Escaping Stigma: Traveling for Mental Health Treatment

Deep-rooted stigmas exist in countries around the world that prevent people from seeking and accessing the care they need to heal. For example, in India, “many villagers still believe mental illness is caused by evil spirits angry that the sick person had killed a cow during a past life.” “There’s little awareness that it’s a real illness,” says Dr. Indira Sharma, president of the Indian Psychiatric Society. “Most people think it’s all a figment of your imagination. There’s still very deep stigma.”

In the Middle East, meanwhile, stigma prevents people from talking about depression and other mental illnesses even as people in the region struggle to cope with the traumatizing effects of war and conflict. “Keep going, walk it off, tough it out, are messages people are used to hearing in Arab culture where invisible illnesses are often trivialized,” writes Yasmine El-Geressi. “Not only is there a lack of awareness and ambivalence on the issue, but an overwhelming majority of people avoid discussing and dealing with the matter altogether.” While the roots and specific nature of stigma differ across cultures, all have the same impact: silencing those who need help.

If you live in one of these areas or in another country with a culture of deep stigmatization, you may be reluctant to discuss your mental illness due to both real and perceived shaming and ostracization. When you have been raised to believe that mental health disorders are the result of personal weakness or, even worse, a sign that you are inhuman or possessed, silence can be a method of self-preservation.

This is particularly true in regions where the mentally ill are subjected to misguided attempts to cure, contain, or punish you. As a result, you are often left to suffer alone, your isolation pulling you further into distress. You may distance yourself from family and friends, weakening the social support networks so critical to emotional well-being. You may also internalize the damaging stigmas that keep you from seeking help, weaving destructive myths into your self-perception and ultimately augmenting your own suffering.

Unfortunately, even if you personally overcome stigma or accept its risks to seek treatment, the pickings are often slim. According to a 2012 study published in The Lancet, 173 million people in China suffer from a diagnosable mental illness, but only 15 million have received any form of treatment. While pervasive stigmas are partially to blame, so too is the lack of psychiatrists. There is currently only one psychiatrist for every 83,000 people living in China, compared to an average of 15.4 for every 100,000 people in developed countries. In India, a country of 1.2 billion people, there are only 4,000 psychiatrists, “compared with 50,000 in the US.”

In the Middle East, the countries with the highest proportion of psychiatrists still only have fewer than 0.5 psychiatrists per 100,000 people. What care does exist in these regions is often subpar; due to a historical lack of acknowledgment of mental illnesses as a public health issue, few healthcare services have been developed to treat them even as other countries have made great gains in treatment approaches and public awareness. Although a number of countries are now implementing policies that seek to expand mental health services and break through stigmatization, they remain far behind developed nations when it comes to both availability and quality of care.