Exploring generational differences in the impact of stigma on mental health among people affected by leprosy in rural India: a qualitative study

Leprosy continues to be highly stigmatised in India, resulting in the continuation of poor mental health outcomes for affected individuals and delays in seeking treatment. Whilst previous research suggests that the effectiveness of intervention strategies to reduce stigma and improve mental health can vary across generations, little is known about how leprosy-related stigma specifically impacts the mental health of different generational groups. This study, therefore, explored these generational differences in rural India. Through qualitative in-depth interviews conducted between June and July 2022 with 20 people affected by leprosy in Sitapur district, Uttar Pradesh, several themes related to stigma and its impact on mental health were identified using thematic analysis. These themes were categorized under broader umbrellas: conceptions, social interactions and behaviours, clinical management, and mental health manifestations. These findings highlight the complex interplay of societal, informational, and psychological factors influencing stigma and mental health outcomes. Understanding how stigma impacts the mental health of individuals affected by leprosy is a complicated and multifaceted challenge. While the findings of this study suggest that knowledge and beliefs play a significant role in shaping how younger and older generations experience stigma in rural India, the implications for mental health are wide-ranging. This work also has broader implications for other remote settings and diseases within similar contexts, highlighting the need for further research to better understand these dynamics.