An exploration of mental health and resilience narratives of migrant workers in India using community theatre methodology

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This highly innovative, interdisciplinary and collaborative global public health partnership aims to explore the mental health challenges and opportunities for resilience for internal migrants in Pune, India using theatre storytelling practices. Our focus is on co-creation of mental health and resilience knowledge for raising mental health awareness and support through community theatre engagement with migrant slum dwellers. This project aims to develop partnerships between UK and India academic researchers, community theatre groups, migrant communities, government agencies and public health NGOs. Our vision is to work towards the UN sustainable development agenda: Transforming our world: the 2030 Agenda for Sustainable Development goals 3, 5, and 10 (Good health and wellbeing, Gender equality, and Reduced Inequalities). There are an estimated 450 million people worldwide with mental disorders and about 75% of them live in developing countries, where insecurity, illiteracy, poverty, and violence increase the prevalence of mental illness. There is the widespread ignorance within society about mental health, which often results in human rights abuses and stigma against people with mental illness. Physical health problems and addictions are also associated with mental health problems. Internal migration is a matter of great importance in Low and Middle Income Countries (LMIC). Shrinking agriculture in rural areas and industrialisation and increasing urbanisation leads to ever increasing numbers of internal migrants seeking livelihoods in the cities. Our collaborative research will be in Pune in the state of Maharashtra, India. The rationale for this location is due to our academic and NGO contacts and partnerships within this area. In Pune the urban poor make up fifty per cent of the population with about 564 slums as per the Indian census data in 2011. Mental health interventions are still typically dominated by deficit-based models of theory and practice. Traditionally, many of the human service agencies have focused on trying to better understand the biological/psychological or environmental risk factors that increase the likelihood of the development or maintenance of at risk behaviour and the potential implications for prevention. Interventions that are based on the deficit, problems, or pathologies of individuals tend to direct the attention of professionals to only one view of the person. Supporting resilience requires a shift away from deficit-based models of mental health theory and practice. Our aim is to examine the opportunities presented by theatre practice for exploring and developing resilience at both personal and community level for migrant communities who are marginalised and struggling to meet their basic needs with very little public health support for health and wellbeing. Mental health narratives of internal migrants in India have hitherto tended to focus on the prevalence of psychological distress, anxiety and depression; but we have scant evidence about the resilience of migrant slum dwellers. The psychological distress and experiences as a result of migration can indeed be a risk factor for higher prevalence of mental disorders, but the lack of knowledge on how migrants mediate risk in the midst of adversities and construct resilience for positive living is an untold story.A key strength of theatre is its capacity to develop narratives capturing, but also powerfully communicating, the whole spectrum of health experiences - exploring not only the crises in people's lives but also asking and answering 'what is the beautiful?' in people's lives (beauty can be a key source of meaning and resilience).With the growing burden of mental ill health among migrant communities this international research partnership adds a new dimension to the co-creation of knowledge and understanding of resilience of internal migrant slum dwellers for developing appropriate public health support and intervention models.