Reflections from PANI’s work in Tarun, Ayodhya
By:
Mukesh Sadana and Shivanjali
Mental health is a topic that remains misunderstood or at best loosely understood by most people. It is rarely discussed among family or friends and is often avoided, ignored, denied, or quietly brushed aside, even by those who sense that they or their loved ones might be struggling with mental health issues.
With the advances made by medical science, the idea of physical well-being has been widely accepted, largely understood, and its tenets are followed by a majority of the population. Intriguingly, although modern medical science has made similar advances in the field of mental well-being, it still remains a taboo subject.
Youth Well-Being Program
Realizing that the first step to acceptance is awareness, PANI designed a program on mental health, which is being implemented with deep engagement with the community. The program aims at Youth Well Being focusing on more than 43,000 youth (10-24 age group) in the Tarun block of Ayodhya district.
The Youth Well-Being (YWB) program of PANI is being implemented across all 97 Gram Panchayats of the Tarun block in Ayodhya district, Uttar Pradesh. Youth population in this block is estimated to be 43,000. PANI’s field staff have successfully conducted initial rapport building and project introduction activities in all 97 GPs. This took time and efforts. However, the benefit of such intense engagement is that not only the youth, but also their families, are open to discussing issues such as anxiety and stress. They are comfortable talking to the field staff about their worries and challenges. The trust that the program team has established within the community has enabled screening of more than 14,000 youth until April 2025 using standardized tools like PHQ9 and GAD7.
Whereas, during the initial days of the program implementation, there was hesitation and a veil of secrecy from the youths’ side, gradually through repeated visits and friendly approach, the program team won their trust and started conversing about the details that matter.
Among the many learning so far, the major ones that stand out are listed below.
Initial Learning
Trust is non-negotiable
One learning as mentioned earlier is that there must be an individual whom the youth can trust with their personal feelings and thoughts. Interestingly, when the program staff reaches out to them to explain the program objectives, activities, assessment tools etc. the youth keenly observe and assess the staff member without explicitly asking any questions. Rather they observe their language, tone, behavior, movements across the community- who all they meet with, how much time they spend, and whether they share things discussed with one individual with others in the village and so on. Only after they find the person ‘trustworthy’ do they agree to take the screening test.
Screening helps
The tools used by the program team are a good starting point to establish the importance of a structured scientific approach to deal with mental health conditions such as anxiety and stress. A large number of those who scored high on either tool initially were in denial of their condition. However, they later confided that when they went through the counselling sessions, depending on the severity of their condition, they realized that they were carrying a large amount of pent-up feelings that needed an outlet. Many of them told that during the counselling sessions they cried while sharing their thoughts. Counselling sessions lightened their mind and heart, leading to an alteration in their outlook and behavior.
Family and community support matters
The screening and counselling sessions are conducted with the youth. These being confidential must be conducted away from anybody in hearing distance. Initially, family members, especially parents were uncomfortable with this method of some outsider talking to their child in private. Who knows what they are talking about? What is so secret that it cannot be shared with parents? Similar questions were deftly handled by the program team.
After a few screening and counselling sessions, and observing positive change in youths’ speech, behavior, attitude, and outlook (whether within their own family or a neighbor’s) parents and community members became quite supportive of the approach for screening and counselling sessions. They now understand that these are conducted in a particular manner for the benefit of the youth dealing with anxiety and stress.
There is a notable change in the community’s perception regarding mental health, which is established by the fact that when the program team visits a youth for follow-up counselling session, the family members not only allow but provide a safe space for conversation between the two. There is no gossip among the neighbors and community, rather a friendly and supportive consent for the screening and counselling sessions.
This kind of change is particularly meaningful in rural areas where professional mental health services are harder to access. With only 0.75 psychiatrists and 0.07 clinical psychologists per 100,000 people in India, and with most services concentrated in cities, locally grounded and consistent community efforts become an important part of the support system.
More remains to be done
Youth is one segment with which this program is being implemented. However, mental well-being is a universal need including children, adults, senior citizens, women, migrants, labor, and farmers, and others, each facing different mental health challenges.
For instance, 22.2% of farmers have been found to experience mild-to-moderate depressive disorders. Among migrant workers, 47.9% report mental health issues, with women showing higher levels of distress. These figures point to the deep connection between mental health and social, economic, and environmental pressures.
There’s also a growing need to strengthen referral pathways and establish better linkages with mental health professionals and institutions to support individuals who need specialized care beyond the first level of support.
Conclusion: A Quiet Shift, A Loud Hope
This journey is just beginning, but the direction is clear. Mental health no longer needs to remain in the shadows. Programs that create trust, offer safe spaces, and encourage honest conversations are laying the groundwork for a more accepting and caring environment.
Mental health should not be a luxury or an afterthought. It should be a part of how we care for each other and ourselves. As trust deepens, as silence breaks, and as more youth open up, we move a little closer to a world where being well mentally is as normal as being well physically.
It is a long road ahead that we must walk “together.”