My name is Geeta, and I am a community health worker based in Dehradun, Uttarakhand. I was born and raised here, and now live with my husband. Since 2022, I have been working at Burans, an organisation that provides mental health services and psychosocial care to socio-economically disadvantaged communities in two districts in the state—the rural areas in Naugaon block, Uttarkashi, and the informal urban areas in Dehradun.
This is my first job. I had studied till class 10, but the organisation gives permanent positions to only those who have completed their schooling. I cleared my class 12 exams through open board, and I am also pursuing a bachelor’s degree now.
Since 2020, I have been struggling with depression. It was difficult for me to accept this, as there is a stigma attached to mental health issues and I didn’t have enough knowledge of mental health conditions. No one could understand what I was going through—in fact, my neighbours believed I was possessed and took me to the local priest. Members from an organisation that used to visit my area told me about Burans. A community worker from Burans then informed me about the symptoms of depression, and while I initially dismissed it, eventually I learned more about the disease. This journey of understanding, accepting, and receiving care and support for depression led me to become a community worker myself.
Burans’s approach to developing programmes, gathering resources, and organising community outreach involves collaboration with Experts by Experience (EBE)—a group of people with lived experiences of mental health conditions, either as patients or as caregivers. This is to ensure that our interventions are contextually relevant for the communities we serve.
8 AM: It’s difficult for me to have a fixed time to wake up; I have an erratic sleep pattern due to depression. But having a job has changed my day-to-day routine. Earlier, I did not have a schedule; I would stay up all night and then sleep through the day. Now that I know I am supposed to reach the office at 8.30 am, I worry about being late. I tell myself that I should aim to reach office by 8.26 am. To get ready and have breakfast before leaving, I wake up by 8 am.
My husband helps me with the chores in the morning, including preparing tea and breakfast.
8.30 AM: Once I reach the office, I go over my tasks for the week, including documentation work. We have weekly plans with details of the areas we need to visit, the people we have to meet, and those with whom we have to conduct follow-ups. We also prepare plans for the new areas that we want to visit.
Most of my work is field-based. Once the plan for the week is sorted, I leave for the industrial area I’ve been assigned. The people here are engaged in labour-intensive jobs and reside in informal settlements. There is also a lack of services in the area. The people in the community are initially resistant to interacting with outsiders, and talking about mental health concerns is even more difficult. They understand the word ‘tension’, but on bringing up mental illness, their immediate reaction is, “Aap mujhe paagal bula rahe hain? (Are you calling me crazy?)”
I don’t blame them for having this outlook—as I had the same mindset. Back then my understanding of depression came from an ad I’d seen, which said that depression was when people kept their doors locked and had compulsive habits. Since I wasn’t behaving this way, I did not think that I could have depression.
I also used to believe that a mental health issue meant that I was crazy and would be locked up in an institution—but I was wrong. A worker from Burans convinced me to visit the hospital. I was scared that they would detain me against my will, declare me insane, and give me electroshock therapy. Due to this fear, I didn’t share my exact symptoms and told the doctor that I couldn’t sleep and had headaches. I was given medicines, but I did not take them for weeks, afraid that they would make me go insane. I would lie to the Burans worker and say that I had taken the medicine and that they weren’t working. After a few weeks, she made a surprise visit and saw my stack of unused medicines. She suggested that I start taking just half the dose. I felt guilty that my condition had worsened to the point of medication. I took them for two to three months but the cycle of guilt made the medicines ineffective for me, so I stopped taking them.
Around seven to eight months later, when I joined Burans myself, I became aware of depression as a condition and learned about its symptoms. I understood that it was a common illness for which treatment is available.
This experience made me realise that awareness of the condition and a trusting relationship with the community health worker are key to comprehending mental illness. Otherwise, people won’t be able to accept what they are going through—just like I didn’t. So first I build a relationship of trust with the community.
During my visits, I listen to their experiences and tell people that mental illness should be viewed just as a physical ailment. If they are taking medication for fever, then why not for a mental health condition? We don’t ignore issues such as blood pressure and sugar, so why ignore mental health? The mind is part of the body and needs to be taken care of. Without the mind, the body cannot function. I am able to persuade some people on my own, and in other cases community health workers call on one another for support.
1 PM: If there’s time, I go back to the office and eat my lunch. Otherwise, I eat between the visits and continue my work in the field.
The socio-economic challenges of the area create mental stressors for the community. Talking to people, I realised that they think they don’t deserve treatment—they aren’t provided any facilities and feel they don’t have any knowledge. Often, I find that multiple people in a family have mental health concerns; one family member might connect us to another who they feel might also need help.
While women are much more receptive to receiving mental health care, it is difficult to talk to men. In my experience, only 2–3 percent of men were open to accepting that they had a mental illness or disorder. I witness instances of substance use and domestic violence, but men aren’t ready to see that mental health conditions could be an underlying cause; the lack of awareness makes it worse.
While people won’t use terms such as ‘anxiety’ and ‘depression’, I understand what they mean when they say they are having ‘thoughts’ or ‘headaches’. I intuitively know that they may be having the kind of thoughts that I did, or might be going through some other issues and accordingly refer them for medication or counselling. Burans has a community health worker toolkit, which helps us screen individuals for various concerns. We have refreshers two to three times a month and are informed of any new policies. The training includes a step-by-step guide on what we should be doing while interacting with community members. We also have progress markers, so we can decide if a different approach needs to be taken during follow-ups.
This helps me as well—I have more control over my emotions. I used to panic in serious situations, but I have learned to address the issue instead. I am more mindful of how I speak to people and put forth my opinions in a way that isn’t hurtful. This helps in maintaining relationships within the community too.
The confidence I have gained has taken me places—I had the opportunity to share my experiences at an event in Kathmandu, Nepal. It was my first time on a plane, and I was alone. I was panicking before the event, but I told myself that I had travelled so far to share my story. If I didn’t do it, if I didn’t speak up that day, I would be failing the many people out there who were trying to improve their lives.
5 PM: I finish my work by evening, and it takes me approximately 10 minutes to reach home. I play some music and go about finishing my household chores, and the time just flies by.
While I stay away from bringing my work home, I share a lot of what I’m feeling with my husband. I try not to let what I see in the community impact me mentally—it shouldn’t be that in the process of helping someone else heal, we end up harming ourselves. But if I feel that something is affecting me, I do have people in the office I can talk to. This is advice I would give to other health workers as well—to share what they are feeling or if something is affecting them.
Familial support is essential during such times. Even though I have my parents and siblings, I felt their absence because they weren’t there for me in tough times—so I understand the value of such support even more. Whenever someone realises that they have a mental disorder or illness, the first thing they tend to do is isolate themselves. Mental health workers should build and strengthen connections between patients and their families, so people facing mental health issues realise that they have a support system and know that there are people around who can help them.
As told to IDR.
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Know more
- Read about a study on the experiences of marginalised communities with mental health services, and what needs to change.
- Learn about community-based and rights-focused approaches to mental health care.
- Understand the importance of situating mental health within broader demands for equity and justice.
