For over two months in 2017, Chetanbhai Bharvad, a resident of Della village in the Mehsana district of Gujarat, couldn’t sleep for more than an hour at night. A school teacher by profession, the 25-year-old would suffer from such deep anxiety when contemplating the future that he would find it difficult to breathe.
Bharvad, who lives with his mother, four brothers, a sister and his wife, said that no one knew why he was suffering and they were deeply worried about him. Visits to doctors and several medical tests, including a CT scan, did not reveal any physical ailments. It was only after an interaction with a mental health worker Sahdevsinh Govindsinh Parmar in 2018 did he learn that he was suffering from depression.
Bharvad’s village, Della, has about 250 families and a little over 1,000 residents. Bharvad met Parmar, a Community Facilitator associated with Atmiyata, when Parmar was visiting the village. Atmiyata is a project by the Pune-based Centre for Mental Health Law and Policy. It is an evidence-based, community-led model to reduce the mental health and social care gap in rural communities.
After showing interest in the project, Bharvad opened up with Parmar about the problems he was facing. Bharvad, at that time, was consuming sleeping pills to be able to sleep. After six counselling sessions with Parmar, Bharvad felt much better. In one of the sessions, Parmar suggested that he do start doing yoga, and this helped him immensely. After the sessions, he no longer required the pills.
In addition to teaching students English in classes nine and 10 at a school 15 km away from his village, Bharvad said he then took it upon himself to counsel his fellow villagers.
People in his village, Bharvad said, often complain of “tanav,” which means stress, tension or depression. However, due to lack of education and access, they cannot recognise symptoms of mental health problems.
“After what I went through, I didn’t want anyone else to suffer and go through something similar. It is not only painful for the person but a huge pain for their family too. My family too faced a lot of problems and used to wonder about what mysterious ailment I had that had no cure at all,” he said.
My family used to wonder about what mysterious ailment I had that had no cure at all.
From survivor to confidant
Atmiyata started their work in Gujarat in 2016, and at present has around 400 volunteers in 615 villages of the Mehsana district for carrying out counselling sessions. The volunteers, who are all residents of the villages, were recruited based on their interest and potential, said Parmar, the Community Facilitator.
The volunteers receive information through mitras, which means friend. These mitras are local residents, who have had a short training on how to identify mental health issues.
After being chosen as a volunteer, Bharvad went through a seven-day training conducted by mental health professionals. During his association with the project for over two years, Bharvad has helped over 30 patients. Given that he is a local and well educated was a plus, Bharvad said, describing how people open up to him without compunctions. His students, he said, know about his work and often ask him questions about mental health.
Before coming across the Atmiyata project, Bharvad said that he had no clue about mental health issues.
Bharvad, who operates in his village, said that people who decide to come to him for counselling are given six sessions, which are 30 to 45 minutes long. In cases where people tell him that they are having suicidal thoughts, Bharvad refers them to mental health professionals. In addition to his counselling sessions, Bharvad also tells people about existing social welfare schemes.
Since the pandemic, Bharvad says that mental health issues have been on the rise.
“The biggest issues are that of unemployment, alcoholism and domestic violence. Mental distress has only been on the rise,” he said. “There are people who even considered ending their lives.”
The three problems of unemployment, alcoholism and domestic violence in the village following the pandemic are inter-linked, said Bharvad. A lot of people, who were working in the city lost their jobs and returned to the village, disillusioned and bitter. With nothing to do and their debts mounting, people took to drinking. And after getting drunk, the men beat their wives and children.
However, with the lockdowns and other restrictions on movement, meeting patients upfront wasn’t possible.
“I can gauge a patient’s body language and emotions when I am in front of them. I can pick up cue points, which help me do my sessions better. Even though some people, who know that I do this work, call for help, it’s not the same as face-to-face conversations,” he said.
Superstition and stigma
As someone who was trying to educate people about mental health in his village, Bharvad said he was constantly battling superstition and stigma. Those suffering from depression still preferred going to sadhu babas. There were times when he had been at the receiving end of abusive language. It was difficult for him to speak with women without someone objecting.
But he persisted.
“Sometimes when I go to their house, they aren’t willing to listen at all. Especially if it is a woman. In the village, it’s still considered weird when a man comes and wants to talk to a woman, it’s viewed in a wrong way,” said Bharvad.
When it comes to reaching out to a woman who needs help, Bharvad said that he tries to find the most receptive member of her family, explain his work, and tries to set up a meeting.
In the village, it’s still considered weird when a man comes and wants to talk to a woman, it’s viewed in a wrong way
“Women don’t open up easily, even if their family members permit a session. They don’t trust a man coming and trying to talk about their problems. It takes about three or four sessions for them to finally speak up about their issues,” he said.
The perspective of a woman
Varshaben Vaghela, a fellow volunteer of Bharvad, and a 30-year-old resident of Sendrana village in the Mehsana district, says that women speak with her, but men older than her do not.
Since her husband is a doctor, they prefer speaking with him, she said. Her husband and mother-in-law, she added, supported her work.
Over the course of the pandemic, Vaghela had arranged for food for several families in the village. She even learnt how to stitch by watching an online program and made over 250 masks for people in her village.
“If these problems persist in people’s minds, how will they be at peace? How will they feel better, if they don’t have money to feed all their children?’ said Vaghela. “Before this project, I’d never stepped up to help anyone. I find joy when people lead a better life due to my sessions. It was here that I understood the satisfaction of helping people.”
If you or someone you know needs help, please call 1800-599-0019, India’s 24/7 toll-free national mental health helpline or 08047192224, a free helpline number being run by the Indian Association of Clinical Psychologists.