Vidarbha Stress and Health Programme

Mental disorders, such as depression and alcohol use problems, are major public health problems in India. Suicide is a major cause of death, especially in young adults and in rural areas. Vidarbha in Maharashtra has been adversely affected by agricultural crises, to which farmer suicides have been linked. However, there are no comprehensive, community-based efforts to address psycho-social distress or mental disorders in the region.

VISHRAM is a four-year community-based initiative to promote mental health and manage mental health disorders in communities such as Vidarbha, in partnership with local institutes and non-governmental organisations (NGOs) operating in the region.

VISHRAM aims to understand the mental health needs of rural communities in Vidarbha, train human resources for improving mental health awareness and delivering community-based mental health interventions, and ultimately improve the coverage of mental health services for common mental disorders, alcohol use disorders and childhood mental health disorders.

Specific objectives –

  1. Assess mental health needs and resources for the provision of mental health care
  2. Train health workers in various aspects of psychosocial and mental health care
  3. Deliver evidence-based psychosocial and mental health interventions
  4. Advocate to raise awareness and demand for mental health care
  5. Monitor and evaluate the impact of the programme
  6. Establish collaborations with partners in Vidarbha region with the aim of scaling up

The project is continually holding clinics, meetings, workshops and training programmes to promote mental health, prevent psycho-social distress and manage mental disorders in its selected communities.

Launched in 2011 in Nagpur, west India, VISHRAM is being implemented in two phases over four years. The first two years is the development phase, during which the programme will be piloted in one block each in two districts – Arvi in Wardha and Chandur Bazaar in Amravati.

During the second phase, the programme will be extended to two more blocks in two additional districts. In order to further the aims of the project, a partnership has been formed with NGOs already working with agricultural communities in Vidarbha such as Watershed Organisation TRust (WOTR) in Wardha and Prakriti in Amravati. Sangath has also formed associations with other stakeholders in the region, notably mental health professionals and community leaders.
The team is focusing on five main domains to achieve its objectives – 1) programme management and governance; 2) capacity building; 3) mental health specialist interventions; 4) primary health care interventions and 5) community interventions.

  1. Multi-disciplinary individuals from the team will ensure supervision of the programme and constantly monitor it for smooth management and governance
  2. community health workers and counsellors will receive mental health first aid to enhance their knowledge and skills
  3. Psychiatrists – including Dr Prakash Behere in Wardha, Dr Abhishek Mamarde in Nagpur and Dr Shrikant Deshmukh in Amravati – have been appointed as consultants to the project and are currently coordinating outreach clinics in villages and providing specialist mental health care when required
  4. Sangath is collaborating with the Maharashtra Health Service Department to deliver primary mental health care at primary health centres
  5. Trained service providers are currently conducting awareness sessions to improve mental health literacy and help-seeking behaviour for mental health disorders.

Some achievements

  • Work packages for community-based interventions have been drafted and are being implemented in the two districts
  • Health counsellors from partner organisations have been trained to deliver counselling treatment to people with depression and drinking problems. They are being supervised by Dr Abhishek Mamarde and Siddharth Gangale
  • Hundreds of patients have been treated so far in the outreach clinics organised every month in both districts
  • Evidence shows that people are accessing treatment for mental illness



To read about the VISHRAM project in detail access its toolkit, click on the following links:

– VISHRAM Toolkit

CHW ManualVISHRAM Toolkit Appendix