RENEE MONTAGNE, host:
We're going to hear now what it means to look for help for mental health problems in India. There aren't a lot of mental health professionals in India. A new study shows there is one psychiatrist for every 400,000 people. It means that most people in India go untreated for substance abuse problems, severe depression and psychotic disorders. Or, at least, they're not treated by doctors. Some turn to the gods. In the first of two reports on mental health in India, Miranda Kennedy traveled to a temple in southern India, where many people believe that the mentally ill can be healed.
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MIRANDA KENNEDY: The Hanumanthapuram temple is always packed with worshipers. They travel from across India for days and weeks, by bullock cart and on foot, to get to this lush, rural part of Tamil Nadu. They come because the powerful Hindu deity who lives here, an incarnation of Shiva, is supposed to purge evil spirits.
Ms. DAMA LAKSHMI: (Foreign language spoken)
KENNEDY: Dama Lakshmi is a tough, wiry woman in her 60s who talks nonstop -even as she slurps her plastic cup of chai, squatting on her haunches. She says that several years ago, evil spirits possessed her daughter, Manimagali. Her husband kicked her out and with her mother, she moved into the temple to wait to be cured. Manimagali's eyes are glazed over. Her mother says she often chants in a language she can't understand.
Ms. LAKSHMI: (Through Translator) She just started behaving very weirdly, and I believe it is because of evil magic. She will talk very filthy language and laugh to herself a lot.
KENNEDY: Faith healers and temple doctors are by far the most socially acceptable way to try to cure mental illness in India. There's hardly any psychiatrists, and a mere 37 mental institutions, to serve the country's whole population of 1.2 billion. But even if there were more professionals, it might not matter. Psychiatrists compete not with each another, but with healers and gurus.
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KENNEDY: Every morning at dawn, Manimagali files inside the temple with a group of somber, trance-like women. The women's saris are grubby, and many of them have allowed their hair to mat into dreadlocks - which is unheard of in a country where neatness is prized.
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KENNEDY: A priest draws back the curtain covering the idol of Shiva, and the women start to shriek and wail. It's as though the image of the god is actually bringing out their psychosis. They throw their bodies against the temple walls, and beat themselves with their fists. The temple priest forbade us from recording the loudest and most disturbing scenes. Porkodi, a social worker who goes by only one name, describes it this way.
PORKODI (Social worker): Each one gets into a trance. One is screaming, one is just shaking all over, one is rolling on the floor. And the bells are ringing. I've seen people calling the deity filthy names, also. This fit happens for about half an hour - and it subsides.
KENNEDY: Porkodi, the social worker, comes here a lot. She spends hours trying to cajole the mentally ill to visit a nearby psychiatric clinic. After she convinced Manimagali to go, the doctor told her she was schizophrenic. But her mother didn't have the money to keep paying for the anti-psychotics he prescribed. In any case, she felt more comfortable dealing with the gods. Porkodi sees that a lot.
PORKODI: People find it easier to say that their children or themselves are affected because of evil magic, because there is so much of stigma attached to mental illness. So in Hindi there is a saying: dawa bhi chahiye, duah bhi chahiye. Dawa is your medicines; duah is your prayers. So a bit of both only will help.
KENNEDY: India's official medical establishment does not agree with the bit-of-both theory. It wants nothing to do with traditional healers. But there are mental health professionals who are more flexible about it. Chris Fairburn is a professor of psychiatry at Oxford University, who helps fund mental health programs in India. After taking a tour of rural hospitals along bumpy roads in Tamil Nadu, he says it seems unrealistic to ignore how pervasive temple doctors are.
Professor CHRIS FAIRBURN (Professor of psychiatry, Oxford University): I think, for those of us interested in trying to work out how to deliver good mental health care to countries where there's very limited resources, we should think about what resources are there. We don't have to approve of them or necessarily condone what they do, but we should acknowledge their existence, and try and find out what they do.
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KENNEDY: Every day in India, medicine must do battle with religion. In Hanumanthapuram temple, it's pretty clear which one wins. After the morning ritual, the resident exorcist makes a dramatic entrance to the temple, wearing a saffron sari. Her face is painted with red and yellow powder, and she proudly wields a three-pronged spear to intimidate evil spirits. Only she is able to reach the god who resides in this temple, she tells Dama Lakshmi. She makes her an offer. She'll expel the spirits from her daughter, for the impossible price of $150.
For NPR News, I'm Miranda Kennedy.
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