Reimagining care: unravelling the psychological toll of tuberculosis through patient narratives in Mysuru, India-a qualitative study

Background: Tuberculosis (TB) remains a major public health issue in India, with significant psychological and social consequences. Despite medical advancements, the emotional toll of TB is often neglected. Stigma, isolation, and fear can adversely impact patients’ mental health and treatment adherence. The objective of the study was to explore the psychological experiences of TB patients and understand the psychosocial barriers affecting their treatment in Mysuru, India. Methods: A qualitative phenomenological study was conducted using in-depth interviews with 20 TB patients from public health facilities under the National Tuberculosis Elimination Programme (NTEP) in Mysuru. Participants were purposively sampled across age, gender, TB type, and treatment phase. Data were collected through semi-structured interviews in Kannada, focusing on emotional experiences, stigma, support systems, and treatment challenges. Depression was assessed using the patient health questionnaire (PHQ-9). Interviews were transcribed, translated, and thematically analyzed using NVivo 12. Results: Four major themes emerged: psychosocial burden, marked by stigma, isolation, and fear of mortality; barriers to adherence, including side effects and emotional strain; socioeconomic hardship, such as financial insecurity and lack of support; and stigma-driven avoidance of healthcare engagement. PHQ-9 scores indicated moderate to severe depression in nearly half the participants. Stigma and emotional distress significantly influenced patients’ willingness to seek care and follow treatment. Conclusions: TB patients face substantial psychological and social challenges. Integrating mental health support, addressing stigma, and providing economic aid are essential to enhance treatment adherence and patient well-being. A holistic, patient-centered approach to TB care is urgently needed.