OBJECTIVE: To examine commonly held indigenous beliefs about mental illness, which often differ markedly from the biomedical models, among community health workers in rural South India. METHOD: Indigenous beliefs about chronic psychosis were elicited from community health workers. The Short Explanatory Model Interview formed the basis of the interview. RESULTS: A variety of indigenous beliefs, which contradicted the biomedical model, were elicited. A significant proportion of health workers did not recognize chronic psychosis as a disease condition, believing that it was caused by black magic, evil spirits and poverty, and felt that doctors could not help. CONCLUSION: The results of the study suggest that training programmes should elicit and discuss local beliefs prior to the teaching of the biomedical model of mental disorders.