My first experience with people in the periphery working in mental health was during 1978-80 when I was doing DPM at Madurai Medical College. As part of community psychiatry, we were posted in Balarengapuram, an outskirt of Madurai. Later during my MD Psychiatry training in PGIMER Chandigarh during 1982-84, we were posted in the village Raipur Rani in Haryana where we came across lots of ordinary people and few mental health workers.

My big break came in 1988, while working as a lecturer in psychiatry at Medical College, Kottayam in my native Kerala.  Kottayam was the first General Hospital Psychiatry Unit in Kerala started in 1967, before which mental health facilities were available only at the three mental hospitals in Trivandrum, Trichur and Calicut.  At Kottayam we had only 30 beds and a huge clientele. Many times patients could not be admitted, as all the beds were already occupied. At other times, we resorted to early discharges, to accommodate other patients.  Around this time, something remarkable happened. Mr. PU Thomas one of our nursing attendant in the ward, thought of a rehabilitation centre for the mentally ill!He told me, he and his friends would take care of 10-12 patients, outside the hospital in a rented building, provided we would give the necessary psychiatric care.

There was a discussion with my colleagues and we all agreed to help Thomas in this small endeavour. At first, patients from distant places especially from the hilly Idukki district of Kerala, who could not come for early follow- up were looked after by this group of lay carers.  This turned out to be a big success. More and more people were seeking their support. Moreover, there were many orphan mentally ill, who had no where else to go.  With our encouragement and with the support of the public of Gandhi Nagar (in Arpookara village of Kottayam) where the Medical College is located, Thomas and his friends decided to form an NGO. Thus the ‘Navajeevan Trust’ was born in the early nineties. With public donations, they purchased a plot of land, about a kilometer away from the Medical College and soon a full fledged Rehabilitation Centre was born.