Family Mental Health in India: A 10-Year Systematic Review

Abstract

Background: Mental health problems affect about 7-8% of India’s population. Families play a crucial role in care due to strong caregiving traditions. This review examines literature from 2015-2025 on family mental health in India, focusing on family dynamics, child and adolescent mental health within family contexts, and family-based interventions. Methods: Following PRISMA guidelines, we searched major databases for peer-reviewed Indian studies involving family factors in mental health. Quantitative, qualitative studies, and reviews were included. Data were thematically synthesized, and study quality assessed using the Mixed Methods Appraisal Tool, mostly rated moderate quality. Results: From 2,500 records, 50 studies met inclusion criteria, including cross-sectional, longitudinal, qualitative, and clinical trials. Supportive family environments were linked to better recovery in depression and schizophrenia, while conflict and criticism increased risk of depression, anxiety, and self-harm. Joint families, facilitating shared caregiving, correlated with lower psychiatric morbidity than nuclear families. Child and adolescent mental health issues ranged from 7-33%, often influenced by family discord, harsh parenting, and lack of parental attention. Children of parents with mental illness face disrupted routines, stigma, and caregiving stress. Family-based interventions, such as community collaborative care for severe mental illness and parent skills training for ADHD, improved symptoms and family relationships, though formal family therapy remains limited. About one-third of caregivers experience significant financial and emotional burden. Stigma within families delays help-seeking and isolates patients. Educating families reduces stigma and encourages treatment. Access to care often depends on family support, critical amid a 70-90% treatment gap in India. Conclusions: Family dynamics significantly affect mental health outcomes in India. Supportive families promote recovery, while conflict and burden increase risks. Wider implementation of family-focused interventions and stigma reduction through education and policy are essential.