As community workers, we need to explain these things to them as we would to children,” says P Manjula, a community mental health worker from Periya Nemmeli. “‘Is this man often angry?’, ‘does his mood fluctuate often?’ we would ask them, and then explain possible reasons and the kind of help the person needs,” she says. “Villagers ostracise people with mental illness. They don’t even know it’s a medical condition.
It requires a lot of patience, but now the villagers are willingly bringing the patients for treatment, and the stigma is slowly waning, she says. Across Tamil Nadu , women with little formal training are being recruited as community mental health workers, helping identify people with such conditions, tackling stigma and connecting families to treatment. Through programmes run by The Banyan and Schizophrenia Research Foundation (SCARF), they are taking mental health care to villages and undeserved communities, often navigating social barriers of their own, while challenging beliefs that label people with mental illness as ‘possessed’. SCARF runs its own community outreach programme to improve mental health awareness and early intervention While The Banyan trains community workers to identify people who need care and connect them with services.
They become less hostile,” says the 38-year-old. She has also helped more than 150 people obtain unique disability IDs (UDID), connecting them with support and services they might otherwise struggle to access. In 2025, SCARF incorporated alcohol and drug dependence into its training, teaching community workers to recognise warning signs and refer people for treatment. The Tamil Nadu govt established or renovated de-addiction centres at 25 locations in 2025.
She was initially told the field worker position involved extensive travel and physical work, but she took it up nonetheless. SCARF has continued training workers in mental health and addiction, with refresher sessions planned to help them respond to emerging needs,” says Koteswara. When Suriya Baskaran, one of the community workers, visits families in Kannakudi village in Trichy to identify people with mental illness, she is often faced with a question: “Which street do you belong to? Villagers ask this to determine her caste. “Sometimes, when I visit houses to identify families with cases of mental illness (MI), they offer me a cup of tea before asking my caste. But I remind myself why I am there. I explain what MI is, how it can manifest in different ways and affect a person’s behaviour. Once a homemaker, she now works across four panchayats, helping families understand mental health conditions and accompanying them to hospitals and therapy sessions. Her responsibilities now include checking whether patients are taking their medication, experiencing side effects and attending counselling sessions, as well as helping them access disability cards and accompanying them to govt offices and hospitals. The programme has also expanded to include substance dependence, particularly among young people. “Community workers can refer people requiring treatment to these centres and medical colleges.