Access to mental healthcare and coping strategies among rural women: a qualitative study from Amroha district, Uttar Pradesh, India

Background: Rural women in India are often confronted with situations that make it difficult for them to access formal mental health services such as inaccessibility, internalized stigma, believing that suffering is due to external causes and gender inequalities. These barriers delay receiving formal care for mental health and make these women resort to informal ways of coping such as community support and local faith healers. Methods: This study aimed to explore the informal coping strategies and beliefs around mental health among 100 rural women over the age of 18 years residing in Amroha district of Uttar Pradesh, India. Being a qualitative study, the method employed for the survey was focused group discussions and the participants were included through a convenience snowball sampling. The discussions were held in Hindi language for the ease of the participants and were recorded for analysis which was done through a thematic analysis approach. Results: The results highlighted six broad themes: (1) burden of responsibilities and emotional burnout, (2) physiological manifestations of psychological distress, (3) normalization of chronic stress, (4) psychological distress arising from marital conflict and gender-based adversity, (5) reliance on spiritual and informal coping strategies in place of formal mental healthcare, and (6) emotional suppression and silent tolerance. Conclusions: The findings suggest the urgent need to design culturally aligned psychotherapeutic interventions that focus on creating awareness through psychoeducation that could reduce stigma as well as helping rural women deal with their unmet mental health challenges.