Rather than resisting Western medicine, many rural families are eager for a seemingly silver bullet solution that doesn't make them travel long distances
or lose a day's wage.
In the fishing village of Kovalam north of Chennai, even the local Muslim faith healer, Allauden, has begun referring his clients to the Banyan clinic.
"The Banyan does it through beds, injections and tablets. We do it through it through wind," he says, explaining the difference between their methods. "I
can see in the patients' face whether I should treat them or send them to the Banyan. I only see small cases now."
Patients seem less concerned with what kind of treatment they are receiving than they are with what works. After trying religious healing or alternative
therapies, patients coming to the Banyan's rural clinic are often seeking a quick medical fix.
"Most of them have this misunderstanding that doctors who administer shots are better," Kavitha says. After taking the time to reach the Banyan clinic,
families would be "unhappy" if they were prescribed counseling and alternative therapies, such as yoga, rather than a pill. "The only thing they will think
is, 'we've come so far, and they won't even give me a tablet?'"
Rao has seen similar reactions among SCARF patients. People often approach him asking for medication to treat issues ranging from menstrual problems to
alcoholism. "People are thinking that if they go to a psychiatrist, they are getting a solution to everything in the world," he says.
Outside the clinic in Sathya's village, a woman approached Rao asking for pills to deal with her headaches. "In a vegetable shop, you can't get chicken or
mutton," Rao explained, despite her repeated requests. "We don't have medicine for those kinds of problems here."
The Indian Mental Health Policy Group hopes to redirect the psychiatric focus of the mental health movement toward more holistic healing. In late June, the
group released a set of policy proposals for the District Mental Health Program. The Group advised a national "focus on improved quality of life of the
client vs. mere symptom reduction... [including] the need for social protection and effective poverty reduction policies."
"The whole country is moving toward this paradigm shift, where we're looking at mental health from a well-being, development lens, and less from an illness
sort of lens," Gopikumar says. "As far as possible, have treatment available locally. And treatment doesn't just mean popping pills."
For patients like Sathya, simply treating symptoms of schizophrenia with medication isn't enough. Because of her illness, her mother is having a hard time
finding her a husband. "No one will marry a mentally ill girl," Rao says of the strong stigma against those with mental health problems. After her rape,
Sathya refuses to let men look at her, including her own brothers.
But a marriage could give her widowed mother one less mouth to feed. Sathya's prescription leaves her hungry and asking for more, so her mother often
spaces out the daily dose to one pill every couple of days. Sathya's family may decide to marry her to her 40-year-old uncle. "Whatever the family decides,
I will agree to that," Sathya says. She is no longer angry and throwing stones. But she is far from being healed.
"Things are not as simple in India. There is so much interplay between poverty, stress, gender insensitivity and discrimination, and mental health,"
Gopikumar says. Those on both sides of the psychiatry debate agree India needs to take a broader view. By reimagining what it means to provide mental
health care in rural India, advocates may end up creating a model for the rest of the world to follow.