Cultural Sensitivity in Global Mental Health

In the context of global mental health, integrating culturally sensitive mental health interventions and acknowledging both visible and invisible challenges in the community becomes particularly crucial in tribal contexts. 

India harbours one of the world’s largest tribal populations, constituting 8.6% of the total population in the country with 705 tribal groups. These communities face heightened vulnerability to mental health issues due to the impact of rapid social changes, lifestyle alterations, shifts in beliefs, and the challenges of acculturation associated with urbanisation. Despite various initiatives, including the formation of the Ministry of Tribal Affairs in 1999 and the National Commission for Scheduled Tribes in 2004 as well as the United Nations Declaration of Rights of Indigenous Population in 2007, there remains a dearth of evidence on mental health morbidity among tribal populations and their needs. The existing literature – such as the ICMR Bulletin (2003), the Report of the Technical Committee on Mental Health (2016), and the National Mental Health Survey (2016) – are inadequate in addressing mental health in tribal communities. Even the Report of the High-level Committee on the Socioeconomic, Educational and Health Status of Tribal Communities in India (2014) provides limited information on tribal people’s mental health. 

Limited research exists on the health of the constitutionally recognised Scheduled Tribe (ST) populations in India, particularly in the domain of mental health, which is already a neglected sub-area within healthcare services. The dearth of data on mental health challenges among tribal communities globally contributes to a poor understanding of their mental well-being. Despite the available data indicating worsening health indicators and reduced access to health facilities among tribal communities, the specific burden of mental health challenges within this population remains poorly documented.

The traditional livelihood system of ST communities has experienced conflicts with forces of modernisation, resulting in the loss of customary rights over livelihood resources, subordination, and low self-esteem, contributing to significant psychological stress. These communities face challenges with poor health infrastructure and limited mental health resources, both notably worse compared to other communities in similar areas.

In low- and middle-income countries (LMICs), only 15%–25% of individuals affected by mental health concerns receive any form of treatment, leading to a considerable ‘treatment gap’. Rural populations, particularly ST communities in India, encounter more substantial treatment gaps due to inadequate infrastructure and resources for healthcare delivery, with minimal capacity for providing mental healthcare.

Efforts to integrate culturally sensitive mental health interventions for tribal people involve tailoring psychological support and therapies to align with the unique cultural nuances and beliefs of these communities. This requires a comprehensive understanding of their historical and social contexts.