Paper short abstract:

This paper examines intersections between experiences of `diagnosis', `access', `care' and `recovery' by those affected by mental health difficulties in India. Contextualizing the local significance of these concepts may open up new ways of engaging with individuals, families, and communities.

Paper long abstract:

Global mental health discourses interpret `access to care' as increasing availability of personnel and interventions. This assumes that diagnosis leads to treatment and re-emergence of a `recovered' subject. This trajectory does not consider the subjective experiences of individuals, families and communities who seek to 'access' interventions. This paper examines intersections between experiences of `diagnosis', `access', `care' and `recovery' by individuals and families affected by mental health difficulties in northern India. Drawing on ethnographic research (2004 - 2014) that maps understandings of 'distress', help-seeking trajectories, and (non) engagement between communities and a state mental health program, this paper reports on a data-subset of longitudinal ethnographic interviews with individuals, families and service providers. Mapping the relationships between `access to care, `diagnosis' and 'recovery', requires an understanding of the local particularities and tracing of how the production of diagnosis impacts 'recovery journeys'. A central question that emerges is - access to `what'? In the absence of culturally accessible mental health provision, the `what' that people access are the inner resources of their selves, families and communities to creatively seek multiple forms of care, whilst attempting to make sense of their 'distress'. The research suggests the importance of examining 'recovery journeys' through lenses of social exclusion, including gender and caste. Technical-universal conceptualizations of `access' and `care' obscure individual & collective decisions and actions in response to distress. Contextualizing the local significance of 'diagnosis', 'access', 'care', and 'recovery' may open up new ways of engaging with those suffering from mental health difficulties, their families and communities.