The Wise Ones Are All Mad: Cultural Dimensions of Mental Illness in India
Authors:   , Tameez Hafsa 
Published: January 2025

<p><strong>This dissertation explores the gap mental health experts perceive between official and popular discourses about mental illness in India, focusing on how historical and cultural factors contribute to differing understandings rooted in different frameworks. It argues that current literature and dominant discourses about mental illness in India, particularly regarding stigma, are limited and influenced by colonial legacies. These legacies are commonly perceived to have shaped contemporary challenges in mental healthcare by restricting public awareness and fostering mistrust towards mental health institutions. However, this research calls for a broader understanding of mental illness in official medical discourses that transcends these colonial influences and acknowledges India's diverse cultural perspectives.</strong></p><p>Drawing from Foucault’s concept of differing bodies of knowledge for a comparative analysis of popular media and official mental healthcare manuals, the dissertation demonstrates that popular portrayals offer a distinct discourse on mental illness. The portrayals depict mental illness through a cultural lens, integrating social and spiritual explanations. These explanations contrast with the medical explanations in official texts and highlight how the official dominant framework fails to encompass this cultural complexity. This suggests that the perceived knowledge gap between experts and the public is more about differing and incompatible knowledge frameworks rather than a lack of understanding. This incompatibility can be traced to the power relations introduced to India during the colonial period, which established the dominance of Western medical frameworks over precolonial frameworks. Further employing Foucault’s concept of epistemic shifts, a historical analysis of understandings of madness in medical and popular texts during the periods when Siddha, Ayurveda, and Unani were the dominant medical systems suggests that precolonial knowledge relations were characterised by a certain kind of pluralism. These relations were disrupted by the colonial processes of knowledge production which imposed a dominant standardised, biomedical approach that dismissed alternative understandings. These colonial power dynamics remain today, in the dominance of the official medical discourses, established by dismissing popular understandings. This limits the official framework by constraining its ability to integrate alternative understandings, which has implications in India where the social and cultural explanations in conceptualising mental illness reveal that contemporary popular discourses continue to draw from historical ways of understanding madness. The narrow focus of the current medical frameworks fails to acknowledge the complexities of mental illness in the Indian context, and extends to the experts' interpretation of stigma, where public responses categorised as stigma might actually reflect historically shaped alternative understandings of mental illness in popular understandings. By highlighting the power dynamics inherent in knowledge production, the dissertation emphasises the need for a more integrated approach that recognises both historical and popular understandings of mental illness as alternative discourses. It suggests learning from the pluralistic precolonial processes of knowledge production to create more culturally attuned medical discourses today. Ultimately, this work advocates for the recognition of non-Western knowledge frameworks within the dominant Western frameworks to effectively address mental illness in India.</p>