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REVIEW ARTICLE
Year : 2021  |  Volume : 48  |  Issue : 3  |  Page : 138-144

Psychosocial burdens of women in India: A narrative review


1 Department of Medicine, College of Medicine, Shaqra University, Shaqra, Ar Riyadh, Saudi Arabia
2 Department of Psychology, St. Philimina College, Mysore, Karnataka, India

Date of Submission05-Aug-2021
Date of Acceptance17-Oct-2021
Date of Web Publication28-Dec-2021

Correspondence Address:
Dr. Dushad Ram
College of Medicine, Shaqra University, Shaqra, Ar Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_107_21

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  Abstract 


Various psychosocial factors play a vital role in mental health. India's rich cultural, traditional, and social value system is well-known throughout the world. However, a considerable proportion of women are disadvantaged in these systems, and as a result, they are more likely to experience a significant psychosocial burden that affects their physical, mental, social, and spiritual well-being. These psychosocial burden also have an impact on their quality of life, personal well-being, and some fundamental human rights. In the light of the current Indian situation, this narrative review depicts the psychosocial burden that a significant proportion of Indian women are likely to face.

Keywords: India, personal wellbeing, psychological wellbeing, psychosocial burden, quality of life, women mental health


How to cite this article:
Ram D, Mathew A. Psychosocial burdens of women in India: A narrative review. J Sci Soc 2021;48:138-44

How to cite this URL:
Ram D, Mathew A. Psychosocial burdens of women in India: A narrative review. J Sci Soc [serial online] 2021 [cited 2022 May 26];48:138-44. Available from: https://www.jscisociety.com/text.asp?2021/48/3/138/333837




  Introduction Top


Mental health refers to a condition of well-being in which a person recognizes his or her own abilities, can cope with everyday challenges, work productively and fruitfully, and contribute to his or her community. It is a condition of balance that is influenced by a variety of biopsychosocial elements. The psychological burden is one of the most important variables that influence mental health. Any psychological or social event that causes severe stress is referred to as a psychosocial burden. Women in India live in a unique biopsychosocial milieu that exposes them to psychosocial burdens and is frequently accepted as a normal part of life in our socio-cultural context. There is a scarcity of research in India that specifically examines the impact of psychosocial burden on women's overall well-being. In order to explore the psychosocial burden that Indian women are likely to suffer, we conducted this narrative review. We have searched online databases with Google Scholar, Scopus, PubMed, PsycINFO, and ResearchGate for eligible articles. Google search engine was used to search for nonacademic journal-based literature and relevant articles. Literature published from 1990 to the date of this review was included. The terms inserted include women and “social factors and mental health,” “mental illness,” “psychosocial consequences and mental illness,” “mental health and reproductive health,” “quality of life,” “psychological well-being,” “burden of care,” finally “personal wellbeing,” and “human right.” Studies and articles found were collated and reviewed to extract content related to the topic of this narrative review. We have included only those studies and articles that were addressed to or relevant to the Indian population.

Social factors affecting psychological health

Poverty has a substantial link to poor mental health.[1] Indian women are more likely to be impoverished because they are more likely to be unemployed, do unpaid domestic work, and be denied ancestral property.[2],[3] The second major national concern, illiteracy, particularly among women, causes a lack of awareness of healthy lifestyles, the inability to manage psychosocial problems rationally and efficiently, and a lack of mental health expertise.[4] Poor housing and abuse (which affects up to 42% of Indian girls) have a negative impact on mental health.[5],[6],[7] Other concerns that may have an adverse effect on mental health include gender discrimination, abortion of female fetuses, female foeticide, early marriage and childbirth, dowry practice, loss of autonomy, burden of care, poor support from in-laws, and family honor traditions.[8],[9]


  Common Mental Issues and Associated Psychosocial Factors Top


As previously mentioned, psychosocial factors have a substantial impact on mental health, and negative repercussions can be avoided.

Gender differences in utilization of mental health services

Women are more likely to obtain mental health treatments than men, and they are more likely to have various mental health issues.[10],[11] The treatment gap is anticipated to be greater in India due to significant stigma and a paucity of mental health services.[12]

Depression

Significant depression affects 10%–25% of Indian women, which is ½–2 times more than men. Abuse and trauma are frequently linked to depression, as are strained relationships, a poor social standing or home environment, and their values, a lack of support system, domestic obligations, and caring for children and aging parents, etc.[13]

Anxiety disorder

Anxiety disorder, like mood disorder, affects women more than males, especially specific phobias, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder.[14] Childhood abuse, physical and psychological abuse/trauma, and more anxious coping all contribute to the development of mental health problems at different stages of life.[15]

Self-harm and suicidal behavior

Self-harm and suicidal behavior are more common among women in India than among men,[16] notably among those who have experienced intimate partner violence, gender discrimination and bullying, stressful family and domestic life, and sexual abuse. They often do not have a support system and fewer options for dealing with stress.[17]

Personality disorder

Personality disorders are estimated to affect nearly half of the population, with the most frequent being borderline, histrionic, and anxious-avoidant.[18] Unavailability of one or both parents, remarriage of the father, witnessing parental abuse by family members, and an overcontrolling child-rearing style appear to have a part in the development of personality disorder in the Indian context.[19]

Premenstrual syndrome and postmenopausal syndrome

Premenstrual disorder affects 18%–58% of women of reproductive age. Backache, stomach bloating, sleeplessness, and widespread aches are all common symptoms. More domestic workload, tea or coffee use, early menarche, and a long menstrual cycle are all factors that may contribute to it. Menopause occurs at an average age of 45 years among Indian women, and it is connected to multipara status, substance misuse, financial issues, and a lack of support.[20]

Perinatal mental disorders

Postpartum depression affects about 22% of women, however, patterns vary. It is the most common in the south, followed by eastern and western India. Family history of mental illness, financial issues, marital conflict, domestic violence, lack of support from spouse, female birth, and husband's alcohol usage are all common associated psychosocial factors.[21] The prevalence of postpartum psychosis is unknown. Bipolar disorder and schizophrenia tend to be more common in those who have had a past or familial history of psychosis, or who have had psychosis during a previous pregnancy. Severe life experiences, persistent stress, and strained relationships with spouse are all common social cause.[22]

Medically unexplained symptoms

The somatoform disorder affects about 6% of women, with those with a lower socioeconomic position and less education being more likely to be affected. Depression, anxiety disorder, and chronic fatigue syndrome are all common comorbidities. Headache, fibromyalgia, persistent pelvic pain, generalized body soreness, and exhaustion are some of the most prevalent symptoms. Women with somatoform disorder are more likely to report trauma, abuse, neglect, or violence.[23]


  Psychosocial Consequences of Mental Illness Top


Women with mental illnesses are more likely to be separated from society and their families, to be subjected to physical, sexual, and psychological abuse, to be neglected, and to be treated inhumanely.[24] The majority would lose their ability to make their own decisions, and they would be denied access to health care, education, and work, as well as vocational training, career development opportunities, and community participation.[25] Partner violence and divorce are more likely to occur in their lives.[24]


  Psychosocial Aspects of Women's Reproductive Health Top


During pregnancy and childbirth

During the perinatal and menstrual periods, a considerable proportion of women have a syndrome of abnormal mental health, as mentioned above. Approximately 80% of women, particularly those who have experienced abuse, have concerns and fears about their pregnancy and the challenges associated with delivering. Fears regarding maternal and infant health, childbirth pain, mode of birth, uncertainty, the future role of life, family reaction to the female child or unwanted child, pregnancy difficulties, and procedures such as cesarean section or assisted birth are all prevalent concerns.[26] Worries, fear, and sadness may intensify in the Indian situation due to a lack of support, lack of autonomy in decision-making, insufficient antenatal care, demand for the delivery of a male baby, and a lack of proper counseling and perinatal psychological services.

Influence on fertility

Education, occupation, urban/rural residency, couple interpersonal interactions, in-law influences, preference for the child's gender, religious belief system, and family support system are all elements that mediate fertility control.[27] In India, most choices are made by the husband, who is frequently influenced by his in-laws. Despite progress, a large percentage of pregnancies are unplanned, and women are mentally unprepared to bear a child.[28] Women are also pressured by societal and cultural norms to have children as soon as feasible after marriage. If a woman struggles with infertility, the psychological toll can be severe. It affects roughly 8% of women and is frequently accompanied by marital conflict, abuse, a drop in sexual relationships, the need for personal adjustment, depression, anxiety, and a reduced quality of life, as well as suicidality.[29]

Pregnancy loss

About 47 abortions per 1000 women aged 15–49 years are performed.[30] Due to stigma and socio-cultural considerations, induced pregnancy loss is more common among women who are unmarried. Another determinant of female foeticide is the desire for a male child, which is often influenced by socio-cultural variables. Almost half of women who have experienced a miscarriage suffer from posttraumatic stress disorder and depression.[31] Most women who have experienced a miscarriage are unlikely to seek professional care for their psychological issues, and there are insufficient psychosocial resources available to them.

Menopause

Aside from postmenopausal syndrome, over half of all women going through menopause have psychological issues. Irritability, anxiety, and a gloomy mood are all common psychological symptoms. Menopause is often accompanied by severe sexual dysfunction.[32] Menopause is frequently associated with mourning for lost fertility, youth, and attractiveness, as well as a perception of being less valuable, and this is a time when women must refocus their lives. The majority of people would rarely seek psychological counseling and regard it to be a regular part of life.[33]

Gynecological conditions

Dysmenorrhea is the most frequent gynecological issue in India, affecting 50%–87.8% of women and accompanied by worry, impatience, difficulties concentrating, insomnia, forgetfulness, tension, anticipatory anxiety, and a poor quality of life. Another prevalent gynecological illness is reproductive tract infection, which affects up to 50% of all women of reproductive age.[34] Depression, anxiety, somatoform illness, culture-bound syndrome, and sexual dysfunction are all common companions. Those with a lower socioeconomic and educational standing are more likely to have these symptoms.[35]


  Human Rights Issue that Affects Psychological Health Top


Gender inequality (particularly in the workplace),[36],[37] gender discrimination (leading to gender-based violence, physical and sexual abuse, and low-or subordinate social status),[23] barriers to education,[38] and insufficient provision to use the right to health protection are all common human rights issues that women face (83% treatment gap),[12] property rights restrictions (financial instability),[24] no protection from unemployment (psychosomatic illness)[39],[40] and, most crucially, the struggle for the right to dignity (rape, restriction, acid attacks, witch hunting, domestic violence).[41]


  Factors Affecting Quality of Life Top


Quality of life refers to a person's perspective of their position in life in relation to their objectives, expectations, standards, and concerns, as well as the culture and value systems in which they live. It denotes the goodness of a multiple aspect of life.

Physical health

According to the World Health Organization, maternal mortality is at 145 per 100000 live births, with a 70-year life expectancy. Both communicable and non-communicable diseases have a higher morbidity rate in Indian women.[42] Malnutrition, poor maternal health, anemia, reproductive health difficulties, sexually transmitted infections, and noncommunicable illnesses are among the most common health problems encountered. Poverty, illiteracy, insufficient health care, poor environmental hygiene, social and cultural pressures, early pregnancy, early marriage, and unsafe abortion are all psychosocial variables that influence these health issues.[43]

Psychological health

In India, roughly 7.5% of women suffer from severe mental problems. However, nearly half of adult females suffer from a less serious mental illness.[12] Due to a variety of psychological issues, women have lower self-esteem and are more likely to experience negative emotions than men.[44] Advertisements put pressure on girls regarding their beauty and appearance concerns, and nearly two-thirds of women aim to be a lower body weight than their current, which has an impact on their quality of life.[45]

Level of independence

Indian women are less self-reliant than their counterparts in the West. They are frequently denied the freedom to leave the house, have limited social freedom, are excluded from decision-making, have little influence over money, and are less likely to seek good health care.[46] There are enormous barriers to women joining the labor sector; the majority wish to work but end up with home responsibilities or even occupations that pay less.[47]

Social relationships

Conflict in partnerships, especially when both partners work, is not unusual. Role conflict as a growing daughter, working girl, wife (homemaker), and working married woman[48] are the key conflicts. More than half of working women have a high level of work-family conflict, and 90% of them are stressed out, owing to various roles, which can lead to strained interpersonal relationships at home or at work, as well as predispose them to psychological illness.[49] The preference for a nuclear family diminished social support at the household level, all leaves women to fret and fight their problems alone. Good social support, on the other hand, can improve both physical and mental health.[50]

Environment

In India, women's safety in public places is still a concern. In a public place, about half of all women are harassed, especially in isolated areas.[51] At least 43% of women are subjected to violence, and India is ranked as the fourth most hazardous country for women in the world.[52] Leisure, sport, and recreation are not in the vocabulary of the average Indian woman. Time and accessibility constraints, safety concerns, cultural and societal norms, inadequate support systems, and financial constraints are all common roadblocks.[53],[54],[55]

Spirituality/religion/personal beliefs

Religious tradition, culture, and social standards appear to influence spiritual wellness. When women are in distress, they are more inclined than men to believe that it is God's will that they are left helpless rather than striving to find solutions to solve the problem. They are more inclined to accept their current living status if they do not take personal responsibility and strive for the best.[56] This, in turn, has a negative impact on one's quality of life.


  Psychological Well-being of Indian Women Top


Feeling good and being able to function effectively are two aspects of psychological well-being. It is a dynamic state in which a person finds contentment and happiness by balancing demanding and rewarding life events. People who are in good mental health are more likely to have better and longer lives. Homemakers are known to have low psychological well-being.[57] Low self-efficacy (the ability to fulfill goals) and self-acceptance (a favorable attitude toward one's own life) make individuals more vulnerable to stress.[58],[59],[60] Low autonomy (perceived level of self-determination and independence) is often associated with cultural and religious conservatism and a lack of education.[61],[62] Control over finance, decision-making power, and freedom of mobility are all individual variables that influence perceived autonomy.[63] According to a government report, 57% of women do not have domestic autonomy or the flexibility to leave the house.[64] Similarly, according to another study, 35% of women lack financial autonomy, 62% lack freedom of travel, and 72% lack household decision-making autonomy.[65] The concept of Life's (feeling of purpose and meaning) remains ambiguous or unrealized. The majority of people aspire to play a domestic role in their lives, rather than any other aim, although this tendency is changing. Positive relationships (warm, gratifying, and trusting interactions with others) vary by socioeconomic status, but males are often assigned a role that determines the types of relationships that a woman can have. In India, romantic relationships or cross-cultural marriage are still frowned upon. Domestic violence affects about 41% of women, indicating a lack of interpersonal interactions in the home.[66]


  Burden of Care Top


Gendered expectations of care and societal sanction encourage women to take on the role of caregiver. Because of their unemployment status, societal, and cultural conventions, women make up between 57% and 81% of caretakers for the elderly. They have role conflict, role strain, and role overload because they play various roles such as spouses, daughters, mothers, or employees. They were more likely to have physical and mental health problems as a result of role conflict and role strain.[67] Brinda et al. reported that when an Indian woman is caring for a common physical ailment such as cerebrovascular disease, Parkinson's disease, greater disability, urine incontinence, or insomnia, she spends on average 38 h per week caring for them and about 10% of them get depression.[68] Leaving them apart, they also spend 15.2 h a day on routine family care duties and 8.4 h on home chores, with the latter being longer for rural women.[69]


  Personal Wellbeing Top


Personal well-being is the most desirable and best state of one's existence or life. A significant fraction, particularly in rural areas, has adapted their lives to a low standard of living.[70] Women's poor health is a key topic that has piqued the government's interest. In the 2015–2016 National Family Health Survey, 22.4% of women were underweight, with 54.4% having anemia linked with it.[71] According to the 2011 census, just 47% of women have access to a toilet, 46.6% have access to drinking water on the premises, 32% are uneducated females, and 24% are currently employed but the house is overcrowded.[72] The gynecological illness affects 75.73% of women and has a negative impact on their quality of life.[73]


  What Needs to be Done Top


In India, more work needs to be done to alleviate women's mental burdens. The first priority should be to alter one's social status. Literacy, employment, fundamental human rights protection, friendly relationships with family and community members, and providing basic amenities and facilities should all be prioritized. There should be a universal, simple access to physical and mental health care, as well as mental health education for women. The government should promote women's empowerment measures and firmly enforce provisions for women's safety and welfare, and a zero-tolerance policy is required.


  Emerging Hopes Top


Women's education has steadily increased, from 8.9% in 1951 to over 57% in 2004. Education has improved the entire quality of life and psychological health by bringing obvious changes in social and economic standing.[74] Women's help-seeking behavior is mediated by education, which helps them gain autonomy.[75] It is hypothesized that changes in overall mental health knowledge and access to mental health treatments among women will occur as a result of social changes in the 21st century.[63] Women are being empowered through constitutional provisions, government policies that allow more chances for work, and participation in nation-building efforts. The government has taken no significant steps to improve women's psychological health. Some changes in the field of mental health to provide health services are expected to be beneficial. The number of mental health experts has gradually increased over time, and the psychiatrist-to-population ratio has improved. The district mental health program is a wonderful idea for providing comprehensive mental health care to the general public, and women's mental health can be prioritized. The Indian Medical Council has included psychiatry in the MBBS curriculum, which may raise awareness of women's mental health among future medical graduates. For the first time, India's government has developed a comprehensive mental health strategy for the entire country. To address the demand on a large scale throughout India, the Indian psychiatric society has organized a Committee on Women Mental Health. Several studies and articles have been published in social media to raise awareness and underline these concerns among Indian psychiatrists. Many NGOs are striving to prevent women's abuse, which may have a role in the developing mental illness. Despite the lack of statistics, there appears to be a minor reduction in stigma as a result of increased knowledge about mental illness propagated through print and electronic media. The ease with which the educated can obtain information has revolutionized the distribution of information, and the majority of mental health-related material is accessed through media.[75]


  Conclusions Top


In India, women are subjected to enormous psychosocial burdens. The bulk of the burden stems from a variety of factors, including societal value systems, culture, tradition, illiteracy, poverty, and so on. Psychosocial burden has an impact on overall mental health. This is an issue that needs to be addressed at all levels. Mental health professionals play a vital role in identifying the hidden psychological burden and taking it into account when dealing with mental health difficulties.

Acknowledgment

The authors would like to thank Yahosha, Shamaya, Hagai, Asther, Yasuas, Marias (Divine Retreat Centre, Chalakudy, Kerala, India), Ashish, and Mini for their moral support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, et al. Poverty and mental disorders: Breaking the cycle in low-income and middle-income countries. Lancet 2011;378:1502-14.  Back to cited text no. 1
    
2.
Mitra K, Pool GR. Why women stay poor: An examination of urban poverty in India. Soc Change 2000;30:153-78.  Back to cited text no. 2
    
3.
WHO. World Health Organization and Calouste Gulbenkian Foundation. In: Social Determinants of Mental Health. Geneva: World Health Organization; 2014.  Back to cited text no. 3
    
4.
Cutler DM, Lleras-Muney A. Education and Health: Insights from International Comparisons. Cambridge, MA, USA: National Bureau of Economic Research (NBER); 2012.  Back to cited text no. 4
    
5.
Pevalin DJ, Reeves A, Baker E, Bentley R. The impact of persistent poor housing conditions on mental health: A longitudinal population-based study. Prev Med 2017;105:304-10.  Back to cited text no. 5
    
6.
Loveleen K, Srinivas V, Kumar P. Study on Child Abuse: India 2007. New Delhi: Ministry of Women and Child Development, Government of India; 2007.  Back to cited text no. 6
    
7.
Choudhry V, Dayal R, Pillai D, Kalokhe AS, Beier K, Patel V. Child sexual abuse in India: A systematic review. PLoS One 2018;13:e0205086.  Back to cited text no. 7
    
8.
Ganiger S, D'Souza AA. A study on perception and prevalence of gender discrimination in an urban family setup. Contem Res India 2013;3:57-61.  Back to cited text no. 8
    
9.
Vigod SN, Rochon PA. The impact of gender discrimination on a woman's mental health. EClinicalMedicine 2020;20:100311.  Back to cited text no. 9
    
10.
Astbury J. Gender disparities in mental health. In: Mental Health. Ministerial Round Tables 2001, 54th World Health Assembly. Geneva: World Health Organization; 2001.  Back to cited text no. 10
    
11.
Fitzgerald P, Dinan TG. Biological sex differences relevant to mental health. In: Kohen D, editor. Oxford Textbook of Women and Mental Health. Oxford: Oxford University Press; 2010. p. 30-41.  Back to cited text no. 11
    
12.
Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K, Singh LK, et al. National Mental Health Survey of India, 2015-16: Prevalence, Patterns and Outcomes. Bengaluru: National Institute of Mental Health and Neuro Sciences; 2016. p. 90-121.  Back to cited text no. 12
    
13.
Bohra N, Srivastava S, Bhatia MS. Depression in women in Indian context. Indian J Psychiatry 2015;57:S239-45.  Back to cited text no. 13
    
14.
Trivedi JK, Gupta PK. An overview of Indian research in anxiety disorders. Indian J Psychiatry 2010;52:S210-8.  Back to cited text no. 14
[PUBMED]  [Full text]  
15.
Hantsoo L, Epperson CN. Anxiety disorders among women: A female lifespan approach. Focus (Am Psychiatr Publ) 2017;15:162-72.  Back to cited text no. 15
    
16.
O'Connor RC, Wetherall K, Cleare S, Eschle S, Drummond J, Ferguson E, et al. Suicide attempts and non-suicidal self-harm: National prevalence study of young adults. BJPsych Open 2018;4:142-8.  Back to cited text no. 16
    
17.
Vijayakumar L. Suicide in women. Indian J Psychiatry 2015;57:S233-8.  Back to cited text no. 17
[PUBMED]  [Full text]  
18.
Gupta S, Mattoo SK. Personality disorders: Prevalence and demography at a psychiatric outpatient in North India. Int J Soc Psychiatry 2012;58:146-52.  Back to cited text no. 18
    
19.
Choudhary S, Gupta R. Culture and borderline personality disorder in India. Front Psychol 2020;11:714.  Back to cited text no. 19
    
20.
Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry 2015;57:S222-32.  Back to cited text no. 20
    
21.
Upadhyay RP, Chowdhury R, Salehi A, Sarkar K, Singh SK, Sinha B, et al. Postpartum depression in India: A systematic review and meta-analysis. Bull World Health Organ 2017;95:706-717C.  Back to cited text no. 21
    
22.
Rai S, Pathak A, Sharma I. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry 2015;57:S216-21.  Back to cited text no. 22
    
23.
Prerana G, Jigar H, Singh S, Shweta C, Singh S, Ibrahim A, et al. Somatization disorder: Are we moving towards an over-generalized and over-inclusive diagnosis in DSM-V? Acta Med Int 2017;4:110-9.  Back to cited text no. 23
  [Full text]  
24.
Moorkath F, Vranda MN, Naveenkumar C. Women with mental illness – An overview of sociocultural factors influencing family rejection and subsequent institutionalization in India. Indian J Psychol Med 2019;41:306-10.  Back to cited text no. 24
[PUBMED]  [Full text]  
25.
WHO. World Mental Health Day 2015: Dignity and Mental Health. Available from: https://www.who.int/mental_health/world-mental-health-day/infosheet_wmhd2015.pdf?ua=1. [Last accessed on 2020 May 23].  Back to cited text no. 25
    
26.
Rondung E, Thomtén J, Sundin Ö. Psychological perspectives on fear of childbirth. J Anxiety Disord 2016;44:80-91.  Back to cited text no. 26
    
27.
Standley T. Psychosocial aspects of fertility control. In: Harrison RF, Bonnar J, Thompson W, editors. Fertility and Sterility. Dordrecht: Springer; 1984.  Back to cited text no. 27
    
28.
Sarder A, Islam SM, Maniruzzaman, Talukder A, Ahammed B. Prevalence of unintended pregnancy and its associated factors: Evidence from six south Asian countries. PLoS One 2021;16:e0245923.  Back to cited text no. 28
    
29.
Jisha PR, Thomas I. Psychological aspects in infertility: A comparative study. IOSR J Humanit Soc Sci 2017;22:88-95.  Back to cited text no. 29
    
30.
Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health 2018;6:e111-20.  Back to cited text no. 30
    
31.
Kotta S, Molangur U, Bipeta R, Ganesh R. A cross-sectional study of the psychosocial problems following abortion. Indian J Psychiatry 2018;60:217-23.  Back to cited text no. 31
[PUBMED]  [Full text]  
32.
Agarwal AK, Kiron N, Gupta R, Sengar A, Gupta P. A study of assessment menopausal symptoms and coping strategies among middle age women of North Central India. Int J Community Med Public Health 2018;5:4470-7.  Back to cited text no. 32
    
33.
Singh N, Shinde M, Dafal H, Trivedi A, Chouhan Y. Age at natural menopause and factors affecting menopausal age: A cross-sectional study among postmenopausal female attendees of obstetrics and gynecology outpatient department. Int J Med Sci Public Health 2018;7:994-1001.  Back to cited text no. 33
    
34.
Beaulah P. Prevalence of gynaecological problems and their effect on working women. Indian J Contin Nurs Educ. 2018;19:103-8.  Back to cited text no. 34
    
35.
Patel V, Oomman N. Mental health matters too: Gynecological symptoms and depression in South Asia. Reprod Health Matters 1999;7:30-8.  Back to cited text no. 35
    
36.
Yu S. Uncovering the hidden impacts of inequality on mental health: A global study. Transl Psychiatry 2018;8:98.  Back to cited text no. 36
    
37.
Patten SB. Are the Brown and Harris “vulnerability factors” risk factors for depression? J Psychiatry Neurosci 1991;16:267-71.  Back to cited text no. 37
    
38.
Vijayalakshmi P, Ramachandra, Nagarajaiah, Reddemma K. Does a woman with mental illness have human rights? Indian J Psy Nsg 2013;5:47-52.  Back to cited text no. 38
  [Full text]  
39.
Van Klaveren M, Tijdens KG, Martin NE, Hughie-Williams M. An Overview of Women's Work and Employment in India. Decisions for Life MDG3 Project Country Report No. 13. Amsterdam: University of Amsterdam; 2010.  Back to cited text no. 39
    
40.
Ishmuhametov I, Palma A. Unemployment as a factor influencing mental wellbeing. Procedia Eng 2017;178:359-67.  Back to cited text no. 40
    
41.
Human Rights Now (HRN). Protection of Lives and Dignity of Women: Report on Violence against Women in India. Tokyo: HRN; 2010.  Back to cited text no. 41
    
42.
Bora JK, Saikia N. Gender differentials in self-rated health and self-reported disability among adults in India. PLoS One 2015;10:e0141953.  Back to cited text no. 42
    
43.
Kowsalya R, Manoharan S. Health status of the Indian women – A brief report. MOJ Proteomics Bioinform 2017;5:109-11.  Back to cited text no. 43
    
44.
Nupur C, Mahapatro M. Gender differences in self esteem among young adults of Raipur, Uttar Pradesh, India. Austin J Womens Health 2016;3:1018.  Back to cited text no. 44
    
45.
Rekha VS, Maran K. Advertisement pressure and its impact on body dissatisfaction and body image perception of women in India. Glob Media J 2012;3:1-9.  Back to cited text no. 45
    
46.
Gailits N, Mathias K, Nouvet E, Pillai P, Schwartz L. Women's freedom of movement and participation in psychosocial support groups: Qualitative study in northern India. BMC Public Health 2019;19:725.  Back to cited text no. 46
    
47.
Fletcher E, Pande R, Moore C. Women and Work in India: Descriptive Evidence and a Review of Potential Policies, Faculty Research Working Paper Series. RWP18-004; 2018. Available from: https://www.hks.harvard.edu/publications/women-and-work-india-descriptive-evidence-and-reviewpotential-policies. [Last assessed on 2020 May 12].  Back to cited text no. 47
    
48.
Pandit S, Upadhaya S. Role conflict and its effect on middle class working women of India. J Bus Manag 2012;4:35-7.  Back to cited text no. 48
    
49.
Somashekher C. Work – Family conflict among women employees in Bangalore city. Int J Res Sociol Anthropol 2018;4:1-7.  Back to cited text no. 49
    
50.
Asnani V, Pandey UD, Sawhney M. Social support and occupational health of working women. J Health Manag 2004;6:129-39.  Back to cited text no. 50
    
51.
Mahadevia D, Lathia S. Women's safety and public spaces: Lessons from the Sabarmati river front, India. Urban Plan 2019;4:154-68.  Back to cited text no. 51
    
52.
Bohra N, Sharma I, Srivastava S, Bhatia MS, Chaudhuri U, Parial S, et al. Violence against women. Indian J Psychiatry 2015;57:S333-8.  Back to cited text no. 52
    
53.
Kaim D. Barriers to women's participation in sport and active recreation. Int J Phys Educ Sports Health 2015;2:96-8.  Back to cited text no. 53
    
54.
Singh C, Kumar R. Financial literacy among women – Indian scenario. Univers J Acco Finance 2017;5:46-53.  Back to cited text no. 54
    
55.
Richardson T, Elliott P, Roberts R, Jansen M. A longitudinal study of financial difficulties and mental health in a national sample of British undergraduate students. Community Ment Health J 2017;53:344-52.  Back to cited text no. 55
    
56.
Bhatnagar S, Gielen J, Satija A, Singh SP, Noble S, Chaturvedi SK. Signs of spiritual distress and its implications for practice in Indian palliative care. Indian J Palliat Care 2017;23:306-11.  Back to cited text no. 56
[PUBMED]  [Full text]  
57.
Krishna KR. Psycho-social wellbeing of mid age Indian women of different societal lifestyle. Indian J Appl Res 2017;6:144-5.  Back to cited text no. 57
    
58.
Varma R. Computing self-efficacy among women in India. J Women Minor Sci 2010;16:257-74.  Back to cited text no. 58
    
59.
Maqbool M. A comparative study on self-concept of employed and unemployed women. Indian Streams Res J 2014;4:1-7.  Back to cited text no. 59
    
60.
Anand K, Nagle YK. Perceived stress as predictor of psychological well-being among Indian youth. Int J Indian Psychol 2016;3:211-7.  Back to cited text no. 60
    
61.
Anbumalr C, Agines DP, Jaswanti VP, Angelin RD. Gender differences in perceived stress levels and coping strategies among college students. Int J Indian Psychol 2017;4:22-33.  Back to cited text no. 61
    
62.
Banerjee S, Roy A. Determinants of female autonomy across Indian states. J Econ Bus Manage 2015;3:1037-40.  Back to cited text no. 62
    
63.
Bloom SS, Wypij D, Das Gupta M. Dimensions of women's autonomy and the influence on maternal health care utilization in a north Indian city. Demography 2001;38:67-78.  Back to cited text no. 63
    
64.
Gupta K, Yesudian PP. Evidence of women's empowerment in India: A study of socio-spatial disparities. Geo J 2006;65:365-80.  Back to cited text no. 64
    
65.
Sabarwal S, Santhya KG, Jejeebhoy SJ. Women's autonomy and experience of physical violence within marriage in rural India: Evidence from a prospective study. J Interpers Violence 2014;29:332-47.  Back to cited text no. 65
    
66.
Kalokhe A, Del Rio C, Dunkle K, Stephenson R, Metheny N, Paranjape A, et al. Domestic violence against women in India: A systematic review of a decade of quantitative studies. Glob Public Health 2017;12:498-513.  Back to cited text no. 66
    
67.
Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family – caregivers of people with mental illnesses. World J Psychiatry 2016;6:7-17.  Back to cited text no. 67
    
68.
Brinda EM, Rajkumar AP, Enemark U, Attermann J, Jacob KS. Cost and burden of informal caregiving of dependent older people in a rural Indian community. BMC Health Serv Res 2014;14:207.  Back to cited text no. 68
    
69.
Sengupta S, Sachdeva S, Chigateri S, Zaidi M, Chopra D. From Double Burden of Women to a “Double Boon”: Balancing Unpaid Care Work and Paid Work. Policy Brief. Brighton, England: Institute of Development Studies; 2017.  Back to cited text no. 69
    
70.
Weich S, Lewis G. Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain. J Epidemiol Community Health 1998;52:8-14.  Back to cited text no. 70
    
71.
Bharati S, Pal M, Sen S, Bharati P. Malnutrition and anaemia among adult women in India. J Biosoc Sci 2019;51:658-68.  Back to cited text no. 71
    
72.
Mishra US, Shukla V. Provision of basic household amenities in India: A progress report. Soc Change 2015;45:421-39.  Back to cited text no. 72
    
73.
Inamdar IF, Priyanka SC, Doibale MK. Gynaecological morbidities among ever married women: A community-based study in Nanded city, India. J Dent Med Sci 2013;7:05-11.  Back to cited text no. 73
    
74.
Nair N. Women's education in India: A situational analysis. IMJ 2010;1:100-14  Back to cited text no. 74
    
75.
Loganathan S, Kreuter M. Audience segmentation: Identifying key stakeholders for mental healthliteracy interventions in India. J Public Ment Health 2014;13:159-70.  Back to cited text no. 75
    




 

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  In this article
Abstract
Introduction
Common Mental Is...
Psychosocial Con...
Psychosocial Asp...
Human Rights Iss...
Factors Affectin...
Psychological We...
Burden of Care
Personal Wellbeing
What Needs to be...
Emerging Hopes
Conclusions
References

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