Facilitators and Barriers Faced by Women With Severe Mental Illness in Gaining Employment- a Qualitative Study From Rural India

Abstract

Abstract Background:Women with severe mental illness (SMI) in India endure various psychosocial issues besides the burden of mental illness. It becomes more challenging in rural areas due to difficulties accessing services and limited employment opportunities. Among various constraints, lack of employment opportunities is quite pressing as being employed helps women with SMI to have a better quality of life and a sense of independence. Given this, we tried to understand the facilitators and barriers women with SMI from rural areas face in gaining and continuing employment. Methods: In-depth qualitative interviews were conducted to identify facilitators and barriers to employment opportunities for women with SMI in rural areas. Fifteen women with SMI receiving treatment from a community-based rehabilitation program run at an agrarian rural block in South India and other stakeholders, namely the caregivers of patients, a social worker, and a community program coordinator from a non-governmental organisation, were interviewed to understand the facilitators and barriers experienced by women with SMI in rural areas. Audio recordings of the interviews were transcribed, translated, and coded. Thematic analysis was used to identify emerging themes. Results:Findings of the thematic analyses indicate that facilitators in getting employed are medication adherence, work experience, support from family and co-workers, and financial gain from employment. Barriers that restricted women with SMI from getting employed were lack of motivation, social exclusion, medication side-effects, default in previous loans (mainly taken for agriculture purposes), lack of proof of identity, stigma from the community, lack of empowerment, and a patriarchal mindset. Conclusion:Employment is an essential part of recovery for women with SMI. The findings indicate the need to address systemic and personal barriers and promote work-related training and family support