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ORIGINAL ARTICLE

Qualitative research methods in psychiatry in India: Landscaping the

terrain
Pranab Mahapatra, Krushna Chandra Sahoo1, Pritam Jitendriya1, Mousumi Samal1,
Sanghamitra Pati1
Department of Psychiatry, Kalinga Institute of Medical Sciences, 1Regional Medical Research Centre, Indian Council of
Medical Research, Bhubaneswar, Odisha, India

ABSTRACT

Background: Qualitative research methods (QRMs) bear a critical role in psychiatry as they explore the phenomenology
of psychiatric illness and its sociocultural dimensions. However, there is limited evidence regarding its use in psychiatric
research in India.
Aim: This study, under the aegis of mapping qualitative health research in India initiative, attempted to landscape the
use of QRMs in psychiatry and elicited expert opinion on its potential, perceived quality, and scope for improvement.
Materials and Methods: We reviewed studies using qualitative methodology published in the Indian Journal of
Psychiatry (IJP) and the abstracts presented at the Annual Conference of the Indian Psychiatric Society (ANCIPS)
between 2010 and 2019. Titles and abstracts were screened and shortlisted; full‑text articles were checked to identify
the relevant ones. In addition, ten experts comprising psychiatry journal reviewers, editors, and conference scientific
committee members were interviewed to elicit their views and suggestions.
Results: Out of 356 papers published in IJP between 2010 and 2019, only 12 papers used QRMs: five qualitative and
seven mixed methods. Out of 2297 abstracts published between 2010 and 2019 in ANCIPS, only 28 had used QRMs,
consisting of 20 qualitative and eight mixed methods. The findings reveal that qualitative research is still an understudied
domain in Indian psychiatry with a substantial need for rigor and quality.
Conclusions: To catalyze the use of qualitative research in Indian psychiatry, continuing medical education programs
through workshops or webinar mode need to be imparted. These trainings should aim at building skills on qualitative
study design, data collection, analysis, and writing.

Key words: India, mapping, mental health, psychiatry, qualitative research

INTRODUCTION

Globally, psychiatric disorders are recognized as one of the

Address for correspondence: Dr. Sanghamitra Pati,
Regional Medical Research Centre, Indian Council of Medical
Research, Chandrasekharpur, Bhubaneswar ‑ 751 023, Odisha, India.
E‑mail: drsanghamitra12@gmail.com
Submitted: 09‑Jun‑2020,  Revised: 08‑Jul‑2020,
Accepted: 29‑Oct‑2020,  Published: 15-Feb-2021
Access this article online
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Website:
www.indianjpsychiatry.org
priority areas in health research and policy, and it is also
included in sustainable development goals.[1] In India, more
than 197 million people are affected by psychiatric disorders
This is an open access journal, and articles are distributed under the terms of
the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License,
which allows others to remix, tweak, and build upon the work non‑commercially,
as long as appropriate credit is given and the new creations are licensed under
the identical terms.
For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com

DOI:
How to cite this article: Mahapatra P, Sahoo KC, Jitendriya P,
Samal M, Pati S. Qualitative research methods in psychiatry in
10.4103/psychiatry.IndianJPsychiatry_665_20
India: Landscaping the terrain. Indian J Psychiatry 2021;63:5-14.

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Mahapatra, et al.: Mapping qualitative research in Indian Psychiatry
of varying severity, a majority of them having depression or
anxiety disorders. The proportion of these disorders to the
total disease burden in India has almost doubled in the last
three decades, and the increase is more prominent among
adults.[2] This rising trend calls for an increased emphasis on
research in psychiatry.
Qualitative research methods (QRMs) are widely
acknowledged approaches used in psychiatric conditions
to know the phenomenology of the illness and its social
and anthropological dimensions,[3] which include stigma,
traditional beliefs and practices, and care‑seeking behavior.[4]
It also explores the effectiveness of the health system and
programs, leading to policy changes.[5] Qualitative studies
generate contextualized understanding of these phenomena
by collecting data from all the possible stakeholders:
patients, caregivers, service providers, managers, and key
decision‑makers. It relies on the collection, analysis, and
interpretation of “language data” in the form of interviews
and written texts to generate hypotheses.[6] The use of
QRMs is gradually increasing in psychiatric research, and
there are several principles and methods related to its use
in psychiatry.[7,8]
In India, there is substantial variation in the prevalence
and manifestations of psychiatric disorders across regions,
genders, occupations, age groups, and ethnicity.[2] Similarly,
differences exist among peoples’ lay beliefs and understanding
of mental health disorders.[3] These have an impact on the
care‑seeking and health services utilization.[4,9] Information
generated from qualitative research can be appropriate for
developing interventions, policy, and implementation of
innovations on mental health issues.[5,10,11] Although QRM
has a significant role in psychiatric research in a country
like India, there is little information available on how it is
currently being used in Indian psychiatry.
Journal articles and conference presentations can be a
surrogate indicator of the adoption and familiarity of any
research method in a discipline. Hence, to better understand
the current state of qualitative research in Indian Psychiatry,
we planned to carry out an evidence mapping exercise.
In this study, we explored the proceedings of the Annual
Conference of the Indian Psychiatric Society (ANCIPS)
between 2010 and 2019 for research presentations with
qualitative methodology. We also attempted to map
the articles with QRM published in the Indian Journal of
Psychiatry (IJP) during the same period. Furthermore, we
interviewed experts to elicit their views on the findings
and suggest measures to enhance qualitative research in
psychiatry in India.
MATERIALS AND METHODS
This study is a part of a larger initiative mapping of qualitative
health research in India to landscape the use of qualitative
6 Indian Journal of Psychiatry Volume 63, Issue 1, January-February 2021
research techniques in clinical and paraclinical and allied
health professional disciplines such as physiotherapy,
pharmacy, and AYUSH. Since the field of psychiatry and
mental health has substantial impetus to harness QRMs,
we decided to carry out our first qualitative health research
mapping exercise in the discipline of psychiatry.
We used an explanatory mixed‑method approach. The study
was initially based on secondary data – a systematic review
of qualitative studies published in IJP and ANCIPS, and the
explanation of these findings was sought through primary
data in the form of interviews from leading academicians,
psychiatrists, and journal editors.
We reviewed conference proceedings of the ANCIPS
and research papers published in the IJP during the past
decade (2010–2019) for the use of QRM. The IPS, with
over 7000 members, is the largest society of mental health
professionals in India.[12] It works for the promotion of
education, training, and research in psychiatry. It works
for the promotion of education, training, and research in
psychiatry. The ANCIPS is the annual event of the IPS having
workshops, symposiums, and free papers that are attended
by faculties and students.[12] The IJP is the official journal of
the IPS that publishes the papers presented at the ANCIPS.
These, along with the published articles, were obtained
from the home page of the journal.
After consultation with experts, we developed a list of
terms indicating qualitative research. These included
“phenomenological,” “perception,” “perspective,”
“opinion,” “view,” “explanation,” “focus group discussion,”
“in‑depth interview,” “observation,” “exploration,”
“qualitative,” “narrative,” “exploratory,” “explanatory,”
“convergent,” “believe,” “mixed method,” “framework
analysis,” “content analysis,” “grounded theory,” “thematic
analysis,” and “interpretative phenomenological analysis.”
We used the above terms to screen for qualitative and
mixed‑method studies in the oral paper presentations
at the ANCIPS and the original research articles of IJP.
First, the titles were looked at, followed by the abstracts.
Furthermore, we also checked the full‑text articles from the
IJP for their methodology.
Two predecided checklists were prepared separately
for conference proceedings and published articles.
After entering the details of the studies in Excel sheets,
we conducted a descriptive analysis. The abstracts
and published articles were shortlisted by two authors
independently to include the mixed‑method and qualitative
studies, and these were further reviewed and cross‑checked
by a third author. All the studies using qualitative methods
were considered, including those with mixed‑methods
research. In the conference proceedings, we excluded the
abstracts of oral papers showing incomplete results.
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Mahapatra, et al.: Mapping qualitative research in Indian Psychiatry

To complement our findings, we contacted ten experts,
members from the scientific committee of ANCIPS, and the
editors and reviewers of the IJP over the phone. Through
semistructured interviews, views and opinions related to
QRMs were elicited. The topics discussed included first,
the current status of QRMs in Indian psychiatry; second,
information related to the submission and selection of QRM
papers or articles to ANCIPS or IJP; and the challenges for
journal editors and reviewers. Their recommendations were
sought. The discussions were digitally recorded transcribed,
coded with MAXQDA software (MAXQDA Analytics Pro 2020,
VERBI GmbH Berlin), and analyzed using content analysis.
The Institutional Ethical Committee of Kalinga Institute of
Medical Sciences, Bhubaneswar, approved the study. We
contacted the key informants over email and telephone,
explaining the purpose of the study, and obtained their
consent. Anonymity and confidentiality of the interviewees
were maintained.
RESULTS
Findings from Indian Journal of Psychiatry publications
and Annual Conference of the Indian Psychiatric Society
presentations
Out of 356 published articles in the IJP during 2010–2019,
only 12 studies (3.4%) used QRMs: five were only qualitative
and seven used mixed methods.
Out of 2297 abstracts published from ANCIPS proceedings
during the same period, a total of 28 published
abstracts (1.2%) used QRMs: 20 qualitative and 8 used mixed
methods. In the first 5 years of the decade under study, 2.7%
of the published articles (four out of 148) had a qualitative
methodology compared to 3.8% (eight out of 208) of them
over the following 5 years. Similarly, in the first 5 years of
that decade, 0.7% of the published abstracts of ANCIPS (six
out of 913) had a qualitative methodology compared to 1.7%
of them over the following 5 years. The detailed mapping
of qualitative psychiatric research in published abstracts of
ANCIPS and articles in IJP during 2010–2019 is presented
in Table 1.
It was observed that although limited numbers of studies
using QRMs were published in IJP (n = 5), all the studies
followed standard qualitative research protocol. These
studies used qualitative interviews using a semistructured
guide for the data collection. Mostly, the studies were
conducted among patients, caretakers, and family members.
Four studies were focused on mental health behavior and
one on treatment delay. The detailed design, data collection
methods, participants, settings, institute, and major domain
of the qualitative studies published in IJP are described in
Table 2.
In Table 3, the details of design, data collection methods,
participants, settings, institute, and major domain of the
qualitative abstracts published from ANCIPS are presented.
Out of 20 published abstracts, two used focus group
discussions (FGDs), ten interviews (in‑depth, semistructured,
key informants), six both interviews and FGDs and one
observation, and one published material in print media.
Major psychiatric disorders found in these abstracts were
related to anxiety, depression, schizophrenia, alcohol
dependence, and smoking. Psychosocial impact or other
medical illnesses such as cancer were also studied. Attitude,
beliefs, and behavior and health‑seeking behavior were
explored in these studies. The studies used QRMs to find
the consequences of psychiatric illnesses or the challenges
in health care. Other issues presented include the role of
media in psychiatry. Many of the abstracts did not have
clarity in study design or a standard protocol. Sometimes,
the analysis of data was not done adopting standard
qualitative approaches.

Table 1: Mapping of qualitative psychiatric research published in the Indian Journal of Psychiatry and Annual
Conference of the Indian Psychiatric Society proceedings during 2010-2019
Years Indian Journal of Psychiatry publish articles ANCIPS proceedings
Total published Mixed methods Qualitative Total conference published Mixed methods Qualitative research
article (n=356) article (n=7) articles (n=5) abstract (n=2297) research abstracts (n=8) abstracts (n=20)
2010 32 1 0 104 0 0
2011 25 0 0 177 1 1
2012 28 1 0 235 1 1
2013 34 0 0 222 0 1
2014 29 1 1 175 0 1
2015 38 1 2 365 2 3
2016 41 0 0 302 2 2
2017 48 1 0 200 0 3
2018 56 0 1 272 1 6
2019 25 2 1 245 1 2
Total 356 7 5 2297 8 20
2010-2014 148 3 1 913 2 4
2015-2019 208 4 4 1384 6 16
ANCIPS - Annual Conference of the Indian Psychiatric Society

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Table 2: Design, data collection methods, participants, settings, institute, and major domain of the qualitative studies
published in the Indian Journal of Psychiatry
Author Study Approach Data Data Participants Data analysis Institute Major domain
settings collection collection
methods tool
Reddy et al., Turuvekere, Phenomenology In-depth Semi- Family members Content analysisNational Institute Health seeking
2014[13] Karnataka interviews structured and caregivers of Mental behavior of
(n=16) guide Health and schizophrenia
Neurosciences, patients living in a
Bangalore, rural community
Karnataka, India
Parameshwaran Washington, Narrative In-depth Semi- Elderly female Content Harvard Divinity Neurophysiological
2015[14] United States interviews structured Caucasian patient analysis using School, Harvard principles and
of America guide neurophysiological University, model
principles Cambridge, USA
Agarwal et al., Lucknow, Document or Observation Checklist Patients with Descriptive Navuday Mental Health seeking
2015[15] Uttar record review of clients mental disorder Content analysis Health Institute, behavior of patients
Pradesh, (n=95) and their relatives Lucknow, Uttar with mental
India Pradesh, India disorder and their
relatives
Nadir et al., Rawalpindi, Phenomenology In-depth Semi- Patients from Content analysis Rawalpindi Doctors behavior
2018[16] Pakistan interviews structured the medical and Medical College, toward patient at
(n=44) guide surgical unit Pakistan the workplace
Dutta et al., Raipur, Phenomenology In-depth Semi- Patients and their Content analysis All India Institute Factor responsible
2019[17] Chhattisgarh, interviews structured family members of Medical for delay in
India (n=25) guide Sciences, Raipur, treatment among
India psychosis patient

In Table 4, mixed‑method studies published in IJP are
presented. It was observed that all seven studies used
convergent parallel mixed‑methods design. The studies
were conducted in India, and the major psychiatric issues
addressed pertained to reproductive and adolescent
health, suicide, child abuse, and autism. It also included
psychiatric education and community mental health. The
studies explored care challenges, care seeking, and capacity
building. Similarly, Table 5 represents mixed‑method
abstracts published in the proceedings of ANCIPS. All eight
abstracts used convergent parallel mixed‑methods designs.
The major psychiatric disorders studied were schizophrenia,
bipolar mood disorder, opioid dependence, and autism.
The issues explored in them were perception toward the
above illnesses and their care‑seeking pathway.
The quality assessment of the five qualitative studies
published in the IJP was assessed using the consolidated
qualitative research reporting assessment tool [Table 6].
Experts’ experiences and views
After analyzing the interviews with experts, five major
categories were identified: (1) current position of
QRMs in India, (2) conference presentations and journal
submissions, (3) current training and orientation,
(4) challenges for editors and reviewers, and (5) promoting
QRMs in psychiatry research.
Current position of qualitative research methods in India
Many experts expressed that know‑how in any kind of
research is increasing among teaching faculties compared
to the past. However, even with this trend, only a few of
them can carry out studies with QRMs. Two of the experts
who also teach in postgraduate institutes expressed that
most faculties have lesser expertise in qualitative than
quantitative research. Although they know about the
methods, they have lesser skills when it comes to teaching
or research. It is treated with either suspicion or with
awe. Many psychiatrists, they said, just write off the entire
qualitative research as a method.
“Previously there was even less understanding about research
methodology itself. Now that has improved among the faculty.
I must say, practically, very few understand qualitative
research.” [E‑8]
Conference presentations and journal submissions
Experts who worked on the selection of ANCIPS papers
reported that the number of QRM submissions was lower,
while many of them were mixed‑method research – very
few were purely qualitative.  According to their opinion, the
research topic, method, and availability of time slots were
considered and QRM papers had equal chances of being
selected. Some of them added that some qualitative research
attracts more inquisitiveness when discussed for selection
and generates more interest. All experts with experience as
editors or reviewers indicated that the number of articles
received with QRMs was very few as compared to those
with quantitative methods. One of them expressed that few
researches are being done having qualitative methods, and
maybe fewer of them appear in publications. Another expert
said that it was only 5% of the usual research published in

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Table 3: Design, data collection methods, participants, settings, institute and major domain of the qualitative studies
published in Annual Conference of the Indian Psychiatric Society conferences proceedings
Author Data collection Participants Study settings Institute Major domain
methods
Singh and Singh 2011 Focus group Cervical cancer patients Not available Institute of Human Cervical cancer survivors
discussions (n=10) Behaviour and Allied experiences
Sciences, New Delhi, India
Singh et al., 2012 Document analysis Published material on Not available Institute of Human Role of media in mental health
mental health in the Behaviour and Allied
print media of the last Sciences, New Delhi, India
five decades
Mittal et al., 2013 Semi-structured Parents of children with Not available Not available Stress and coping pattern in
interview (n=20) autism parents of children with autism
P.V Indu et al., 2014 In-depth interviews Various stakeholders, Five districts Department of Health care among geriatric
(n=166) elderly people, slum of Kerala, Psychiatry, Government patients
Focus group dwellers, tribal India Medical College,
discussions (n=9) promoters, and Thiruvananthapuram,
caregivers Kerala, India
Ahmed and Barmi 2015 In-depth interviews Street children Not available PsyCare, India Street children with drug abuse
(n=40)
Murthy et al., 2015 Semi-structured Family members of Not available The Association for the Role of parents of a person
interview (n=60) intellectual development Mentally Challenged with intellectual development
disability individuals disability
Kukreti et al., 2015 Focus group Patient of dual diagnosis New Delhi, Institute of Human Belief, attitude, and behavior
discussions (n=7) in a tertiary care India Behaviour and Allied among smokers
psychiatry centre Sciences, New Delhi, India
Banerjee et al., 2016 In-depth interviews Mothers with severe Bangalore, National Institute of Mental Experiences and perceptions
(n=20) mental illness Karnataka, Health and Neurosciences, of motherhood among severe
India Bangalore, Karnataka, India mental illness women
Ahuja et al., 2016 In-depth interviews Stakeholders Country base EMERALD Challenges and opportunities
(n=33) study for convergence mental health
in the management system
Nebhinani and Suthar 2017 In-depth interviews Patients with syndrome Jodhpur, All India Institute of Assessment of “Dhat
(n=30) of semen loss Rajasthan, Medical Sciences, Jodhpur, syndrome” for better
India India understanding and
management
Banerjee et al., 2017 In-depth interviews Severe mental illness Bengaluru, National Institute of Mental Experiences and perceptions
(n=30) patients Karnataka, Health and Neurosciences, of motherhood among severe
India Bangalore, Karnataka, India mental illness women
Bayetti et al., 2017 Observation (n=9) Postgraduate psychiatry Not available Government Training Postgraduation psychiatry
student and their Institute training among students
teachers
Hossien et al., 2018 In-depth interviews Caregivers of the elderly Ranchi, National Institute of Mental Awareness of late-life
persons with dementia Jharkhand, Health and Neurosciences, neuropsychiatric illness among
India Ranchi, Jharkhand caregivers of dementia
Hegde et al., 2018 In-depth interviews Postgraduate psychiatry Indian medical Senior Resident, St Challenges in taking sexual
Focus group trainees college general John’s Medical College, history among postgraduate
discussions hospital Bangalore, Karnataka psychiatry trainees
Banerjee et al., 2018 In-depth interviews Mothers with severe Bangalore, National Institute of Mental Experiences and perceptions
(n=30) mental Illness Karnataka, Health and Neurosciences, of motherhood in mothers with
India Bangalore, Karnataka, India severe mental illness
Basu et al., 2018 In-depth interviews Caregivers, treatment Chandigarh, Postgraduate Institute of Recovery of opioid
(n=13) providers, opioids Punjab, India Medical, Education and dependence patient in drug
Focus group dependence, and mental Research, Chandigarh, deaddiction center
discussions (n=4) health professionals India
Mahapatra et al., 2018 In-depth interviews Women, and family Tribal Kalinga Institute of Perceptions and beliefs
(n=19) members; and local dominated Medical Sciences and among tribal women and the
Focus group community leaders and districts of Regional Medical Research community toward alcohol
discussions (n=2) health workers Odisha, India Centre, Bhubaneswar, consumption during pregnancy
Odisha, India
Deb et al., 2018 In-depth interviews Patients of severe mental New Delhi, All India Institute of Role of smartphone for
Focus group illness patients and their India Medical Sciences, New managing severe mental
discussions care-providers Delhi, India illnesses in low-income
settings

Contd...

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Author
Sahadevan et al., 2019
Banerjee and Rai 2019
Table 3: Contd...
Data collection Participants Study settings Institute Major domain
methods
In-depth interviews Undergraduate medical South India Malankara Orthodox Syrian Attitude toward psychiatric
Focus group students Church Medical College, illness, treatment among
discussions Kerala, India undergraduate medical
students
In-depth interviews General physicians Bangalore and National Institute of Mental Perceptions and challenges
Impala, India Health and Neurosciences, of physicians while treating
Bangalore and Regional patients with dementia
Institute of Medical
Sciences, Impala

Table 4: Design, data collection methods, participants, settings, institute, and major domain of the mixed methods
studies published in the Indian Journal of Psychiatry
Author Mixed method Qualitative data Quantitative Participants Study Settings Institute Major domain
approach collection data collection
Chaturvedi Convergent In-depth Questionnaire Faculty members, Bangalore, National Institute of Mental Teaching method
and Chandra parallel interviews senior residents, Karnataka, Health and Neurosciences, for postgraduate
2010[18] social workers, India Bangalore, Karnataka, India psychiatry trainees
junior residents, and
postgraduate students
Kotecha et al., Convergent Focus group Questionnaire Adolescent students Boroda, Department of Preventive Teachers’
2012[19] parallel discussion (n=10) (n=1440) and school teachers Gujurat, India and Social Medicine, sensitization
of urban schools Medical College, Baroda, toward
Gujarat, India reproductive and
adolescent health
Sahu 2014[20] Convergent In-depth Questionnaire Community members Kolkata, West Institute of Psychiatry, Community
parallel interviews (n=13) (n=548) of Municipality Bengal, India Kolkata, West Bengal, India mental health
Focus group program
discussion (n=10)
Eynan et al., Convergent Focus group Questionnaire Physicians Mumbai, Department of Psychiatry, Capacity building
2015[21] parallel discussion (n=40) (n=46) Ahmedabad, JSS Medical College and additional
and Mysore, Hospital, Mysore, training toward
India Karnataka, India suicide risk
behavior
Subramaniyan Convergent In-depth Questionnaire Parents and law Bengaluru and Ramaiah Medical College, Male child abuse
et al., 2017[22] parallel interviews enforcement team Mysore, India Bengaluru and JSS
members Medical College, Mysore,
Karnataka, India
Yadav et al., Convergent In-depth Review of Nursing staffs, Bangalore, National Institute of Mental Challenges
2019[23] parallel interviews hospitals (IPD) consultant, junior/ Karnataka, Health and Neurosciences, at inpatient
records senior residents and India Bangalore, Karnataka, India adolescent
guardians psychiatry center
Mahapatra Convergent In-depth Questionnaire Parents of ASD Bhubaneswar, Kalinga Institute of Parents’
et al., 2019[4] parallel interviews (n=76) (n=76) children Odisha, India Medical Sciences and perception
Regional Medical Research regarding ASD
Centre, Bhubaneswar,
Odisha, India
ASD - Autism spectrum disorder; IPD - Inpatient department

the common popular psychiatric research journals in India.
However, journals are receiving an increasing number of
submissions and are publishing more QRM papers than
before. According to one respondent, many of the papers
submitted with QRM come from a few reputed institutions,
and a good proportion of them is received from allied
branches, such as clinical psychology and psychiatric social
work.
“There is hardly any qualitative research. I don’t know how much
it is done but it doesn’t figure in publications.” [E‑5]
10
Current training and orientation
Some of the respondents who worked as teaching
faculties said that there is no specific training for
medical postgraduate students in QRM, this is part of
the research methodology module in the curriculum. One
of them suggested that QRM should be included in the
postgraduate curriculum. According to him, during their
academic training in the weekly journal club discussion,
students mostly analyse quantitative articles. Training
that develops an eye for understanding or interpreting
QRMs is limited. Three of these experts reported that
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Table 5: Design, data collection methods, participants, settings, institute and major domain of the mixed methods
studies published in Annual Conference of the Indian Psychiatric Society proceedings
Author Qualitative Quantitative Participants Study Institute Major domain
data collection data collection settings
Sundaram Focus group Online survey Psychiatrists United Suffolk Mental Health NHS Role of clinical
et al., 2011 discussion Kingdom Trust, Suffolk, UK supervision of psychiatrists
in implementing clinical
governance
Agrawal et al., Focus group Questionnaire Medical and nursing Not available Not available Knowledge, attitude, and
2012 discussion staffs, and patients practices among medical
and nursing staff
Karambelkar Narrative and Questionnaire Patients with Not available Government Medical College, Experiences of stigma,
et al., 2015 semi-structured schizophrenia and bipolar India discrimination in
interview mood disorder in the schizophrenia and bipolar
out-patient department of mood disorder patients
tertiary healthcare facility
Rathi et al., In-depth Feedback 100 Medical college Mumbai, King Edward Memorial Knowledge, attitude, and
2015 interviews assessment student India Hospital, Mumbai, India skills among psychiatry
interns
Rathi and In-depth Feedback 65 Medical college Mumbai, King Edward Memorial Assessment of knowledge
Parkar 2016 interviews assessment student India Hospital, Mumbai, India about Psychiatry among
interns
Seth et al., Semi-structured Questionnaire Patients taking opioid Surat, Government medical college, Cognition and opioid
2016 interview substitution therapy Gujarat, India Surat, Gujarat, India substitution therapy drug
adherence among patients
with opioid dependence
Mahapatra Semi-structured Questionnaire 76 parents Bhubaneswar, Kalinga Institute of Medical Parents’ perception
et al., 2018 interview India Sciences and Regional regarding ASD
Medical Research Centre,
Bhubaneswar, Odisha, India
Pati et al., 30 in-depth 125 structured Psychiatric patients at Odisha, India Kalinga Institute of Medical Contextualized care-
2019 interviews questionnaire tertiary healthcare facility Sciences and Regional seeking pathway tool for
interviews Medical Research Centre, psychiatric illness
Bhubaneswar, Odisha, India
ASD - Autism spectrum disorder

few students in their MD psychiatry thesis have begun
QRM studies, but these are mostly mixed‑method designs
and there are hardly any purely qualitative studies. Some
of them reported that there were few specific training
programs for QRM. According to them, qualitative
research involves a lot of hard work in the form of
interviewing, transcription, and analysis, and therefore
practical training is very important. On the contrary,
much less time was spent teaching QRMs.
“As long as we don’t have right mentors who can guide the
students to carry out QRMs, it may be difficult to progress
further.” [E‑3]
Challenges for editors and reviewers
Experts with editorial experience reported that limited
articles in QRMs had been submitted to journals and
minimal articles had followed the appropriate checklist.
One of them noted that, over the last 2 years, there has
been an increasing trend in the submission of QRM articles,
but most of them are mixed‑method articles, with very few
being purely qualitative. They noted that a limited number
of researchers were also pursuing and reviewing qualitative
articles. It was difficult for them to find adequately trained
reviewers to assess the quality of qualitative research
and to examine the appropriateness of the methods. As
they see it, many submitted papers have just conducted
QRMs without adequate knowledge of their rationale and
methodological accuracy. They all agreed that clarity of the
process is needed in the design, development of the tools
and analysis, and interpretation of the findings.
“We’re getting a few QRMs papers; obviously, we’re not getting
quality papers; the researchers are not very comfortable or
conversant with QRMs.” [E‑7]
Promoting QRMs in psychiatry research
Many experts believed that QRMs have their place in
the research scenario because certain phenomena – the
experience of patients, caregivers, and providers – are
difficult to address quantitatively. They expressed that
there was a substantial need to conduct, interpret, and
publish the findings from a qualitative perspective, and
these findings need to be translated into clinical and
theoretical applications. Some experts proposed that there
was a need to increase the capacity and competence in
QRMs. They suggested that proper workshops are crucial
for orientation and raising awareness and that hands‑on

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Mahapatra, et al.: Mapping qualitative research in Indian Psychiatry

Table 6: Quality assessment of the qualitative studies published in the Indian Journal of Psychiatry using consolidated
criteria for reporting qualitative research assessment tool
Reddy et al., Parameshwaran Agarwal et al., Nadir et al., Dutta et al.,
2014[13] 2015[14] 2015[15] 2018[16] 2019[17]
Research team and reflexivity
Personal characteristics
Interviewer ● × ● ● ×
Credentials ● ● ● ● ●
Occupation × × × × ×
Gender × × × ● ×
Experience and training ● × × × ×
Relationship with participants
Relationship established ● × × × ×
Participant knowledge of the interviewer ● × ● ● ×
Interviewer characteristics ● × × ● ●
Study design
Theoretical framework
Methodological orientation and theory ● ● ● ● ●
Participant selection
Sampling ● ● ● ●
Method of approach ● ● ● ● ●
Sample size ● ● ● ● ●
Nonparticipation ● × × × ×
Setting
Setting of data collection ● ● ● ● ●
Presence of nonparticipants × × × × ×
Description of sample ● ● × ● ●
Data collection
Interview guide × × × ● ●
Repeat interviews × × × × ×
Audio/visual recording ● × × ● ●
Field notes ● ● ● × ×
Duration × × × × ×
Data saturation ● × × × ×
Transcripts returned × × × ● ×
Analysis and findings
Number of data coders × × × ● ×
Descriptions of the coding tree × × × × ×
Derivation of themes × ● ● ● ●
Software × × × ● ×
Participant checking × × × × ×
Reporting
Quotations presented ● × × ● ●
Data and findings consistent ● ● ● ● ●
Clarity of major themes ● ● ● ● ●
Clarity of minor themes ● × × ● ●
● - Addressed the point; × - Not addressed the points

training in QRM is essential because it takes a lot of effort
to have an understanding and expertise.
DISCUSSION
Qualitative research in psychiatry is yet to make its mark in
India, as evidenced by published conference presentations
and research papers. Not much is known about the extent
and use of QRMs in psychiatry in India. To our knowledge,
this is the first mapping exercise exploring the use of
QRMs in Indian psychiatric research, reviewing conference
proceedings, publishing papers, and obtaining expert
opinions. The findings help identify areas for intervention
to catalyze qualitative research in the practice of psychiatry.
There is an increase in qualitative research in recent years,
but traditional methods continue to dominate in Indian
psychiatry. Our findings reveal that only a few articles
published in IJP in the last decade (3.4%) used QRMs. Most
had a mixed‑methods approach and limited articles had
a purely qualitative methods.[13‑17] Similarly, the papers
presented at ANCIPS had few researches using qualitative
methodology (1.3%). Analyzing further, it was found that
the published articles and conference abstracts showed a
rising trend when those from the second half of the decade
are compared with the first half. This reflects an increasing
interest worldwide in the use of QRMs in psychiatric
research, given its usefulness in exploring aspects not
covered by quantitative research.[24,25] Qualitative research

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Mahapatra, et al.: Mapping qualitative research in Indian Psychiatry
is often featured in prominent international journals.[24] The
journals publishing qualitative research in mental health
includes Biomed Central group (psychiatry, public health,
health services research, research notes, women’s health,
family practice, complementary and alternative medicine),
and other psychiatric journals like – International Review
of Psychiatry, The Canadian Journal of Psychiatry, Australian
and New Zealand Journal of Psychiatry and The British
Journal of Psychiatry, to name a few.[3,5,9,24] Despite the
increase in interest in QRMs, much more needs to be done
to utilize the approach in Indian psychiatry.
The present review revealed that a phenomenological
approach to qualitative methods is mainly used to study
psychiatric disorders. The disorders covered are mainly
schizophrenia; autism and intellectual disability; geriatric
health issues; tobacco, alcohol, and drug dependence; and
psychological aspects of systemic illness such as cervical
cancer. These studies also explored issues such as health
system challenges, psychiatry teaching and training, and
the role of media and mental health. Different approaches
to qualitative research can be utilized to inform us in
various aspects of an illness. Ethnography, phenomenology,
and grounded theory are major approaches in qualitative
study designs. While ethnography explores culture groups,
phenomenology deals with the psychosocial aspects by
examining the lived experience of individuals. A grounded
theory approach is used to develop theories grounded in
real‑world observations.[26] Phenomenological approaches
studying psychiatric disorders involve patients, their
caregivers, and care providers or any stakeholder, exploring
their views and experiences concerning a phenomenon. It
tries to analyze their behavior and responses in the face
of illness.[3,4] Barriers to care vary in different settings and
it can be best studied by qualitative research.[4,27] Among
the other uses in the field of psychiatry, QRM provides the
most context‑specific answers when we want to develop
acceptable healthcare services, effective policies, and
programs in a specific setting.[5] It also can shape medical
education and training by developing effective ways to
teach psychiatry.[28] Although qualitative studies have the
potential to inform on various aspects of psychiatric care,
our findings have shown that QRMs are yet to be used to
their true potential in Indian psychiatry research.
Most of the published research followed appropriate
qualitative methods. All the studies published in IJP followed
standard qualitative research guidelines. However, of the
studies presented in ANCIPS, only a few followed standard
QRMs guidelines. The studies using mixed methods were
mainly parallel convergent design. Although quantitative
research is more likely to get published,[29] qualitative
research, when properly carried out, is equally likely to be
published.[30‑32] Experts who were interviewed emphasized
the need to design and present methodologically sound
studies to get them published. Hence, to increase the
Indian Journal of Psychiatry Volume 63, Issue 1, January-February 2021
presence of qualitative research in psychiatry journals,
the submitted papers should convey a clear methodology,
analysis, and presentation.
Most of the experts interviewed were of the view that
few qualitative researches are being carried out in Indian
psychiatry as there are fewer researchers adequately trained
in QRMs. The availability of fewer training opportunities
leads to a few trained in qualitative research and that
results in less published papers.[33] The scarcity of qualitative
research may also be due to its recent appearance in Indian
psychiatric studies and the fact that qualitative methods
have not yet been accepted by the scientific community
as an alternative or complementary form of research.[34]
Qualitative research requires complex skills in the design,
execution, analysis, and presentation of information. This
includes the ability to think qualitatively, to perform skills
such as interviewing, transcription, coding, and writing
findings.[6,26] A culture or ethos of QRMs in psychiatry is
needed to accelerate the learning process. This calls for
greater emphasis on methodological training, including
teaching curricula and applied research, starting from
postgraduate studies in psychiatry.
The quality evaluation of the studies suggests that the studies
reported in the IJP have followed a defined standard protocol.
However, few studies presented in the ANCIPS have adopted
a standardized protocol in which only the design portion
of the research was dealt with. The authors found that the
ANCIPS did not publish the full manuscript; rather, only
abstract was published. The authors propose that if ANCIPS
publishes short qualitative papers in the range of 1000 to
1500 words instead of only abstracts, the content would be
improved in terms of clarity and quality and the results could
be used for practice and policy recommendation.
To increase the credibility of this systematic synthesis, a
research triangulation approach was followed – information
was collected from various sources and mixed‑method
approaches were used for data collection and analysis.
Besides, the authors come from a variety of educational and
professional backgrounds, which broadens the analysis. The
limitation of this study was that although many journals
publish psychiatric research in India, only publications in
the IJP were considered as it is the official journal of the
IPS. Some of the researches carried out in India could have
been published in international journals, which were not
examined. Second, in our study, we have considered only
ANCIPS, the conference of IPS. However, we believe that our
study findings in India can inform on the present landscape
of a QRM in psychiatry.
CONCLUSIONS
The findings of the study reveal that qualitative research
is an unexplored area of clinical psychiatric in India. The
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Mahapatra, et al.: Mapping qualitative research in Indian Psychiatry
prevailing paucity of such research in psychiatry and the
absence of focused training programs contribute to the
limited number of professionals well versed in qualitative
research. Capacity building programs should be carried out
in the form of CME, workshops, or webinars to enhance the
acceptance of qualitative research in psychiatry. In future,
we intend to undertake an assessment of the curriculum
and teaching program for postgraduate degree courses
in psychiatry for the inclusion of qualitative research. We
further propose to explore the perspectives of faculty and
residents of psychiatry on their perceived necessity and
competence to undertake qualitative research in their
practice‑based research. To obtain a more comprehensive
landscape, we would complement the existing findings
by encompassing all relevant journals dwelling on Indian
psychiatric scenario.
Acknowledgment
We record our deep gratitude to Dr. Sujit Sarkhel, Associate
Professor, Institute of Psychiatry, Kolkata, for facilitating
the study at key stages. We sincerely thank the Indian
Psychiatric Society for their kind support. We are also
thankful to Dr. Banambar Sahoo, Library and Information
Officer, ICMR‑RMRC, Bhubaneswar, for making available the
necessary articles for the study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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