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NEHRA ET AL./ MENTAL ILLNESS, STIGMA AND KHAP PANCHAYATS

discrimination such as loss of social status and self-esteem, delayed


seeking of treatment and prolonged course of illness, to mention a
few (Link, Struening, et al., 2001; Link & Phelan, 2006). Now there
are mounting evidences all over the world including India, which
have shown clearly that stigma is associated with mental illness
(Thara&Srinivasan, 2000; Gureje, Lasebikan, et al., 2005). Stigma is
an issue that most people with experience of mental illness and their
relatives would recognize, seeing it either in them or in other people.
Self-stigma refers to the internalized feeling of guilt, shame,
inferiority, and the wish for secrecy experienced by those who live
with a mental illness (Goffman, 1963). Courtesy stigma or stigmaby-association namely, the stigma experienced by parents, siblings,
spouses, and children of people with mental illness (Goffman, 1963).
It is generally believed that stigma arises from internalizing the
negative messages and behavior that people with experience of
mental illness receive from others. It leads to negative emotional
reactions of low self-esteem and self-efficacy and other deleterious
effects (Link, 1982; Link, Cullen, Frank, et al., 1987). As a
consequence they assume they will be rejected socially and so
believe they are not valued (Livingston & Boyd, 2010) and avoids
the search of work. Presence of stigmafound to be having profound
impact on patients as well as on relatives of sufferers. Hence, destigmatization of psychiatric problems is essential to improve the
condition of this vulnerable population. Corrigan &Rusch (2002)
argue that the most effective means of combatting self-stigma is by
attacking societal stigma (discrimination). So, there is an urgent need
to start a genuine attempt to move away from stigma. Understanding
and talking about the effect of the stigma is the first step in a journey
to bring the change in community's acceptance.
In Dr. N.N. Wig's words, we found now gross discrimination
against people with mental illness in all spheres of life like job,
housing, marriage, immigration etc.; thus greatly reducing the
opportunities for mentally ill for their rightful participation in the
society. In fact, many people hesitate to get help from mental health
professionals for fear of being looked down upon. It is unfortunate
that this happens in spite of effective treatment available for
psychiatric conditions. They need help, but still face hostility and
discrimination at home, at work or in the community. People with
mental illness often recover and person become able to work, learn
and participate fully in the community. Indeed, the stigma
experienced by people with a mental illness can be even more
damaging than the symptoms of illness. The effects of stigma are
various. Stigma.
n Causes feelings of isolation, hopelessness, and low self-esteem.
n Creates problems with employment.
n Negatively impacts housing.
n Causes Harassment.
n Causes physical violence.
n Negatively impacts community participation.
n Reduces resource & opportunity access.
n Causes a person to deny the illness.
n Causes a person to refuse treatment.
n Leads inadequate coverage of mental health treatment by health
insurance companies.

Why to involve Khaps in fighting against Stigma?


Mental health services in India are ignored; mental health
professionals face huge challenges in working to promote the mental

well-being. The diagnosis of psychiatric illness is considered as


damage to an individual and his family and negative consequences
linger for life time. Recovery is not just about remission of
symptoms of illness, it should also be used to plan for future holistic
growth. There are several factors that will act as determinants in the
recovery of individual. It is important to recognize which of these
has more substantial effects as well as how the effects on one domain
of life impact other domain of people's lives.
Stigma is a formidable obstacle in the progress of mental health
treatment. The stigma and negative societal views attached to these
disorders can make the diagnosis more distressing. The associated
stigma with these disorders can devastate the lives of sufferers as
well as their caregivers via increasing distress, disability, reduced
productivity and lowered quality of life. In general, respondents are
fearful of people diagnosed with mental illnesses and desire
emotional distance from them. The public attitudes tend to
characterize these people as dangerous, unpredictable, unreliable
and so on (Jackowska, 2009). Although, there are instances that
showed that awareness (e.g. showing intervention films)
significantly improved general attitudes to serious mental illness
and social distance, with a trend towards reducing perceived danger
(Kerby, Calton, et al.,2008). A major impediment in the holistic
treatment is social exclusion by the general population (Kingdon et
al, 2006). The outcome of educating the public and community
involvement creates a significant positive attitudinal change in those
with mental illness.
The experience of the development of de-stigmatization
programs is a complex process that faces several important barriers.
Researchers believe that to prevent mental health problems in
marginalized and vulnerable groups and to treat mental health
problems need immediate attention from the government,
policymakers, and civil society organizations (Kumar, 2011).One of
the solutions of these problems is to involve the social institutions
that have already been deep rooted in the society. Khap is one of the
most powerful social forces that determine an individuals' and
groups' behavior. The benefits of Khaps collaboration are difficult to
ignore. Although, connotation of Khap has, thus, undergone a
paradigmatic shift from its reputation of being 'positive decision
makers' and being criticized for honor killing involvement (here it
is important to remember that Khap Panchayats have always denied
their role in honor killing). It has now emerged as a strong mean to
social change (e.g. protection of girl child or stop foeticide killing
points of view), and can surely develop nationally as a positive
force. Involving Khap in mental health promotion will be a
significant investment to promote mental health need in community.
It will not only help in promoting mental health but also reduce
associated stigma that will lead to significant successful recovery
from mental illness. A relatively brief educational program and joint
team work, will demonstrate that attitudes can be changed.

Khap Panchayats: an overview


When people consider the question 'What is the role of Khap
Panchayats', they are usually thinking about what has been recently
portrayed bymeans. But there is another way of looking at this
question that you should consider for enhancing mental health
services for rural India. That is, we should seriously think about what
these panchayats are able to do in terms of the rehabilitation of
psychiatric patients back into community.Khap panchayats (castecouncils) are community groups usually comprising elderly men