The Invisible and Unseen Tribal Communities in Maharashtra are Struggling to Grapple with Mental Health Issues

At dawn in rural Maharashtra, Inus, 35, sits motionless outside his home, the quiet broken only by the faint stirrings of his six children inside. Diagnosed with schizophrenia, he has been on medication for years, navigating both illness and fatherhood in silence. “I couldn’t sleep, couldn’t eat and was very sick,” he says. “It is as difficult financially as it is mentally. Though consistent care and improvement in my mental state make me want to show up.”

His story is a fragment of a vast, hidden and silent epidemic—a haunting reflection of a country where mental illness is drowned out by stigma and a system that fails to catch those falling through the cracks. 

India is home to over 700 Scheduled Tribe communities, along with many unrecognised groups that form a vital part of the country’s indigenous populations. It raises a crucial question—does tribal mental health even exist as a recognised concept?

One might argue they have more pressing concerns than decoding mental health jargon or seeking therapy. But thinking from that privilege misses the point. Every person with a thinking mind and a life they move through is capable of feeling—and therefore, of struggling. Mental health isn’t limited to illness. It includes navigating emotion, managing stress and coping with trauma as these are universal needs.

In smaller towns and marginalised belts, mental health remains as inaccessible as it is misread. In line with the urbane lens on mental health, it remains stigmatised and routinely dismissed. The less visible the illness, the quicker it is reduced to imagination, or mistaken for a flaw in upbringing or character.

A closer look at Thane and Palghar districts in Maharashtra reveals a collective idea of wellness rooted in balance between mind, body and spirit. Their limited acceptance of mental health struggles, though open-minded, is largely shaped by this worldview. These communities were historically resettled during dam construction projects from the colonial era.

Drawn from multiple regions and diverse tribal backgrounds, their forced displacement severed ties to land and resources. This disruption continues to impact generations that follow. Across these villages, kaccha roads soaked in rainwater, rice fields, tin-roofed homes, poultry sheds, and corner kirana shops define the landscape. 

Mental health is also shaped by the very real daily scarcities of food, shelter and water. For tribal communities, these aren’t just natural resources, but lifelines. As the Tansa River winds through these villages, its water doesn’t belong to the people who live near it. Instead, colossal pipelines divert it to Mumbai, leaving the locals with nothing. Amongst them are people from the Katkari, Warli, Ka Thakur, Ma Thakur & Kokna tribes.

Many remain unable to access the monthly ration for their families, lacking legal documents like Aadhar and PAN cards, both of which are now gatekeepers to any form of upward mobility. Transport is sparse, and crumbling infrastructure turns even the simplest commute into a daily ordeal. This inaccessibility is both symptom and cause, reinforced by scarce resources, poor education, multiple pregnancies driven by a desire for a male child and gaps in maternal and child care.

The result is a generation of children who grow up undernourished and unsupported, increasing their vulnerability to mental health issues from the start. It’s this cycle that  The Banyan’s community workers in Aghai are determined to break. These community workers, drawn from within the tribal communities, are trained in mental health through a six-month diploma and equipped to provide basic support, care and direction. In Bhiwandi, Shahpur, and Wada, 20 gram panchayats collectively empower 20 such workers, ensuring that help—be it a doctor, a tablet or a listening ear—is largely accessible and seldom out of reach. 

But intangible obstacles persist, rooted in deep-seated mistrust of medical systems and the perception of costly treatment as a form of exploitation. The understanding of mental illness remains limited as well, where many continue to interpret it through spiritual or supernatural beliefs. Witch accusations, black magic and ill luck are still common explanations for poor mental health. Yet disagreeing with these beliefs cannot become a reason to withdraw support. Aid must meet them where they are, not where we expect them to be.

Community worker Dilip explains: “In some cases, we collaborate with traditional healers (Bhagats) to support individuals who are sceptical of medical interventions. This integrative, community-sensitive approach recognises that both sides ultimately aim to help.”

Ashok Raghunath Walte, 55, a masala-mill owner, spent months battling schizophrenia and relentless whispers he couldn’t shut out. “I thought I was going insane… I stopped working, stayed home all day, just hoping the noises would fade.” After exhausting visits to traditional healers and trying alternative remedies like ayurveda, it was regular medication that finally offered him relief—bringing stability to his mood, energy and daily life.

Nilesh Patil, the centre manager at The Banyan, explains: “In tribal communities, where trust in outsiders or even medical care is rare, word of mouth carries weight. Help must reach everyone, by any means possible. When one person heals, they want the same for others. They send friends and family forward, ensuring no one is left behind.”  

Mental health isn’t all theory and no movement. While awareness is often reduced to lectures, campaigns or short films, these mean little to communities where the vocabulary itself is missing. For many tribal populations, recognising mental illness requires a different approach. Community worker Tejal clarifies: “Most people are out for work—they do not have time to sit through and absorb awareness campaigns.”

Despite all obstacles, flexible mental health care and support are the only ways to ensure people aren’t dying out of neglect. Struggle must be identified before it can be named, and named before it can be treated. Outstation doctors Rosaline Chokar and Ravindra Chavan travel to Aghai each week for client check-ups. Over time, they’ve begun identifying recurring mental health patterns across this population, even as the exact triggers remain elusive. Alcoholism remains a grave concern here, as many turn to it in a desperate attempt to cope with life and deteriorating mental health.

Older adults, especially over the age of 50, often experience depression tied to family breakdown and isolation as children move away for work or marriage. Epilepsy and depression remain the most common issues, with epilepsy affecting children as young as six, and adults in their late 30s and 40s grappling with depression.

Alcoholism, epilepsy, and unemployment fuel mental health crises. Children’s ailments, such as epilepsy, strike at the core of their well-being, exposing the inescapable tie between social conditions and psychological health. Bipolar disorder, schizophrenia and psychosomatic symptoms appear too, though less often. Awareness here looks like going door to door, observing, asking, listening—relentlessly.  

Education remains restricted as schools and colleges for higher grades grow distant, both in reach and by public transport. When education fails to translate into opportunity, survival shifts to physical labour, often as construction workers, factory employees or farmhands. With annual rainfall averaging 2,000–2,500 mm, rice remains the primary crop. Though seasonal, it sustains most livelihoods, with the rest of the year spent in daily-wage jobs, either within or outside the village. A pattern follows: the girl child is less likely to attend school and often the first to drop out, limiting dignified work prospects and reinforcing her perceived value in the community. Reports of domestic violence and crimes against women remain alarmingly high.

Pratibha Raghunath Namde, 38, currently under treatment for psychosis, recalls excelling in school until ninth grade—until she woke up one day, overcome by an unplaceable frustration: “I loved sewing. I don’t know why I can’t seem to do that anymore. I sit in a corner, gazing endlessly into the distance. I try to pray it away. On better days, I try washing the dishes and clothes.”

She spends her time tending to their chicken coop, but any mental strain unsettles her—memory slips, appetite falters and sleep disappears. Caregivers and families often endure silent, years-long battles trying to understand and manage a loved one’s mental illness. The emotional toll is immediate and deeply personal. Namde’s family has spent nearly a lakh on treatment and now lives between exhaustion and concern. It becomes vital, then, to equip them with the tools to handle episodes, recognise symptoms and safeguard their own mental health in the process.

Despite the weight she carries, Namde tries to take her medication with discipline. Follow-up care is one of mental health’s biggest challenges. Any lapse in medication or ignored symptoms can sharply tip the scales, sometimes between life and death. A person grappling with mental health often finds even basic tasks like bathing, eating or sleeping difficult to manage. Community workers intervene with home visits and regular check-ins, ensuring no treatment lapses. These encounters are driven by empathy and consistency, offering Namde and others like her a steadier way forward.  

It’s wide-eyed and optimistic to assess a few cases wherein dedicated community help is present and assume mental health access or awareness is in place. The real challenge lies in convincing people to navigate the system—show up for check-ups, manage medication, flag early symptoms.

Among the most affected are isolated family members—those who’ve lost loved ones or no longer live with them. Within these gaps stands Suneeta Shankar Patil, 70, mother of Suresh Shankar Patil, 45, a spirited woman who speaks candidly about her and her son’s mental health struggles: “Suresh used to sit in a corner and talk to his wife in his head, who had passed away. He would call her lovingly, and his daughter too, who is no more. It was hard to even take him for a check-up. He refused to get into the vehicle parked right outside our home.” Difficult as it was, her son now works at a car showroom and takes his medication regularly. She, too, no longer lets her depression or anxiety dim her spark. While this attitude appears ideal, mental health must be met at every edge of its expression. 

Across cases, one response recurs with clarity: taking medication regularly makes a difference. Fewer towns, villages or districts have dedicated mental health workers or consistent awareness. What follows is unattended deaths, diminished lives and trauma that quietly travels across generations. Many go their entire lives without ever receiving the necessary care.

Community workers remain vital, bridging this gap with weekly free consultations, medicines and steady support. Yet, before any of this, the hardest step is speaking up at all. Vulnerability feels misplaced in a setting that doesn’t truly feel safe.

As interviewers willing to listen, even our genuine concern sat uneasily with them. What’s truly needed is a space that quiets judgement and promises help, no matter the outcome. Trust holds the first key to recovery. Whether it is Aghai, Shahpur or the villages around them, mental health still suffers from limited reach.

Even the smallest towns deserve a life of dignity—with access to sound mental health care, education, employment and the means to maintain physical well-being. In tribal communities, it is the difference between survival and erasure. Despite their battles and efforts to improve mental health, these individuals remain deeply kind, caring, and spirited. They tend to their animals, nurture their crops, and support the fabric of their tribal communities with unwavering dedication. Mental health shouldn’t remain a footnote in policy. Neither should it be considered secondary to urban mental health. Financial stability undoubtedly helps, but it cannot be the deciding factor for who gets to heal. 

Sakshi Salil Chavan is a sub-editor at Outlook Entertainment desk.

This article appeared in the October 11, 2025, issue of Outlook Magazine, titled "I Have A Lot Left Inside" as "Invisible, Unseen".