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Mental Health In India: Underserved And Underfunded

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By Ayesha Marfatia, Sneha Philip:

Harsh Mariwala is the chairperson of Marico Limited and the founder of Mariwala Health Initiative (MHI), and Rajvi Mariwala is the director of MHI, which provides grants and strategic support to organisations and collectives to create access to mental health services for all.

In this interview, they discuss what the redistribution of wealth means to them, why they decided to fund mental health—a deeply intersectional and intersectoral issue—and how using a rights-based approach has the potential to change philanthropy’s top-down approach.

Harsh Mariwala is the chairperson of Marico Limited and the founder of Mariwala Health Initiative (MHI), and Rajvi Mariwala is the director of MHI, which provides grants and strategic support to organisations and collectives to create access to mental health services for all.

India Development Review: Could you tell us about your philanthropic journey?

Harsh Mariwala: My life has gone through three phases: learning, earning and giving. Growing up, my focus was on learning, and later on earning. But after I built my career, I began to think about how I could give back. Everyone wonders what their purpose is at some point.

“There are two ways of giving back—corporate social responsibility and personal social responsibility.”

When it comes to giving, there are two ways of going about it. One is corporate social responsibility, which is giving back from the company’s side. This is a separate journey. I wanted to also focus on personal social responsibility—giving back from the personal side—and I was very clear that I didn’t just want to do this monetarily. I wanted to give my time and energy as well.

When you start doing this—giving not just money, but engaging in more active giving—the kind of satisfaction you get is much more. There’s also a higher degree of ownership, particularly in terms of how you think about sustaining your giving. This is not to say that everybody must invest time, I realise that not everybody has the liberty to give their time. So, if somebody has money and not time, they can still do their part.

It’s also important to choose an issue that you are passionate about. If you don’t have passion, you may have time, but the willingness to give it may not be ignited.

Rajvi Mariwala: Put simply, I see philanthropy as an exercise in social justice, in the redistribution of wealth. My privilege is not limited to wealth and money alone; I have an accumulation of far more privileges. It’s important to know who is gatekeeping wealth, and unless I invest in challenging the structural frameworks that have put me here, my philanthropy isn’t good enough. Using a welfare approach to philanthropy might be top-down, but using a human rights-based approach and examining social inequality has the potential to change that around.

“Put simply, I see philanthropy as an exercise in social justice, in redistribution of wealth.”

If I want to challenge a top-down philanthropic approach, I need to hold myself accountable as a funder. Am I only using my social networks to find organisations to fund? How inclusive is my work? How many women, or Dalit, Bahujan, and Adivasi people are we serving? Does my advisory board include people from the margins that I want to serve?

Accountability depends on your principles of giving.

My approach to philanthropy might differ from my father’s in terms of language, but we found a meeting point when we decided to focus on mental health.

IDR: So, how did you come to identify mental health as a focus area?

HM: From the outset, I knew I didn’t want to make a donation to a hospital or school that would be managed by somebody else. I wanted to give actively, to an issue where I could really add value. My passions lie in the area of entrepreneurship and preventive health. When Rajvi and I started discussing areas we could support, we learnt that mental health is an area that is heavily neglected by philanthropy. It is underserved and underfunded, and I saw a pioneering opportunity for us to enter this space.

Apart from supporting existing actors in this sector, we wanted to create newer capacities, fund research, and focus on the intersection of mental health and other issues—gender, for example. We also wanted to create learning mechanisms and identify synergies between the organisations we partner with so that they can learn from each other.

RM: As my father said, it started out as a conversation, after which we reached out to a range of mental health professionals to learn more. We saw that there’s so much work happening in the mental health field already, and decided that there was no point in reinventing the wheel. Rather than setting up our own services, we wanted to build the capacity of existing services and help them scale.

We took over a year to set up Mariwala Health Initiative (MHI) because we wanted to establish what our approach was going to be, what our guiding principles were, and which pillars we would build on.

Our first partner was iCall, a psycho-social helpline, which started as a field action project at TISS. Soon after this, we identified three other partners doing stellar work in mental health. We learnt more about mental health from these four partners, and those learnings enabled us to jump from working with four partners in 2016 to the 17 partners we work with today. Taking the time to learn from our partner organisations also enabled us to take a few risks with our funding.

People fallling into a net Illustration_mental healthThere are various oppressions within mental health that we must be aware of, and we must be mindful of whether we’re complicit in creating them. | Illustration: Shirish Ghatge

RM: If we chose to fund education or hold health camps, access to numbers is much easier, but with mental health, quantifying impact is more difficult.

We work with a wide variety of stakeholders—including activists, nonprofits, and government representatives. Bringing these stakeholders to the same table, when they don’t always want to talk to each other, is very hard. But this dialogue needs to happen. If my philanthropy is social justice-led and focuses on structural frameworks, I have to support civic participation, activists, and people’s movements.

At the same time, I also have to work with the government. It’s my role to identify how to bring them together. For example, according to the Mental Health Care Act of 2017, every state should have a State Mental Health Authority. I have access to technical experts who can help the government set these up, and so it’s my role to connect these actors as well as figure out how to get mental health experts and activists onto these bodies.

“Dissent with diplomacy is extremely hard, but it’s really about doing it strategically.”

Dissent with diplomacy is extremely hard, but it’s really about doing it strategically. As a mental health advocate, I’m accountable to point out that the government’s transgender rights bill is not okay, or that the mental health situation in Kashmir is terrible.

I may have to bide my time or hold my tongue sometimes, but it’s important to speak out.

Mental health is also a deeply intersectional and intersectoral issue. The Mental Health Care Act passed in 2017 laid down a very strong anti-discrimination clause, but there are various oppressions within mental health that we must be aware of, and we must be mindful of whether we’re complicit in creating them.

For example, Section 377 was struck down in 2018. But there’s still a major gap in mental health when it comes to the LGBTQ community, as the approach is still largely rooted in socio-cultural norms and the hegemony of cis-heterosexuality. And so, this bias has to be approached in multiple ways.

We have programmes that work on peer support practices with LGBTQ communities and have also created a programme called Queer Affirmative Counselling Practice, along with working on curricula changes with medical colleges in Maharashtra when it comes to gender and sexuality.

IDR: How would you define success for MHI?

HM: We’re still in the early days of our journey and have a long way to go in terms of what we want to achieve. We’re getting good traction now, and that will help us accelerate our journey as we go forward, but I don’t think we should get to a point where we label ourselves as having been a success. Yes, we should be confident that we are on the right track and are creating impact, but if we say that we are already successful, there isn’t any motivation to go further.

There is still a lot to be done. If we are able to influence the government—or even more funders—to give more support and funding to mental health, that is one measure of success.

RM: An immediate short-term goal for me would be to get other funders involved in mental health, particularly more rights-based funders. A second goal would be to help people who work in health or education realise that mental health is intersectoral and that they need to introduce facets of it into their work.

IDR: According to you, what can philanthropy in India do differently?

RM: When we were fighting for independence, there were plenty of industrialists who donated to the revolt against British rule. I find that passion and commitment to rights and freedom missing today, and I hope it returns.

“If you build for margins, the centre will get covered. If you build for the centre, the margins will never get covered.”

I would also like to see more philanthropists focusing on social justice. If you build for margins, the centre will get covered. If you build for the centre, the margins are never going to get covered. If we don’t change the frameworks for philanthropy, the status quo will persist.

I’d like to live in a society where we redistribute wealth such that we can get rid of philanthropy altogether.

This article was originally published on India Development Review.

About the authors:

AYESHA MARFATIAAyesha is an analyst at India Development Review. At IDR, in addition to writing and editing, she handles research-driven reports and curated content. She also supports the team with website management and digital marketing. Her work has been featured on The Wire, Scroll.in, and Quartz India. Ayesha holds a BA in Sociology and Anthropology from St Xavier’s College, Mumbai.
SNEHA PHILIPSneha leads content development and curation at IDR. Prior to IDR, she has worked at Dasra and EdelGive Foundation, across research and diligence verticals, on issues such as public health, sanitation, gender and strategic philanthropy. Sneha also worked at AIESEC—the world’s largest youth-run nonprofit organisation and was a founding member of SELTI International (now Educate Learning Center), a language training company in Budapest, Hungary. She has an MA in Development Studies from the Institute of Development Studies, University of Sussex and a BA in Economics from St Xavier’s College, Mumbai.
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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