Feature

Building for the Margins

Raj Mariwala’s Journey of Pioneering an LGBTQIA+ Lens in Philanthropy and Mental Health

GivingPi Editorial Team

28th September 2023

"As a philanthropist, if you don’t have an LGBTQIA+ lens, you are actually actively keeping LGBTQIA+ people from accessing whatever supporting you are providing."

“Mental health is a term that’s been heavily stigmatized,” says Raj Mariwala—director of the Mariwala Health Initiative (MHI). Prior to when Raj and Harsh Mariwala set up MHI in 2015, funding for mental health initiatives had been quite limited. “In fact, people explicitly warned us not to use the term ‘mental health’ in the name of our organization because of the baggage and negativity that surrounded it,” says Raj. When Harsh Mariwala stepped down from chairman of Marico, the duo started MHI – an organization aimed at supporting quality mental health services, enabling ongoing research, and encouraging innovative, culturally sensitive, and inclusive community-based interventions.

When talking about MHI’s work Raj stresses that “mental health is a development issue, and we cannot neatly separate it from issues such as homelessness, poverty, and food security. These issues have very real mental health consequences; in fact, they share a bidirectional relationship.”

LGBTQIA+ Lens in Philanthropy and Mental Health

MHI has always aimed to unearth mental health narratives that have historically remained invisible. According to Raj, “When the more visible narratives are the privileged ones, we tend to uphold certain frameworks that leave behind those who have been historically marginalized.”

MHI strongly advocates for the adoption of an LGBTQIA+ lens in both philanthropy and mental health. This means centering the experiences of LGBTQIA+ individuals and understanding the unique stressors they experience. Raj explains that historically, they have been subjected to violence from mental health and releated disciplines. For example, homosexuality was classified as a disorder in psychiatric manuals until as late as 1990, leading to practices such as conversion therapy and institutionalization as standard forms of “treatment” for queer individuals. Adopting an LGBTQIA+ lens, which acknowledges such historical discrimination and seeks to learn from their lived experiences, is a crucial step towards making mental health services and support accessible to people from the margins. Raj emphasizes that this transcends the mere establishment of these services; it pertains to their usability, approachability, and appropriateness for the users.

Elaborating on this lens, Raj distinguishes between 'queer friendly' and 'queer affirmative' approaches in mental health. A queer friendly practitioner maintains a neutral approach in the therapy room and may not fully understand the experiences of LGBTQIA+ individuals who experience discrimination, stigma, and stress on the very basis of who they are, compared to their heterosexual counterparts. In contrast, a queer affirmative practitioner not only acknowledges these deep-rooted inequalities but strives to address the discrimination faced by LGBTQIA+ individuals. Such practitioners demonstrate active allyship and advocate for LGBTQIA+ individuals in different spaces.

Building Mental Health Awareness at Women's March 2018

"We’ve funded everything from an organization sitting in the heart of Mumbai with an English-speaking leadership team to a two-person informal organization that works on mental health in Shillong."

- Raj Mariwala

How MHI is fostering an environment of accessible, affirmative, rights-based and user-centric mental healthcare

Leading by Example

To foster a queer affirmative approach among mental health practitioners, MHI established their Queer Affirmative Counseling Practices (QACP) course in 2019—a 6 day program designed by queer and transgender Mental Health Practitioners (MHPs) that trains MHPs to be queer affirmative. Since the course’s inception, MHI has trained 535 MHPs under QACP. Additionally, 100 individuals have been trained in providing peer support for LGBTQIA+ communities.

In 2022, MHI also launched the QACP resource book, which aims to help MHPs in identifying and addressing the unique stressors faced by LGBTQIA+ persons as they navigate through challenges faced in institutional, social, and individual settings. The resource book presents a well-balanced blend of knowledge, perspectives, skills, and a diverse array of pedagogic tools to engage with its content, which is rooted in the lived experiences of queer and transgender realities. This valuable resource can help MHPs in deepening their understanding and responding in affirmative ways to the unique challenges encountered by those marginalized due to their gender and sexuality.

In their efforts to design programs across various marginalized communities, Raj initially envisioned using the QACP program as a reference. However, they soon recognized the underrepresentation of historically marginalized groups in the mental health field. In response, MHI began exploring how they can support more individuals from marginalized communities in becoming mental health professionals. To this end, they developed affirmative hiring practices, and today, a portion of MHI's team comprises individuals hired through an internship program exclusively open to marginalized communities.

Raj notes that funders often view LGTBQIA+ issues in a vacuum, which, though well-intentioned, can pose challenges. The absence of a more rounded perspective on the issues that impact these communities leads to funds being diverted to stereotypical LGBTQIA+ causes such as HIV/AIDS. Raj emphasizes that without an LGBTQIA+ lens in philanthropy, funders inadvertently hinder LGBTQIA+ individuals from accessing the support they aim to provide. “Consider supporting education without this lens—what happens to queer and trans children? They may end up dropping out of school. And when it comes to conducting sexual and reproductive health lessons, how can we truly address the needs of these communities without such a critical perspective?”stresses Raj.

Raj Mariwala and the MHI team at their head office in Mumbai

Championing Change for the Margins

As demonstrated through their work on QACP, Raj is driven by a firm conviction in supporting those on the margins. “The credo that I believe in is that if you create systems for the margins, you will cover everyone; but if you start building a system for the center, you will never reach the margins,” says Raj.

In line with this belief, MHI works on grant-making, advocacy, and capacity building with organizations that cover a spectrum of marginalization, including those that serve LGBTQIA+ communities, caste marginalized communities, Adivasi communities, people with disabilities, and communities in remote geographies. Raj believes that when looking for systems failures, the most glaring gaps emerge when we look at the margins. “If we fix these gaps, we fix them for everyone.”

Raj cites disaster shelters as an example to underscore why we must consciously build for the margins. Highlighting how queer, transgender, and Dalit individuals were discriminated against and denied entry into disaster shelters after being displaced during the 2006 tsunami, Raj emphasizes that a one-size-fits-all approach often excludes those on the margins. The disabled individuals who managed to make it to the shelters also had to contend with inaccessible bathrooms. “What must that do to your mental health when you’re already living through a disaster?” Raj says.

MHI’s aim of building for the margins also influences the kinds of stakeholders they choose to fund. In addition to funding formal mental health organizations that employ psychiatrists or community mental health workers, they also fund independent researchers, activists, grassroots organizations led by those from marginalized communities and the work led by those with lived experiences of mental illness.

Amidst a philanthropic landscape often characterized by networks of privilege, MHI takes intentional steps to expand their reach and impact. Particularly during emergencies or disasters in the regions they operate, MHI actively collaborates with grassroots partners to spread the word about their funding opportunities. This allows smaller organizations in these regions to access funding and support at a time when they may need it most.

Moreover, MHI is committed to breaking language barriers and ensuring accessibility for all. Raj explains, “If applicants need support in languages other than English or Hindi, we arrange assistance, conduct phone interviews, and aid the application process.”

Beyond Grant-Making

Philanthropy can often be limited to grant-making, however, Raj strives for MHI’s work to transcend this paradigm. In order for the organization to help develop a mental health ecosystem that endorses a rights-based, bottom-up approach, it needed to take up advocacy. Advocacy was also the key to drawing more funders into the space. Underscoring the critical role of advocacy, Raj says, “I realized that there was no way to build other courses like QACP without significant investment aimed towards changing the way in which the mental health disciplines are structured in this country.”

Foregrounding counter narratives is also a guiding principle of MHI. While advocacy can contribute to achieving this, the organization also recognizes the need for capacity building. As a result, the QACP resource book is available free of cost to those who want to access it, and so is ReFrame— MHI’s journal that endeavors to not only transform existing discussions around mental health, but also to widen the scope for participation in these crucial conversations.

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Shruti Chakravarty, Pooja Nair, Gauri Shringarpure, authors of the QACP resource book

Navigating the Journey: Challenges and Learnings

Although Raj’s cogent philosophy on mental health and philanthropy may make it seem like they’ve always had it all figured out, their journey as a philanthropist has not been without its fair share of challenges.

“Philanthropy has been a lonely space,” Raj says. “Since there aren’t many philanthropists funding mental health, it feels like my opportunities to learn different approaches to philanthropy have been limited.” As a funder who wants to ensure that mental health philanthropy does not uphold ableist dominant narratives, Raj senses a lack of philanthropic mentors to learn from.

MHI has always believed that in an ideal mental health ecosystem, community leaders would drive mental health work in their own communities. But Raj observes that MHI only understood how to operationalize this idea after immersing themselves into the field. “We now fund a lot of community-based organizations who traditionally did not work on mental health. So we had to slowly learn how to operationalize our vision by understanding mental health alongside them.”

Through MHI, Raj envisions fostering an environment of accessible, affirmative, rights-based, and user-centric mental healthcare and aspires to work on vital initiatives such as suicide prevention, climate change's impact on mental health and deinstitutionalization of mental health institutions.

For philanthropists looking to enter the mental health space, Raj stresses the need to view mental health and provision of relevant services as a human right. This perspective is crucial, especially in a country where people from vulnerable communities living with mental illnesses are often deprived of their rights. More importantly, Raj emphasizes the need to avoid pathologizing mental health, which means using science to fit certain types of behavior into disease models, thereby labeling non-normative genders and sexualities as disorders or illnesses.

But what does recognizing mental health as a rights-based issue look like in practice? Raj explains, “We cannot sidestep the need to address the social, economic, and institutional exclusion that contributes to psychosocial distress. This means that we must widen the ambit of mental healthcare beyond affirmative mental health services and policy to demand freedom from violence and food insecurity and the provision of social safety nets, labour rights, LGBTQIA+ rights, and human rights.”

As India approaches 100 years of independence, there is a critical role that philanthropy needs to play, and as Raj highlights, “We must guide ourselves with the principle that none of us is free until all of us are free. Indian philanthropy has a ready-made blueprint that we need to follow, set by one of India's greatest leaders - Dr Babasaheb Ambedkar. His thoughts on democracy and development are not only globally relevant but are also clearly linked to the tangible pursuit of India achieving the Sustainable Development Goals.”