While waiting for a delayed departure at Goa airport recently, I engaged in conversation with a fellow frustrated passenger who happened to be an American tourist. Upon discovering that I had spent eight months in Goa initiating a field study on common mental disorders in primary care clinics, she expressed amazement exclaiming “but surely there can't be mental problems in this place… it's so beautiful and everyone seems so happy!”. After a brief moment wondering whether my companion was joking, I realised that my work in Goa could in itself seem a bit of a joke to colleagues and friends who associated Goa with being a holiday destination. Not only is the view that living in an apparent paradise is somehow conducive to better mental health a smokescreen, I had come to realise that mental illness was a considerable problem in this coastal state. Perhaps this essay could be an opportunity to explain why.