In Odisha’s Lakshmipur district, 57-year-old Ghasini Muska was affected with mental illness after she got divorced. Her condition worsened after the death of both her parents shortly after her divorce. Not only did she start showing violent behaviour towards members of her community, but also began running away from home. Then, as is often the case in rural areas where awareness and access to mental health resources are low, she had to be tied down at home. Her sister and caregiver tried to give her a variety of local medications, but nothing worked.
That’s when LiveLoveLaugh, the mental health foundation launched by actor Deepika Padukone, stepped in. Under the foundation’s rural program, Muska was given the necessary psychiatric intervention, as well as regular counselling. Medication was provided to her at her doorstep, as it was difficult for her sister to step out and access the same. As her condition improved, the foundation also trained her in making brooms, turmeric, sunflower cultivation, and potato cultivation.
She is one of the nearly 15,000 beneficiaries in the rural communities in Davangere, Gulbarga and Mysore in Karnataka; Lakshmipur and Narayanpatna in Odisha; Thiruvallur in Tamil Nadu and Chindwara in Madhya Pradesh, where the program is running. A key aspect of the program is to highlight the fact that mental health crisis is not merely an urban phenomenon.
“Mental illness doesn’t discriminate and can affect anyone, from any age group or social economic background. It was a very clear choice for us that while work in urban India would continue, we also wanted to support rural mental health, where a vast majority of the Indian population lives,” says Anisha Padukone, CEO of the foundation.
A survey-based paper published in BMC Psychiatry last year found that nearly one-third of older adults dwelling in rural India reported symptoms of depression. Prevailing stigma, lack of access to mental health professionals, and a scarcity of medication makes it much harder to tackle than urban areas. While recognising this, Anisha points out that the key is to train and work with local community members and NGOs, in order to make a sustainable difference. The first pilot was launched in 2016, and has been scaled up considerably since then, with nearly 61 taluks identified.
“What we basically do in terms of the model, it’s fairly simple. We pick a particular geography or a location, and then adopt that location and the entire community within that location. The first geography was Davangere district of Karnataka, which comprises six taluks that form the entire district. We started off our work in about two taluks, and then slowly expanded, and by the third year, we covered the entire district,” Anisha says.
Under the model, the foundation ensures that a decentralised process of implementation is followed. It works with a wide network of local grassroot partners, and people living within the communities, including ASHA workers. “If we were to go in from the cities, there would be a lot more resistance. Whereas individuals from within the community are easier for the patients to accept,” Anisha adds.
A crucial aspect of the program is to train different individuals within the community as leaders and caregivers, so that within a period of about five to seven years, the community is trained to be self-sustainable and not require lifelong dependence. In order to tackle stigma and misinformation, street plays are conducted, pamphlets distributed. Medication is stocked up in local pharmacies, and training is given to ASHA workers and other healthcare workers in the local administration, in order to ensure doorstep delivery. Counselling is provided not only to the patients, but also the caregivers, in the form of support groups, where they discuss their common challenges and problems.
Apart from psychological rehabilitation, vocational training is also looked into. As both patients and caregivers — who are often daily wage earners in rural areas — lose out on income due to challenges posed by mental illness, there’s a focus on helping them generate alternate livelihoods. “In Odisha, in one of the programs that we run, there is leaf plate making, turmeric cultivation, jaggery cultivation training. And in Mysore, a lot of them are trained to get jobs with the government as bus conductors or making paper bags.”
Awareness campaigns about government schemes which can be beneficial are also conducted. For instance, Anisha points out that many in such areas are not aware of pension schemes under the Mental Healthcare Act of India. Telling them about it, and explaining how they can go to local authorities and claim it, becomes crucial.
The foundation is also pushing for mental health to be given equal importance or treated on par with physical illnesses where insurance is concerned in India. “We’ve been working on this for the last maybe about four or five months now actively. I think the general consensus, whether it’s been speaking to insurance companies or other like-minded mental health organisations and everyone involved, is that everyone understands the need and the relevance of this,” Anisha says. However, she recognises that the road ahead is not going to be as simple as it is for physical illness, primarily because physical illnesses have tests and are slightly easier to diagnose.
That’s when LiveLoveLaugh, the mental health foundation launched by actor Deepika Padukone, stepped in. Under the foundation’s rural program, Muska was given the necessary psychiatric intervention, as well as regular counselling. Medication was provided to her at her doorstep, as it was difficult for her sister to step out and access the same. As her condition improved, the foundation also trained her in making brooms, turmeric, sunflower cultivation, and potato cultivation.
She is one of the nearly 15,000 beneficiaries in the rural communities in Davangere, Gulbarga and Mysore in Karnataka; Lakshmipur and Narayanpatna in Odisha; Thiruvallur in Tamil Nadu and Chindwara in Madhya Pradesh, where the program is running. A key aspect of the program is to highlight the fact that mental health crisis is not merely an urban phenomenon.
“Mental illness doesn’t discriminate and can affect anyone, from any age group or social economic background. It was a very clear choice for us that while work in urban India would continue, we also wanted to support rural mental health, where a vast majority of the Indian population lives,” says Anisha Padukone, CEO of the foundation.
A survey-based paper published in BMC Psychiatry last year found that nearly one-third of older adults dwelling in rural India reported symptoms of depression. Prevailing stigma, lack of access to mental health professionals, and a scarcity of medication makes it much harder to tackle than urban areas. While recognising this, Anisha points out that the key is to train and work with local community members and NGOs, in order to make a sustainable difference. The first pilot was launched in 2016, and has been scaled up considerably since then, with nearly 61 taluks identified.
“What we basically do in terms of the model, it’s fairly simple. We pick a particular geography or a location, and then adopt that location and the entire community within that location. The first geography was Davangere district of Karnataka, which comprises six taluks that form the entire district. We started off our work in about two taluks, and then slowly expanded, and by the third year, we covered the entire district,” Anisha says.
Under the model, the foundation ensures that a decentralised process of implementation is followed. It works with a wide network of local grassroot partners, and people living within the communities, including ASHA workers. “If we were to go in from the cities, there would be a lot more resistance. Whereas individuals from within the community are easier for the patients to accept,” Anisha adds.
A crucial aspect of the program is to train different individuals within the community as leaders and caregivers, so that within a period of about five to seven years, the community is trained to be self-sustainable and not require lifelong dependence. In order to tackle stigma and misinformation, street plays are conducted, pamphlets distributed. Medication is stocked up in local pharmacies, and training is given to ASHA workers and other healthcare workers in the local administration, in order to ensure doorstep delivery. Counselling is provided not only to the patients, but also the caregivers, in the form of support groups, where they discuss their common challenges and problems.
Apart from psychological rehabilitation, vocational training is also looked into. As both patients and caregivers — who are often daily wage earners in rural areas — lose out on income due to challenges posed by mental illness, there’s a focus on helping them generate alternate livelihoods. “In Odisha, in one of the programs that we run, there is leaf plate making, turmeric cultivation, jaggery cultivation training. And in Mysore, a lot of them are trained to get jobs with the government as bus conductors or making paper bags.”
Awareness campaigns about government schemes which can be beneficial are also conducted. For instance, Anisha points out that many in such areas are not aware of pension schemes under the Mental Healthcare Act of India. Telling them about it, and explaining how they can go to local authorities and claim it, becomes crucial.
The foundation is also pushing for mental health to be given equal importance or treated on par with physical illnesses where insurance is concerned in India. “We’ve been working on this for the last maybe about four or five months now actively. I think the general consensus, whether it’s been speaking to insurance companies or other like-minded mental health organisations and everyone involved, is that everyone understands the need and the relevance of this,” Anisha says. However, she recognises that the road ahead is not going to be as simple as it is for physical illness, primarily because physical illnesses have tests and are slightly easier to diagnose.
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