Personal Narrative on Mental Health, Recovery, and the Intricacies of Treatment - As Told by Kali
In the heart of India, the struggles of marginalized individuals like Roshni and Jyoti serve as a stark reminder of the challenges faced in the realm of mental health care.
Roshni, a woman from a tribal district, developed schizophrenia postpartum and was abandoned by her husband. She endured abuse and neglect until she was connected to telepsychiatry services and community support, which significantly improved her condition. Jyoti, another resident of the same district, had intellectual disabilities and behavioral challenges, and lacked family support, requiring institutional rehabilitation for safety and care.
These cases underscore the need for compassionate, timely, and community-based approaches rather than solely medical models. Mental health professionals advocate for integrating services within existing community development efforts to reduce stigma and improve acceptance. This approach is exemplified by rural digital intervention programs like Atmiyata, which trains community volunteers to identify mental illnesses and raise awareness, reducing stigma through peer contact and embedding services locally.
At the systemic level, India’s National Mental Health Programme (NMHP) and its District Mental Health Program (DMHP) provide frameworks for community-based care involving multidisciplinary teams at district levels. Telepsychiatry initiatives like Tele MANAS enhance access to services, especially in remote or underserved areas.
However, caregivers in such settings face numerous hardships, including social isolation, stigma, and lack of support. Professionals highlight the importance of community education, family involvement, and rights-based approaches to ensure dignity and inclusion for marginalized patients.
The tragic story of Beeni's sister serves as a grim reminder of the consequences of problematic responses to mental distress. Beeni's sister, a woman in her 40s from a northern tribal community, experienced psychosis that ended in her tragic and violent death by stoning for behavior that people considered irrational and unreasonable. Kali, another victim, was a member of the same community and had wandered away from home, possibly due to a lack of access to mental healthcare and immense disadvantage. Kali refused medicines but enjoyed conversations and acknowledged and validated friendship offers. She was eventually carried to the hospital, where she died.
In contrast, Vani, a woman who struggled with mental health issues and had a deep, unconventional way of thinking and loving, questioned the role of work in recovery, the role of boundaries and power in therapeutic relationships, and the use of contemplative discussions as a tool to heal. Vani believed in the use of contemplative discussions as a tool to heal, as did the author.
The author and their colleague cared for Kali until her death, which took an emotional toll on them. Vani, too, was cared for by the author and their team, and her last days were marked by hope and resilience. Despite her struggles, Vani was hooked on to an oxygen concentrator, smiling and chatty even in her last days. She once said, 'I'm happy because I'm alive.'
The natural question that comes to one's mind is: How does one accompany someone through suffering in a manner that is supportive for the mind, to seek some semblance of calm and peace? A healing space is described as where one feels heard, understood, able to express inner thoughts freely, able to watch TV and read favourite books, part love, part food, part care, part entertainment, and friendship, and where one can work.
The author wishes that diversity might be embraced and individual or institutional disagreements forgotten. Ideological rigidness and intellectual reductionism replaced collective attention and exploration in the discourse on mental health. The author hopes that all forms of stifling are challenged, and unjust barriers are broken, and that mental health is demystified, and many engage freely in conversations and contribute towards the advancement of mental health sciences.
In 2025, the authors and their team have cremated and buried over 600 people. The case study of mental health care for marginalized communities in India reveals significant challenges and some promising community and rights-based interventions. Yet, the journey towards comprehensive and compassionate mental health care for all continues.
[1] Atmiyata: A Rural Digital Intervention for Mental Health in India. (n.d.). Retrieved March 11, 2023, from https://www.atmiyata.in/ [2] National Mental Health Programme (NMHP) and District Mental Health Program (DMHP). (n.d.). Retrieved March 11, 2023, from https://www.who.int/mental_health/evidence/nmhp_dmhp/en/ [3] Tele MANAS: National Tele Mental Health Programme. (n.d.). Retrieved March 11, 2023, from https://telemanas.gov.in/
- The community-based approach in mental health care, such as Atmiyata, emphasizes integrating mental health services with food for nourishment, peer contact for support, and education on mental health issues to reduce stigma and promote wellness.
- The tragic events of Beeni's sister and Kali underscore the need for improved access to health care and more mental health services in remote or underserved areas, including science-based treatments, education, and nutrition, which are essential components of physical and mental well-being.
- To accompany someone through suffering in a supportive manner, a healing space should not only offer contemplative discussions but also encouragement to pursue personal interests like education, hobbies, or social activities, which can positively impact mental health and overall well-being.
- The integration of mental health care, education, and wellness programs is crucial in cultivating a society that embraces diversity, fosters open dialogue, and breaks down unjust barriers, ensuring that mental health care is accessible and affordable for all, regardless of their socio-economic status or location.
