In India, around 1.41% of the population has schizophrenia, and 0.42% currently have schizophrenia (Hedge et al., 2023).

In  India, around 1.41% of the population has schizophrenia, and 0.42% currently have schizophrenia (Hedge et al., 2023). The recommended psychiatrist-to-population ratio is 3 psychiatrists for every 100,000 individuals, but as per the latest collected data, the ratio in India remains at 0.75 psychiatrists for every 100,000 individuals (Garg et al., 2019). Noting this glaring gap, which existed even in 1984, the Schizophrenia Research Foundation (SCARF) was established in Chennai. This foundation works towards providing mental health services and advocates for individuals with schizophrenia, as well as other mental illnesses, and works towards further research in this area (Scarf India).
Over the last 40 years, SCARF has worked tirelessly to improve the standard of living and the mental health of individuals all over India. They provide inpatient and outpatient care, daycare programmes, mobile telepsychiatry, teleconsultation services, and community outreach programmes to reach as many people as possible. Additionally, besides these clinical services, they have specialised programs as well, such as early intervention programs for psychosis, youth mental health, and carer for dementia programs, to name a few. They provide psychosocial rehabilitation and counselling programs as well. They help individuals not only in terms of their mental health but also help them adjust to reintegration into society by helping them develop skills necessary for professional growth. Further, they provide additional training to individuals looking to enter this field through their postgraduate training, workshops, intervention-based training, and internship programs. The research accomplishments of having completed 150+ projects, 500+ applications, national and international recognition, and a position among the top 11 medical research foundations in India speak for themselves. Acknowledging the barriers that still exist in terms of mental health in India, SCARF focuses on creating and implementing unique events and initiatives to connect better with the target population.

SCARF Community Initiatives

The approach taken by SCARF to draw attention and to advocate for individuals with mental illnesses remains to be rather unique. Rather than traditional fundraisers and conferences, the events conducted by SCARF include ‘Frame of Mind,’ Media for Mental Health Awards, Mental Health Cafe, Body and Mind lecture series, ‘Into The Mind,’ and so on. The Frame of Mind event is an international film festival that accepts films related to mental health and is followed by a panel discussion and award event to recognise the best films on the topic. The Media for Mental Health Award by SCARF in collaboration with the Press Institute of India calls journalists and writers to submit their articles on any topic under the umbrella of mental health. The awards for mental health reporting go a long way to help boost the confidence of authors who wish to write and publish about this unspoken topic. Into The Mind calls for photographers to submit images that they have clicked and believe to represent not only the world outside but also their true selves. The Mental Health Cafe is an initiative aimed at facilitating conversation about mental health over coffee; the lecture series is a series of panel discussions following professionals who come together to discuss the role of mind and body in various illnesses. SCARF also celebrates World Health Day, World Mental Health Day, Disability Day, and World Schizophrenia Day.

The varying events allow for individuals from a range of professions and passions to come together to advocate for a cause they all believe in while using their way of expression. Initiatives like these call for a larger group to participate, sharing the message that SCARF wishes to pass on in a new and interesting manner. The events portray mental health in a new light, allowing for the stigma surrounding the same to take a hit. The interactive events and the accessible platform make this a powerful community-centered approach, bringing together different groups. In a country like ours, where many are yet hesitant to accept mental health as an important indicator of overall health, these kinds of grassroots initiatives are the need of the hour. Recently, SCARF celebrated 40 years by hosting a grand mela: there were counselling booths set up, skills training resources, legal aid information, and sensitisation workshops to help improve the accuracy of mental health in different forms of media—all under one roof.

Shinrin-Yoku: Adding nature into the mix

In its longstanding history, Indian medicinal and healing traditions are closely related to nature. For instance, Ayurveda, a traditional form of medicine in India, and homoeopathy, are both based on natural elements (Frawley & Ranade, 2001). The use of these medications has proven to show positive signs in terms of treatment efficacy in cases of schizophrenia as well (Achutan et al., 2024). Apart from nature-based medication, interventions that take place in nature are extremely beneficial, helping individuals improve mindfulness, resilience, and self-awareness (Chhajer & Hira, 2024).

While integrating creativity and innovation is a powerful aspect of community-based mental health interventions, the Japanese concept of ‘Shinrin-Yoku’ provides an environmental approach to interventions to promote mental health care. Shinrin Yoku, also known as forest bathing, is a Japanese practice that aligns with aspects of nature therapy (Japan National Tourism Organisation). Developed by Dr. Qing Li and explained in his book about the same ‘Forest Bathing: How Trees Can Help You Find Health and Happiness,’ this practice has historical roots tracing back decades. The practice is rather simple, requiring an individual to step into nature and completely immerse themselves where they are—this includes forgetting everything else and just being in the moment. By doing so, the practice helps in reducing stress and anxiety and enhances immune function and mood. The nature aspect can be either stepping into a forest, if accessible or simply just entering a green pocket wherever you find one. The practice of forest bathing shares many similarities with other traditional Japanese practices, such as Zen meditation; the individual is required to be completely present in the current moment, focusing all their senses on what is present in their vicinity at that given time.

SCARF looks beyond medications and focuses on community approaches and interventions to improve awareness and knowledge related to the field of mental health. The integration of interventions such as Shinrin-Yoku can complement SCARF’s mission of making mental health more accessible. Using the concept of forest bathing to connect with populations reached via mobile telepsychiatry services, community well-being outreach programs, and awareness programs can help cater to a wider audience and truly help them. For instance, nature-based interventions that are easy to understand and implement can prove to be particularly useful for rural populations that are not easily accessible to help them reduce stress levels. By integrating international approaches and techniques, SCARF can expand its mission and vision of promoting mental health and illness as something that is way beyond just traditional psychiatry and medicines.

Authors: Muskan Shah, FLAME Alumna, & Prof. Moitrayee Das, Faculty of Psychology, FLAME University.