Paper short abstract:

An ethnographic account of people living with severe mental illness and negotiating their experiences of suffering within three distinct mental healthcare structures in India. The socio-culture ineptness of 'recovery' would be discussed vis-à-vis narratives of contextually-situated expectations.

Paper long abstract:

The traditional biomedical models of severe mental illness (SMI) and clinical recovery dictate mental healthcare practices and situate the responsibility of health and wellbeing within the individual. The newer mental healthcare policies guided by the Global Mental Health movement are also focusing on individualistic notions of personal recovery and human rights. However, this emphasis on personal transformation and agency does not necessarily align with the social, political, and cultural realities of India. An ethnographic study was undertaken at three distinct sites of mental healthcare - a halfway home, a private psychiatric hospital, and a community outreach centre- to understand the meaning-making processes around SMI. Analysis of semi-structured interviews, observations, field notes, and secondary material brought forth discourses of suffering situated in the complex socio-political hierarchies. Culturally-specific idioms of distress and subjective understandings of people living with SMI are consistently disregarded as they fail to align with the goals of the existing mental healthcare system. Thus, suffering in SMI was found to be further accentuated by an imposed 'quest for recovery'. This compels one to question the meaningfulness of such clinical engagements. The paper further problematizes the concept of recovery in the Indian context and explores alternative discourses through first-person narratives of people living with SMI.

Keywords: severe mental illness, recovery, India, socio-cultural context, alternative discourse