RENEE MONTAGNE, host:
We took you to India yesterday to hear the stories of people with severe mental illness, people who do not go to doctors. There aren't many psychiatrists there. Instead, some with mental problems visit temples and shrines. Some social workers are trying to change that by focusing efforts on India's schools. In the second of these reports, Miranda Kennedy visited a school in Goa, a strip of Indian along the Arabian Sea.
Ms. PRACHI KANDAYPARKER (Child Psychologist): The name of the session is Motivation for Teachers. And the facilitator's name is Prachi.
MIRANDA KENNEDY: A dozen teachers, young men, are sitting solemnly around a meeting table at this small rural high school. The students here are poor, the children of miners and fishermen. They mostly speak the local language, Konkani, rather than English, the language of the upwardly mobile. The fans are whirring overhead but they can't dispel the humidity. They're listening to a child psychologist.
Ms. KANDAYPARKER: And please remember every thought process has three parts: thought, feeling and action. And that is - what do you call it? (Foreign language spoken)
KENNEDY: Prachi Kandayparker is leading a workshop to train teachers to deal with mental health issues among their students. She has a bright, engaging manner that draws out the reluctant teachers, in spite of the sapping heat. Soon there's a lively discussion in the room about how to deal with difficult teenagers.
Unidentified Man: (Unintelligible)
Ms. KANDAYPARKER: (Unintelligible)
(Soundbite of laughter)
KENNEDY: After a while, one of the teachers starts describing a problem he's having in class. The laughter subsides. A line of sweat glistens above his moustache. A 17-year-old girl has been telling the other students that she's in love with him, he says. He worries about his reputation in this small town. The girl also says she has a brain tumor and epilepsy, and he doesn't know what to believe or what to do.
Later, as we drive away, Prachi lays out her plan for the 17-year-old girl.
Ms. KANDAYPARKER: No, what is happening is she's been referred to the counselor as well. So what we've decided, we'll do a little bit of groundwork in terms of just getting to know her friends and family and things like that, and if need be, maybe get a psychiatric evaluation.
KENNEDY: Taking her to a psychiatrist, of course, requires the consent of the girl's family. Prachi, who grew up near here, knows that they're unlikely to agree. Even though her organization, Sangath, will offer therapy and medication for free, finances aren't the biggest obstacle to treatment.
Ms. KANDAYPARKER: Most of the time you will have parents or teachers saying that it doesn't happen here, that most times it happens to somebody with a lot of problems, and we don't face that. When it comes to anything of mental illness, it would be a big no-no and don't tell, it happened a long time back, it won't happen again, that kind of (unintelligible) it would be hidden.
KENNEDY: The fact that the student is a girl further complicates the problem, Prachi says. Her parents would be even less willing to take action because it could scuttle her chances of marriage. Word almost always gets out in India, where the most private of matters are considered public domain.
That's what Rukmini Pillai says. She's a middle class housewife in the Indian capital, New Delhi. It took her over a year to fully realize that she should seek treatment for her 16-year-old daughter.
Ms. RUKMINI PILLAI: She was not sleeping at all in the nights, dropping things. Like if you gave her a cup of milk or something, she would just drop it. And she got to the point that she would just sit on the bed and she couldn't recognize her face, she said. And she would start crying sometimes, and she would start laughing at times.
KENNEDY: Rukmini is educated, married to an officer in the Indian Air Force. Yet when her daughter's school principal recommended that she take her to see a mental health professional, her first thought was of the dishonor it would bring.
Ms. PILLAI: I got so scared. Psychiatrist? That's the end of her life. Who's going to marry her? I rang up my parents, but they said it's your fault, you've not got her married, and this comes with sexual frustration, this kind of behavior. So I stopped talking to my mother after that.
KENNEDY: Rukmini's parents haven't seen their granddaughter for 15 years, since she was diagnosed with schizophrenia and forced to drop out of school. Rukmini hasn't had much help from other quarters either, because there are few support groups or psychiatrists in India.
Ms. PILLAI: Generally physicians were not aware of the nature of the illness. Initially they would say that, you know, do some yoga and do some meditation. And you must not have given proper food diet to your child, that's why she became ill.
KENNEDY: Eventually Rukmini began lobbying the Indian government to pay more attention to its mental health program, which she says is toothless and underfunded. India has largely succeeded in de-stigmatizing HIV and AIDS, she points out, but it hasn't done the same for mental illness. Rukmini says she can only conclude that that the government doesn't consider it a priority.
For NPR News, I'm Miranda Kennedy.