A Shelter Story

By Nikita Prasad – Student Journalist from Asian College of Journalism

Muruggan* is busy painting and repairing a broken chair on the ground floor of The Banyan Open Shelter For Men with Psychosocial Disabilities (co-run with the Corporation of Chennai) at Dooming Kuppam, when his duty nurse calls him out for lunch. With his hands soiled in white paint, he gets up and greets the nurse with a bright smile.  The shelter dog Apu runs to him wagging his tail, he jumps with delight upon seeing his furry friend.

After petting him for a while he says, “I love the food that we get here. Never have I gone to bed empty stomach.”

“He is a big foodie and has always eaten whatever is served in our kitchen. The prospect of food makes him happy”, says Keerthana, a case manager at the shelter.

The man who has slightly matted, thinning grey hair and a short beard was found outside the Santhome Church six months ago, when team members from The Banyan located him and offered him a place in the Open Shelter. In the next two days, he was welcomed him into the shelter as a residential client. ‘Kind City Happy People’ is their street engagement program, through which they build rapport with homeless individuals on the streets, provide them with food and water, and attempt to get the person to come receive services from the shelter. 

Muruggan told them that he used to work in Velankadu and had a brother who lived near the crematorium there as well. However, The Banyan workers were unable to trace his address or family, even after repeated attempts. “Even though we found him wandering the streets , there was no sign of mental illness when we conducted our assessment. All he needed was a place to stay, where he was cared for’’ said Keerthana.

An OP (outpatient) client, who works as a carpentry trainer at Banyan, has been teaching Muruggan the skills required for carpentry for the past two months. He has shown great interest in learning carpentry and loves to paint, shape or repair wooden commodities. The OP client who comes to Banyan everyday for a fixed number of hours, trains all residents who show a keen interest in carpentry or are talented at it. “Some residents, come once in awhile, Muruggan works with me every day either with repair work or painting, and has picked up the skills of carpentry very fast”, said the OP client.

Whenever Muruggan is free he can be found playing with shelter dog, Apu. However, upon asking him who his best friend is at the shelter, he promptly replies “the duty nurse’’ without a blink. The nurse is closely associated with the residential clients at the shelter; she stays with them throughout the day, even through their daycare activities.

Other activities conducted at the shelter as part of creative and conventional training include paper folding, bead making, basket decorating and designing which increases the dynamic engagement and brain function of the residents.

Apart from day-care shelter residents, there are seven clients enrolled in their night shelter program in which they outside for their work during the day and come back to the shelter at night.

‘’For men who are old and destitute, a single meal puts a gleam of hope and gratitude in their eyes. We ensure a good life for them by providing them with food, clothes, work and shelter, so that they feel safe and comfortable here’’, said Keerthana.

Many residents like Muruggan, have found a new life at The Banyan despite having gone through unimaginable struggles in their past, having lost faith in life, and becoming depressed. Here, their sustainability is assured as they know they are taken care of.

After finishing his lunch, Muruggan picks up his tools to resume his carpentry work. Upon being asked where his home is, he says, “this is my home.”

*Names have been changed to maintain confidentiality 

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BALM – Sundram Fasteners Centre for Research and Social Action in Mental Health

Mental health issues are a problem that a large proportion of the population in India face today. The National Mental Health Survey estimates that 150 million individuals are currently living with mental illness in India. This staggering statistic demands a response of equal magnitude from the government, mental health professionals and individuals in the community. There is a dire need for reflection upon the trajectories that lead to mental ill health, effective treatment options and community-based solutions, for this is a serious public health concern that India is currently faced with.

September 17th marked the launch of The Banyan Academy of Leadership in Mental Health (BALM) – Sundram Fasteners Centre for Research and Social Action in Mental Health.

This centre is a collaborative effort between BALM and Sundram Fasteners Limited (SFL) that aims to develop comprehensive mental health services for vulnerable individuals, transform models of care and build strong practice-driven evidence through transdisciplinary research while educating individuals to work as professionals in the field.

Several noteworthy individuals were present at the centre’s launch last weekend, including Dr. Soumya Swaminathan, Director General of The Indian Council for Medical Research (ICMR), Dr. Nachiket Mor, Country Director of The Bill & Melinda Gates Foundation, India, Prof. Dr. Tom Burns (CBE) from the University of Oxford, Prof. Dr. Sanjeev Jain, from the Department of Psychiatry at NIMHANS, Dr. S. Parasuraman, Director of the Tata Institute of Social Sciences, Mr. Keshav Desiraju, the former Secretary of Health for the Government of India and Dr. J. Radhakrishnan, the current secretary of health and family welfare for the Government of India, Tamil Nadu.

These seven individuals participated in a panel discussion on transforming the state of mental health care in India that was moderated by Mr. N. Ram, the Chairman of Kasturi and Sons.

As with conversations that are engaging and productive, this panel discussion went on for two hours, an hour longer than originally planned for, touching upon numerous topics of interest.

 Lack of qualified professionals

An issue that was brought up by almost all of the panel members was that of the paucity of qualified mental health professionals available in India.

Unlike other illnesses of the body, mental illness is something that always exists within a social situation, a point brought up by Prof. Burns. He maintained that because of this fact, our treatment of these issues must emphasize the whole systems that individuals live in.

Dr. Jain expressed that the psychiatric training conducted in India puts a lot of focus on western psychological theories, such as those of Freud and Jung, while ignoring contextual backdrop of India.

“Almost every woman that I’ve come across at NIMHANS has been a victim of abuse” he voiced.

Gender discrimination and sexual assault are glaringly obvious problems in India that have been linked to mental health issues (1, 2) so why aren’t they a focus of psychiatric training? These issues along with those of poverty and scarcity of human resources hand in hand with a rising population level are social factors that need to be addressed in the mental health framework.

Dr. Jain stated context-driven training is of utmost importance, as it would improve the quality of psychiatrists working in the mental health field, rather than just the quantity, thus taking into account the systems that individuals are living their daily lives in.  

On top of psychiatrists, Dr. Gopikumar expressed that we need to look further into nurses, social workers and community lay-members for assistance. BALM in collaboration with TISS currently offers a diploma in community mental health programme that trains non-specialist members of the community to identify mental health issues within their communities and engaging with clients to navigate their daily lives while managing their illnesses.

Dr. Parasuraman declared that this programme would soon be available online, which will make its reach considerably more widespread.

Programmes like this have illustrated reductions in the prevalence of common mental health issues (1, 2) which in turn can reduce the burden of care in the long run.

Effective Interventions

Those who suffer from mental health issues have a life span that is 30 years less than the average, said Dr. Jain, expressing that professionals need to begin viewing these disorders as non-communicable diseases in order to treat them promptly and effectively.

Inspiration can also be drawn from The Echo Model, which links specialist teams with primary care clinicians through electronic devices in order to spread valuable knowledge to those who need it in an efficient manner.

Dr. Sarin highlighted the importance of the identification of effective treatment models, as well as the need to be open, flexible and responsive to users when developing new interventions.

Thus far, there have been no audits investigating the outcomes of the District Mental Health Programmes (DMHP) in India, even though they have supposedly been in place for years.

The role of government vs. the role of community

The Government of India recently implemented the National Mental Health Policy,  a policy that members of The Banyan played an integral role in writing.

It was brought up during this panel, however, that with total healthcare expenditure at a dismal 1.9% of the total budget, the responsibility of improving mental health care in India cannot be shouldered solely on the government.

Mr. Desiraju expressed concerns that the government would not show the leadership required to change the current course of mental health care in India.

In fact, Tamil Nadu is the only state in India that has the DMHP running in all 32 of its districts. As articulated by Dr. Radhakrishnan, South India’s health care and mental health care programmes have been consistently more stable and widespread than those in other parts of the country and thus it is integral to find out why that is, and perhaps replicate the success of the South in the rest of the country.

A robust study of DMHP outcomes across the country will be invaluable in aiding the government in figuring out what parts of the programme they need to alter and what parts they need to build upon.

Dr. Swaminathan, the director of the ICMR, called attention to the fact that there are several “islands of excellence” across India, however they are unable to scale up to governmental or centeralised levels,

Why is this the case? Possibly, lack of published research and documented protocols make replication efforts stagnant. She affirmed that the only way to move rapidly forward is through implementation research that results in well-documented and published studies.

A collaborative effort

The main take away from this panel was the absolute need for multiple stakeholders, including government officials, mental health care professionals, academics and community members to work together to solve these problems.After all, mental health care starts with attitude and goes up to treatment and therefore addressing issues of stigma are also paramount in tackling these issues at their root.

Current practices need to be viewed with a critical and reflective lens, and different groups and stakeholders need to come together – like they did during the launch of this centre – to brainstorm and innovate creative solutions for complex problems.

The collaboration with Sundram Fasteners Limited for this centre is a great one, for at SFL they are an organization that are highly committed to social justice and responsibility.

This centre, the first of its kind, is a prime example of how a multi-organisational, multi- stakeholder strategy aimed to tackle these mental health issues can work and we’re very excited to see what this collaboration will do for the future of mental health in India.

 

A Family Celebration

 

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Gold and white sarees were glittering in the sun. Broad smiles were spread across the faces of the residents and staff, alike. There was excitement in the air the day Onam was celebrated at The Banyan’s co-housing facility, the residence of several long-term clients of the organisation.

Residents at the co housing home dressed up to celebrate the Onam festival

One resident, when handed the Kerala saree she had spent her own salary to buy, bubbled up with joy. She can’t speak, but expressed her delight by enveloping the health care worker who had just handed it to her in a huge hug. Their laughs reverberated through the room.

Many of the residents living at the home use their income to buy things for occasions such as this one. They earn their pay through participating in vocational training activities or jobs from block printing, basket weaving, beading necklaces, to cooking food and working as assistants in the convenience store or library. And as I saw the morning of Onam, they are nothing short of delighted when able to enjoy the harvests of their hard work.

The Onam Festival is traditionally celebrated by Hindu-Malayalis, however at The Banyan these confining boundaries of identity are constantly being broken. On this day, I witnessed not just the Hindu residents from Kerala participating in the festivities, but residents from northern and southern India and residents from Hindu, Muslim and Christian backgrounds.

Staff, residents and health care workers at the co-housing home in Kovalam

The Banyan Academy of Leadership in Mental Health (BALM), a combination of a research facility, a capacity building establishment as well as an educational organisation that offers three full time master’s programmes (Social Work, Clinical Psychology and Counseling Psychology) is located in the same site as the co housing home.

Many of the residents who live at this group home don’t have the ability to speak and thus can have a difficult time communicating their needs- especially in times of distress. However, the staff, students and faculty maintain a demeanor that is patient, calm and kind; constructing a community that is built on affection, understanding and care. This integrated space is a perfect example of the values that are implemented here at The Banyan. Regardless of class, religion, diagnosis or position at The Banyan, everyone is treated with equal compassion and respect.

At the group home, the occasion was commemorated with a programme organized by the BALM students, which included performances of Malayali songs and dances. The residents of the Urban Shared Housing program competed in a Pookolam competition and joined the staff and clients at the Transit Care Centre to celebrate the occasion with them. Furthermore, students from a local college visited the Transit Care Centre and spent time with the clients and staff playing games and of course, enjoying a special Onam Sadhya meal.

The Banyan celebrations that took place in Kerala, the birthplace of the festival, were even more colourful.

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All the staff and the residents of the Home Again program there gathered at the Kerala office and together, and spent two hours creating a very large Pookolam after which they enjoyed a potluck style meal paying tribute to both Onam and Eid.

In a beautiful show of hospitality by the neighbours who live beside the Home Again project homes in Malappuram and Calicut, invited the residents to attend their family celebrations of both Onam and Eid. What’s more, the Home Again program residents also attended a government school in Mallapurram’s annual Onam celebration as the chief guests.

The celebrations that took place for Onam and Eid in Kerala this year provide a wonderful example of how the Home Again initiative created by The Banyan can help those with mental illness assimilate with their social surroundings. This not only allows for an improvement in well-being through added social interaction and support, but inadvertently improves understanding of mental illness and decreases stigma in the neighbouring communities.

For me, a recent addition to The Banyan, the highlight of the Onam festivities took place when the BALM students called for everyone- residents, staff and faculty- to come on stage and dance with them to the lively Malayali music. Despite the fact that it was my first week, many of the health care workers at the co-housing facility, pulled me on stage to dance alongside them and the residents. The cheer that spread through the auditorium in that moment made me feel warm, and that I was already part of The Banyan family.

The story of Onam is a story about community. King Mahabali was one of the most successful kings of his time, and legend has it that his kingdom was very prosperous and all of his subjects adored him. He was known for his kindness and his generosity, and his success was so great that it made even some of the gods jealous and fearful of his power.

On account of their fear, the gods begged Lord Vishnu to rid the world of Mahabali, and he agreed.

He disguised himself as a dwarf Brahmin, Vamana, and approached king Mahabali. The king ignorant of his true identity, took pity on Vamana and offered to grant him anything he desired.

Vamana requested that he be granted the amount of land that he could traverse in three steps, Mahabali although confused by the minute scale of the request, accepted.

Following the request’s approval, Vamana assumed his true enormous size and walked three steps. His first step covered the earth, his second the waters and his third, he placed on top of Mahabali’s head, condemning him to hell.

His subjects, however, were true devotees of Mahabali and could not forget their remarkable king so easily, they pleaded with Lord Vishnu to kindly bring him back.

Lord Vishnu was touched by the people’s devotion and agreed to allow Mahabali to return to Kerala once every year for 10 days right after the crops were harvested. Mahabali’s return signifies the Festival of Onam, which was celebrated at The Banyan this year.

This story, illustrates a community’s love for a king who valued inclusivity and social justice for all its subjects. A message that resonates through The Banyan’s reach across India.

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Ready Mix Powder Workshop for Caregivers at The Banyan’s Day Care Centre

The State Resource cum Training Centre (SRTC) at K.K. Nagar, where The Banyan’s Day Care Centre is functioning, is a government office where the goal is identification of all disabilities, intervention, vocational training and employment for the disabled.

Camps are being held for issuing Identity Cards for the disabled for availing welfare schemes. There are model special schools for each disability.  It serves as an intervention centre.

There are nearly 60 mothers who come with their little ones and stay the whole day since they too need to be trained to communicate and understand their disabled children’s needs at home. The caregivers sometimes would sit outside and have time for themselves.

The Banyan had conducted a Parenting Workshop last year focussing on acceptance of their children with special needs.

This November, after discussing with them about their areas of interest, The Banyan held a workshop on the 26th.  The Workshop was on making ready mix powders, which the caregivers could prepare at home and start selling at shops as an income generation activity.

Volunteer, Ms. Indra, along with Vocational Training Coordinator Ms. Mary Sasikala conducted the workshop in the premises of SRTC. 32 caregivers attended the workshop.

They were first told how to use the induction stove and then taught the preparation of ready mix powders. The ingredients were explained and the caregivers noted it down.  For those who couldn’t write, a photocopy was given.

The group was very interested. Ms. Indra conducted the workshop in a simple and  clear manner. She gave instructions to make sambar mix, rasam powder mix, Idli powder mix and dhall mix (can be mixed in rice).

Caregivers were happy about the workshop and gave their feedback saying that in these days of fast food and unhygienic snacks, which can be found at every shop, they wanted to learn about making cake and biscuits and other nutritious dishes from Ms. Indra hygienically at home.

Navaratri Celebrations at Adaikalam!

It was joy and vibrance that filled Adaikalam, The Banyan’s Transit Care Centre, on the eve of the Navaratri. The celebration, hosted on the 30th of September, displayed the combined enthusiasm of the residents and staff.

The festival involved the setting up of the Golu, wherein dolls of various religious deities were arranged by the clients . A miniature setup depicting a typical town life showcasing its well-lit huts, streets, grazing cows, and a temple at the centre reflected their enthusiasm.

Following this was the traditional ritual of the lighting up of the kuthu vilakku by an elderly resident and that kickstarted the carnival of good vanquishing evil. Everyone took the aarti.

Even hours after the pooja, Adaikalam retained a festive air filled with smiles and laughter.

If you would like to participate in The Banyan’s work, please follow the links below….

Click here to VOLUNTEER!

Contact Fanny for more info: +91-9884008643. volunteers@thebanyan.org

Click here to DONATE!

Contact Kamala for more info: +91-9840275085. kamala@thebanyan.org