient’s belief in the cause of illness. Investigating psychiatric status of those who were attending a temple in North India, Sathija and Nathawat (1984) identified a wide variety of psychiatric problems including anxiety neuroses, depression, dissociative states and chronic psychoses. In the rural community in South India, religious and traditional modes of treatment were opted for psychoses, depres- sion or hysteria (Thara et al. 1998). Parallel access to various forms of mental health care systems is a notable feature of help seeking practices. Medical treatment offered by medical systems such as allopathy, ayurveda, siddha, unani and homeopathy are widely accessed, as is religious help. Madan (1969) reported that nearly 66% used multiple forms of therapy. Thara et al. (1998) also reported this practice. Some studies report that religious resources are often accessed earlier as compared to seeking help from the official health care system (Campion & Bhugra, 1997). In their study, over half the number of patients seeking help at a psychiatric facility had consulted a religious healer prior to seeking medical help. The findings in these studies would be a reflection of the site where the studies were conducted.

This present study aimed at understanding the reasons why religious sites were chosen by the patients and their families for managing abnormal behaviours. The main objectives of the study were to:

1. To elicit the explanations offered for psychiatric symptoms by patients and their families at various religious sites in South India.

2. To understand why people resort to religious places for help to manage abnormal behaviours.

3. To study the ‘religious’ behaviors adopted by families and patients.

140 INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY 51(2) Hinduism And Mental Health Assignment 11

MATERIALS AND METHODS

Participants: Twenty six participants who were interviewed were persons who appeared to have a chronic psychotic illness and their family members present at the site. A diagnosis of a psychotic illness, especially schizophrenia, was made on the basis of information obtained from the family member and where possible, an examination of the patient.

Locations: Interviews were carried out at three Muslim darghas at Kovalam, Yerwadi and Nagoor and two Hindu temples at Sholingur and Hanumanthapuram, in the state of Tamil Nadu, South India. These places of worship were popular for the ‘curing’ of abnormal behaviors. Each site had specific rituals and practices, largely in accordance with the religion.

Interview technique In-depth interviews using an interview guide were undertaken. The interviews focused on onset of illness, course, significant events in the lives of the patients, explanations for per- ceived abnormal behavior, experiences with treatment, and reasons for choosing a specific religious site for ‘treatment’.

The interviews were carried out at the religious site in Tamil, the local language, by psychiatrists or psychiatric social workers trained to undertake qualitative interviews. The caregiver and/or patients were interviewed after having obtained informed consent. The interviews were tape recorded, translated and transcribed. Thematic analysis was done by systematically coding segments of the interviews.

RESULTS

The participants consisted of caregivers and/or patients at the various sites. A total number of 26 exhaustive interviews were carried out at the various sites, after obtaining consent. The number of patients included 12 men and 14 women. The average age of the patients was 42� 18 years (range 22–71 years). The average duration of illness of the persons recruited for the study was over ten years (SD 4.5 years). Most patients at the religious sites had not received medical treatment for several years. They had either not sought medical treatment at all or had given up medical treatment.

Of the 26 interviews, interviews were carried out with eight patients alone as there were no family members. These interviews were sufficiently informative for analysis. Of the 18 patients whose caregivers were interviewed, 11 interviews were comprised of a caregiver– patient pair. The majority of caregivers were mothers or wives. In two cases, male spouses, less than 25 years of age, were staying with their sick wives at the temples. In seven cases, the respondents were only caregivers, as the patients were too sick to be interviewed or had refused to be interviewed.

Duration of stay of the respondents at the sites varied. People who were interviewed were seen to stay in the place for a minimum period of one month to as long as five years. Difficult living conditions, often inhumane, poverty and physical illnesses, did not deter people from staying there. We did not include patients who just visited the place, but did not stay there.

PADMAVATI ET AL.: STUDY OF RELIGIOUS PRACTICES 141

Persons in charge of the sites willingly gave permission for conducting the interviews. Five caregivers refused to be interviewed, stating that they were not willing to discuss a divine matter with anyone.

The main findings of the interviews were:

Explanations Explanations for the illness were largely based on culturally accepted reasons such as evil spirits, planetary positions or sins of the past birth. The explanations were ones that were commonly available in the community and were often suggestions by various persons like close family, faith healers, priests, astrologers or significant others.

The belief that the cause of the change in behavior was due to the effect of evil spirits was an oft-repeated theme in most narratives. In most cases, the evil spirit was reported to be as directed by other relatives or neighbors. The following narrative of an interview with a woman patient at a Hindu temple is an example:

Q. What do you think is the cause of this illness? A. This is not an illness. If it was, then I should have become better by going to the doctor.

This has been done by men who make evil spirits to trouble us. They will trouble us very badly and make us lose consciousness, make us unaware of what we are doing or saying. When I was pregnant, they took me to a hospital where they gave me glucose water. The water would enter me for some time and then stop by itself. It is all the effect of evil spirits. Hinduism And Mental Health Assignment 11

Q. Who do you think was responsible for this? A. I know that it was my uncle who did this black magic on me.

Confirmation of the correctness of the religious explanation was evident especially in those cases where the problem seemed to improve. A respondent at a dargha, stated:

If he did not become alright after coming here, then we should think of other reasons (for his change in behavior). But he is now alright. People who come here leave only after they become alright. Nobody goes away without a cure.

Attribution of the illness to the doctrine of ‘Karma’, an important theme in Hindu Philoso- phy, is seen in the following narrative:

Q. What do you think is the cause for your son’s problems? A. I think it is his Karma that he has got schizophrenia. The actions of your previous

birth make you suffer in the present birth. That is what we Hindus believe.

Help seeking While the choice of source of help was largely based on the explanations for the illness, there were other factors which influenced the choice. In a majority, seeking religious treatment was advised by significant others. The significant others included people who had experienced a ‘cure’ at these centers, priests, astrologers, faith healers or elders in the family. As most

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psychotic persons do not seek help for themselves, the initiative to seek religious treatment was usually by the family. Various significant persons often negotiated this decision through time, each of whom would have their own impression of what to do.

The choice of the place of worship often went beyond the boundaries of religious faith. Irrespective of their religion by birth, patients and families went to temples or dargha or a church for a ‘cure’. Very occasionally, conversions to other religions were seen. Hindus were seen to visit a Muslim dargha for treatment. A Christian or a Muslim would visit a temple in the hope of a ‘cure’.

This is a narrative of a Hindu informant interviewed at a Dargha:

Q. You are Hindu. How did you decide to come to this dargha? A. This place is known for healing persons with such problems. Also, a boy in my village

became better after coming here. So, we came here.

Another respondent at a temple stated: Hinduism And Mental Health Assignment 11

A. Many people come here for getting cured. Muslims and Christians also come and worship here. They also perform the rituals that are to be done here