Mental health literacy in urban and rural communities in Kerala India: An interdisciplinary approach using applied theatre methodology

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This highly collaborative international interdisciplinary partnership examines the applicability of the evidence based intervention of mental health literacy (MHL) for urban and rural communities through a multi-centre study in India using participatory theatre and media. We believe that our mutual sharing of research experiences, cultural identities and interdisciplinary exchanges will enable us to build our capacity for planning collaborative research of international significance. Our vision is to work towards the UN 2030 Agenda for Sustainable Development goals 3, 5, 8, and 10.The WHO estimates that mental and behavioural disorders account for about 12% of the global burden of diseases and this is likely to increase to 15% by 2020 . Our focus is in Kerala which has higher prevalence of mental ill-health (14.4%), suicidal risk (12.5%) and alcohol abuse than the rest of India. Thus there is a dire need to develop acceptable and affordable evidence based mental health interventions that are responsive to the local cultural and social contexts. Despite the high Human Development Index (HDI), stigma is widespread in Kerala and hence people with mental ill-health can internalise the public perceptions and become resistant to approach mental health facilities. Mental health literacy is proposed as an evidence based approach for enhancing tolerance, self-care, care for others and to reduce stigma. It is proposed that raising MHL can improve understanding about the risks to mental health, and methods of coping with these risks, thus promoting mental health for all. This project will extend partnerships and develop new collaborations between UK and Indian academics & researchers, service users, families, theatre practitioners and NGOs. Our plan is to conduct a multi-centre study using a 'theatre for development' (TFD) model, adopting a participatory approach to engage and empower urban and rural communities through co-production and co-creation of culturally appropriate knowledge and practice in promoting MHL. We will use participatory co-research methodology embracing the principles of co-production and use theatre and media for research engagement and data collection. Our mode of practice and co-production will draw heavily upon the methodologies employed under TFD but we will also incorporate and extend the community storytelling approaches in partnership with local communities and theatre workers to pilot an approach that allows communities, policymakers and professionals working with mental health to explore mental health as an issue of social justice and to promote MHL. It will do this by creating an interrogative performance space that brings together local practices and attitudes, professional orthodoxies, policy-related data and the latest understanding of mental illness in a way that allows multiple stakeholders to collectively imagine possible solutions. This project will also include widespread public engagement with people in creating mental health literacy through active public engagement programmes. The partnership will innovate and develop new knowledge by: (1) developing and promoting a culturally appropriate MHL programme (2) developing a participatory applied theatre model for promoting mental health literacy (3) co-producing a piece of applied theatre on MHL reflecting the lived experiences of urban and rural communities (4) public engagement of users, families and communities on talking about MHL and pathways of services. Our partnership will facilitate the development of lasting research partnerships combining knowledge of public mental health challenges with awareness of evidence based interventions and its cultural transferability, adding value to health humanities, mental health research and service development.