Title: Women's Narratives on Illness and Institutionalization in India
Description: In India, various underlying gender related structural factors (i.e., interpersonal violence, lack of social supports, limited opportunities, poverty, and gender biases in mental health practice) serve to keep women living with serious mental illness isolated in psychiatric institutions. Despite this, narratives of women living with serious mental illness and their experiences within institutions have received limited visibility in research. The present study addresses this crucial gap by documenting the lives of women who are former inpatients of a mental hospital and are currently residing at a halfway home in India. I adopted a social constructivist narrative approach to incorporate women’s experiences and examine the context and ways in which their experiences were shaped and situated. Specifically, the study explored the following questions. 1. How do women describe their experiences and perceptions related to the illness and living at a psychiatric institution (i.e., mental hospital and the halfway home)? 2.

What are the physical and social characteristics of the halfway home serving women living with serious mental illness in India? I answered the first question using narrative data, collected through 34 in-depth interviews with 11 women residents at the halfway home, I examined the second question using field notes that included everyday observations and interactions with women residents, staff members, and interviews with the Director, the Psychologist, the Social Worker, and the Head Housemother at the halfway home. Thereafter, using the theories of self-in-relation (Miller, 1976; Surrey, 1985), institutionalization (Goffman, 1961), and intersectionality (Crenshaw, 1990), I dissect the two research questions further to analyse how women’s experiences and perceptions related to illness and institutionalization are shaped by their gender and social positioning. Using a gender lens, I also critically examine the psychosocial rehabilitation program at the halfway home and ways in which it supports women living with serious mental illness.

I used Fraser (2004) guidelines to analyse the narrative data and Emerson, Fretz & Shaw (1995) guidelines to analyse field notes. Women’s narratives highlight that gender and social positioning significantly shape their experiences of living with mental illness in India. Women perceived their discriminatory social context, particularly restrictive gender norms, a lifetime of denied opportunities, loss of relationships, and violence both in the natal and marital family as factors that contributed and/or exacerbated their illness experiences. Women’s narratives of institutionalization were also embedded in discriminatory social contexts. Poverty and gender disadvantage were the primary reasons for women’s admission to mental hospitals. Furthermore, the shift in care from institutions like mental hospitals to less restrictive institutions like the halfway home did not necessarily improve the lives of women living with serious mental illness. Women share several gender-specific barriers to leaving the halfway home.

Furthermore, psychiatric institutions often mirrored patriarchal social relations by perpetuating illness and gender related biases in the delivery of care.