For Ambedkar, dignity could not be secured by asking the oppressed to develop self-respect while continuing to live under a system that denied them equality. His embrace of the Buddha’s Dhamma on October 14, 1956 marked a rejection of caste as the basis for organising human life and an assertion of a different moral and social order grounded in liberty, equality and fraternity. This was about more than religious conversion. It was about reclaiming the right to live as an equal human being, exercise agency and determine the course of one’s own life. Dignity, in this sense, also requires changing the social conditions that produce humiliation, exclusion and unequal access to resources and opportunities.This raises a question that remains important for mental health care today: What does it mean to care for someone whose distress is shaped by the social conditions they live in? Care must take these conditions into account, as well as the power relations that influence how distress is understood and addressed. It also requires asking whose knowledge counts, whose experiences shape the response, and whether people have the freedom to define what healing means in their own lives.I came to these questions through Dalit Alchemy, a Dalit mental health initiative I led at the Mariwala Health Initiative (MHI). Naming the Pain and Discovering User-Centric Mechanisms to Heal the Generational Trauma of Being a Dalit was one research project within this larger initiative. Working with five Dalit human rights defenders, we explored how caste-based violence, humiliation and exclusion shape psychological experiences, and what becomes possible when people have the autonomy and material means to define their own care. As a Dalit mental health practitioner, I found that much of what participants shared resonated with my own experiences of living in a caste-based society.The myth of caste as historyThe work began with something deceptively simple: naming the pain. This required more than recognising individual experiences of distress. It meant bringing into language experiences that caste has normalised, silenced or made difficult to recognise as harm, and understanding how they are connected to the social structures that produce and sustain them.Caste-inflicted distress remains outside of the traditional psychological understanding. Caste shapes everyday experiences, relationships, self-perception and a person’s sense of safety, worth and belonging. Its effects cannot be understood by looking at the individual alone.This distress may appear as fear of public humiliation, memories of being treated as invisible or inferior, pressure to remain silent, anxiety about losing work or safety, or the exhaustion of having to prove one’s worth repeatedly in spaces where one is not treated as an equal. For Dalit people today, caste is not simply a matter of history. It continues to shape experiences in classrooms, universities, workplaces, institutions, relationships and public life.When such distress is understood only through an individual clinical lens, the focus gets shifted towards perceived shortfalls such as “poor coping, low resilience or withdrawal.” But asking what has happened to a person, and what conditions they continue to live under, can change how these responses are understood. Anger, caution, silence or withdrawal may be responses to experiences in which speaking up, asserting oneself or challenging unfair treatment has carried life-threatening consequences.When distress arising from structural violence is treated solely as an individual pathology, the responsibility for addressing its effects shifts onto the person experiencing it. In contrast, the conditions producing the distress remain unexamined. The person is expected to adapt, recover and fix themselves, even when the circumstances contributing to their distress have not changed.Recognising caste as part of this context allows people and practitioners to consider distress rather than interpreting it as a personal failure. It also makes it possible to ask what support is needed and what changes in a person’s circumstances might help.The power of agencyThe second lesson from our research concerned autonomy. For one year, each participant received an unconditional monthly mental health allowance. The goal was to create an opportunity for participants to decide how they wanted to use the support for their own well-being, rather than requiring them to follow a prescribed therapeutic model.Participants used the allowance for rest, solitude, journaling, retreats, music, storytelling, body care, ritual, learning opportunities, travel, food, family time and community support activities.These choices matter in a context where Dalit people have historically faced restrictions on their labour, mobility, access to resources and control over their time. Having the means to decide how to rest, travel, learn, celebrate or care for one’s community creates space for choices that may otherwise be difficult to make. The allowance was therefore significant as a means of exercising choice, rather than simply as financial assistance.Participants were not required to demonstrate healing in a form defined by someone else. They could decide what mattered to them and how they wanted to use the opportunity. Their experiences raise an important question for mental health care: are people recognised as agents who can define their own needs and shape their care, or are they expected to receive services designed around someone else’s understanding of what they need?The participants’ experiences offer different ways of understanding what this freedom to choose meant in practice.Rest and Embodiment: One participant used the allowance to prioritise rest, time in nature and bodily care through head and foot massages. Her choices drew attention to the importance of having time and resources to care for one’s body, particularly in a social context where Dalit labour has historically been exploited and devalued. Another participant used the allowance around her mother’s death anniversary to organise a community food offering. She also bought soft toys that she had been denied in childhood. These choices connected personal memories, grief, family and community in ways that were meaningful to her.Learning and Self-Investment: Another participant used the allowance for training and learning opportunities. She chose to invest in knowledge and skills that mattered to her. This was more than professional development. It gave her the opportunity to decide what she wanted to learn and where she wanted to invest in herself, based on her own priorities.Travel, Reflection and Culture: Male participants used the support in different ways. One saved his allowance over two months for a solo trip to a place he had not visited before. He stayed in a simple homestay, walked through unfamiliar streets, tried regional food and journalled without work responsibilities. He also invested in a gym membership to support his physical and emotional well-being. On another occasion, he took his family to watch the film Phule, creating an opportunity for a family outing and conversation about history, dignity and community struggles. These choices show how participants understood their own needs and incorporated different forms of care into their lives.Collective Care and Leadership: Another participant used the funds for peer travel, musical and cultural programmes in villages, storytelling nights and overnight community gatherings. His experience of receiving unconditional support also influenced how he thought about his responsibilities as a leader managing a high-stress team. He reflected on the need to provide similar opportunities for self-care and mental health support to his staff. His experience raised a practical question about how organisations care for the people responsible for supporting others.Taken together, these experiences show that participants understood care in different ways. Their choices included individual activities, family experiences, learning and community engagement. They also demonstrate why care cannot be defined only through formal treatment or clinical appointments. People may need different forms of support at different points in their lives, and they should have a meaningful role in deciding what is useful to them.Honouring the wound in mental healthIndian law recognises and criminalises specified caste-based atrocities, including certain acts of humiliation, under the Scheduled Castes and Scheduled Tribes (Prevention of Atrocities) Act. Yet, mental health discussions have been slower to examine how experiences of caste-based discrimination, exclusion and humiliation affect a person’s sense of safety, agency and self-worth.Recognising these experiences matters for mental health practitioners. Distress must be understood in relation to the circumstances in which it develops, including experiences of discrimination, threats to livelihood, exclusion from institutions and repeated attacks on a person’s dignity. Practitioners need to consider these factors rather than interpreting every response through individual symptoms or coping abilities alone.A dignified approach to mental health care also requires practitioners to recognise that support does not always have to take place within the clinical consulting room. Depending on a person’s needs and preferences, care may include opportunities for rest, learning, bodily well-being, relationships, cultural activities or community support. These options should complement appropriate clinical care when needed, not replace it.Mental health organisations also need to examine their own practices. Do they take caste-related experiences seriously? Do they make space for people to participate in decisions about their care? Are their services accessible to people who face material and social barriers? Do they recognise the limits of individual interventions when the conditions contributing to distress remain unchanged?These questions are necessary if mental health care is to respond adequately to the experiences of people whose distress is shaped by structural inequality.An invitation for todayDhamma Chakra Pravartan Din invites us to look beyond tribute and consider a contemporary question: as dignity was central to Dr. Ambedkar’s vision of social transformation, what would it mean to make dignity central to mental health care?Healing cannot mean learning to endure caste oppression while the conditions producing harm remain unchanged. When distress arising from caste is treated solely as an individual problem, people are expected to regulate their emotions, adapt their behaviour and recover, while the circumstances affecting their dignity, safety and agency escape scrutiny.Mental health care must therefore recognise the relationship between individual distress and social conditions. People need the opportunity to name their experiences, understand their distress in context and decide what support they need. Their access to care should not depend on proving the severity of their suffering, demonstrating resilience or learning to adjust to injustice. Practitioners and institutions must also take responsibility for identifying and addressing the barriers that affect people’s well-being.The experiences of the five participants in our research raise an important question about how care is designed and delivered. It does not suggest that one approach will work for everyone. When people are invited to identify their own needs and are given the means to act on their choices, care can become more responsive to their lives and circumstances.Making dignity central to mental health care requires us to consider both how people are supported and the conditions in which they live. It requires care that respects people’s agency, takes their experiences seriously and does not place the entire responsibility for “assumed recovery” on those experiencing distress.Dr. Vaishali Sonavane is a Dalit mental health practitioner, researcher and founder of Alchemy Healing Hub and Ease Evolution. She led Dalit Alchemy, a Dalit mental health initiative at the Mariwala Health Initiative, and the research project Naming the Pain and Discovering User-Centric Mechanisms to Heal the Generational Trauma of Being a Dalit as part of this initiative.