Social Security Measures for Persons with Mental Illness: Access and Utilisation in Rural India

Abstract

Social security measures for people with disability, including those with mental illness, is a mandate of the State policy framework in India for effectively addressing various socio-economic vulnerabilities. The paper explores the access to various social security measures instituted by the State and their utilisation by families having Persons with Mental Illness (PMI) in Thiruvarur District, an economically and educationally backward rural area in the State of Tamil Nadu, India. A mixed-method approach was undertaken for the study, which included a survey method using Interview Schedule, which covered two hundred families, and an in-depth interview using Interview Guide undertaken among the caregivers of the PMI in ten families. Stratified sampling technique, a probability sampling method, was done based on three strata—region (Taluk), age groups, and gender of the PMI. The data was collected from the respondents through Government hospitals in each Taluk coming under District Mental Health Programme and the private healthcare facilities. Significant findings of the study highlighted low awareness among the families about disability certification for the PMI, poor utilisation of the welfare services and schemes instituted by the State, and near absence of participation in community mental health conscientisation programmes. Intersectional vulnerability, ignorance about mental illness, social stigmatisation, lack of knowledge about policy provisions, poor reach of mental health and social care services, as well as bureaucratic delay in rural areas adversely affect informed decision-making and health care participation of the families creating barriers to access and effective utilisation of the State support systems.