Employment Among Women with Severe Mental Illness Availing Rural Community-based Rehabilitation Program: A Qualitative Study from South India

Abstract

Background: Women in India are often disadvantaged in accessing education, employment, health services, and decision-making within families. This inequality is particularly pronounced among women with severe mental illness, especially those from rural areas. Methods: The study explored the employment status, facilitators, and barriers to employment among women with severe mental illness availing a rural community-based rehabilitation (CBR) program in Jagaluru, South India. Interviews were conducted with 15 women, their family caregivers, the CBR program social worker, and a community program coordinator of a nongovernmental organization partner. The study used a qualitative research design. Thematic analysis was used to identify emerging themes. Results: Ten women were employed. Among five unemployed women, two independently took care of household responsibilities, and one assisted the family. Medication compliance and the desire to earn money for oneself were significant facilitators. Employment opportunities for some women were hindered by poor bus connectivity in interior villages, patriarchal familial attitudes, and challenges in availing loans for livelihood ventures. Conclusion: Rural families access treatment for severe mental illness when it is available at the nearest government health facility. With symptom improvement, many women could avail themselves of local employment opportunities without additional inputs from the CBR team.