This Bihar caregiver says 60% of India can’t access basic mental health support

Growing up in a small town in Bihar, Bhawesh Jha’s family struggled to find an experienced psychiatrist for his brother, who lives with schizophrenia. Years of heavy medication, severe side effects and repeated relapses followed before his brother finally received a proper assessment in Mumbai. ‘But not everyone can afford to go to Mumbai for care,’ said Jha, who is also a project and policy officer with the University of Edinburgh and a member of the Bihar State Mental Health Authority.

He believes India’s mental healthcare conversation remains centred on diagnosis and psychiatrists, while rehabilitation and community support receive far less attention. Services such as supported employment, day-care centres, skill development programmes and trained social workers remain scarce outside a handful of specialised institutions in cities like Bengaluru and Delhi. ‘The question is, how are the 60 per cent of Indians living in villages and small towns supposed to access these?’ he asked.

Jha said India’s continued reliance on institutional care is rooted partly in history, with colonial-era laws that treated people with mental illnesses as individuals who needed to be confined in asylums — a mindset he says is often reinforced by films portraying people with schizophrenia as violent or dangerous. ‘Often, I’ve felt that the illness itself is only 40 per cent of the problem. The rest of the suffering is caused by society and community,’ he said, adding that discrimination continues long after people leave hospital, at times affecting even their right to property or marriage.

Yet Jha’s own family tells a different story: after their mother suffered a paralytic stroke, it was his brother who became one of her primary caregivers. ‘If your loved one is living with schizophrenia or any mental illness, I want you to know that you are not alone. Do not forget to take care of yourself,’ he said.

Image: Wikimedia Commons/by Dr Partha Sarathi Sahana