Expert-Backed Solutions On How Rural Communities Can Build Mental Health Safety Nets in Times of Crisis

When a flood, cyclone, or sudden economic shock hits a rural village, the damage isn’t just physical. Daily life is disrupted, social ties fray, and invisible wounds — anxiety, grief, and trauma — ripple through families.

Advertisment

Add The Better India As A Trusted Source

• Stories
• Visual Stories

This World Mental Health Day, themed ‘Access to Services: Catastrophes & Emergencies’, experts emphasise that timely mental health support in rural India is not a luxury — it is essential.

In many rural areas, access to mental health services is limited. Hospitals and clinics may be hours away, transportation is unreliable, and stigma often prevents families from seeking help. Even when care exists, the lack of culturally attuned, language-appropriate services means many go untreated.

In such situations, the first line of support is often not a psychiatrist, but a neighbour, teacher, or ASHA worker — someone trusted in the community who can notice signs of distress early.

“When disaster hits a village, it doesn’t just break homes — it stirs a silent storm inside. In rural India, healing begins not with clinics, but with connection. A listening ear, a safe space, and a shared story become the first threads of a mental health safety net,” Dr Aninda Sidhana, psychiatrist and medical advisor for HealCycle, tells  The Better India.

The power of community in recovery

Communities often become the first responders in crises, providing care, attention, and continuity where formal services are absent. For Dr Roop Sidana, a senior psychiatrist with over four decades of experience across Rajasthan, compassion is the cornerstone.

Through his work with Nishkam Foundation, he has led efforts to rehabilitate patients with severe mental illness — many of whom were still treated inhumanely in society. “Healing begins when people are seen as humans first, not as cases to be managed,” he says.

Emphasising how community-led care transforms individuals, Dr Sidana recalled a patient from his early practice:

“He was an engineer from a poor family who had left home in an acute psychotic episode. He was found naked and covered in dirt at the railway station. Ten neighbours brought him in. We bathed him, changed his clothes, and started treatment. Many members of the community took care of him. Over time, he recovered fully, and I followed him for 20 years as he became a chief engineer.”

Practical steps for grassroots caregivers

Dr Sidana highlights a practical approach for rural caregivers:

• Cue cards in local dialects: Include calming scripts, routine checklists, danger signs, and emergency contacts.

• Neighbour buddy pairs: Daily 10-minute check-ins, shared chores, mutual respite.

• Anchor in gatherings: Short psychosocial segments in gram sabhas, SHGs, schools, and spiritual meetings.

• Supervision: Weekly phone support from ASHAs/PHCs and monthly in-person review by a mental health supervisor.

“Immediate priorities in the first 48–72 hours include identifying one family focal person and two neighbour allies per hamlet, linking each hamlet to ASHA/PHC contacts, and pairing psychosocial outreach with food or shelter,” Dr Sidana explains.

Such models of community resilience became even more critical in the COVID-19 pandemic.

Lessons from the pandemic

The second wave brought bereavement, economic collapse, and rising suicide risk to rural Odisha. Dr Amrit Pattojoshi, who has helped design government-backed wellness programmes and suicide-prevention helplines, believes that early intervention must start at the grassroots.

He explains how a three-tier response helped in Odisha:

• Local ASHAs and teachers trained in Psychological First Aid checked in on vulnerable households.

• A regional helpline, staffed in Odia and Sambalpuri, linked callers to district mental health teams.

• Medication kits were delivered to patients whose treatment had been interrupted.

“One ASHA flagged a widow showing signs of severe depression and suicidal ideation. She was connected to the helpline, stabilised with medication, and later joined a peer-support circle. That group went on to support others, creating a ripple of recovery. We didn’t just prevent a tragedy, we seeded a network of care that outlasted the crisis,” says Dr Pattojoshi, MD, honorary secretary of the Indian Psychiatric Society, speaking to The Better India.

He also stresses the importance of accessibility:

“A helpline number in a ration kit can be the quiet lifeline that saves a life. We cannot wait for people to reach the brink. Mental health education in local languages, through teachers and community workers, is as vital as physical first aid.”

He adds that care should be decentralised, integrated into local health centres, and supported by telemedicine:

“Technology can make mental health truly inclusive, but only if digital access is paired with empathy.”

Six critical needs in rural crises

Experts outline six key strategies for immediate and ongoing support:

1. Psychological first aid and safe spaces: Rapid, empathic listening in shelters, schools, and community halls reduces panic and restores a sense of safety.

2. Continuity of care for severe mental illness: Deliver medications and follow-up for patients with schizophrenia, bipolar disorder, or substance dependence.

3. Protection for vulnerable groups: Women, children, older adults, and people with disabilities need gender-sensitive outreach and child-safe zones.

4. Psychosocial support linked to survival needs: Combining emotional care with essentials like food, cash, or legal aid increases recovery rates.

5. Community-led detection and referral systems: Training ASHAs, anganwadi workers, teachers, and volunteers doubles the number of people connected to care.

6. Culturally attuned communication: Using everyday language like ‘tension’ or ‘worry’ normalises distress and builds trust.

Connection as the foundation of care

In rural India, recovery after catastrophe begins not in clinics but in connection — empathy, trust, and community-led care.

This World Mental Health Day reminds us that when local voices are trained, supported, and trusted, they form safety nets strong enough to save lives — and restore hope.

As Dr Pattojoshi concludes, “Mental health frameworks don’t need to be invented anew for rural India — they need to be translated, trusted, and tied to survival. When we adapt what works in schools and workplaces to the musings of rural life, we don’t just respond to crises — we build resilience.”

Feature image from Getty Images