Agents of change

Print edition : June 26, 2015

TISS Hyderabad students at their convocation.

At TISS, Mumbai. The TISS goes beyond linkages to cater to needs across the country. Photo: Shashi Ashiwal

Through creative partnerships and meticulous research, the TISS tries to close the gaps in state intervention to address social deprivations and sufferings.

IN 1993, two young women barely out of college, Vandana Gopikumar and Vaishnavi Jayakumar, took upon themselves the challenge of caring for mentally ill destitute women. They founded The Banyan, in Chennai. “Our responses were patient-centric and based on the perceived need. We took up the issue of homeless [mentally ill women] hoping it would end there,” says Professor Vandana Gopikumar, founder trustee.

It did not. Rehabilitated patients wandering away from their homes after being reunited with their families, the lack of mental health care facilities in two-thirds of the country’s districts, and The Banyan’s own belief that institutionalisation is not the way to go ahead in caring for the mentally ill, forced it to transition into a centre that offers comprehensive care packages for men, women and children in distress and/or afflicted with severe and common mental disorders. Its strategic focus to prevent and/or adequately address a descent into homelessness or a state of acute psychological distress, often as a consequence of illness and untreated mental disorders, has resulted in the development of four critical areas of work: emergency and therapeutic services for homeless persons with mental health issues; inclusive ecosystems for persons with mental health issues; health and mental health systems and NALAM—social inclusion, skills development and well-being.

It took The Banyan more than two decades to build a model that comprehensively addresses the needs of homeless people with mental health issues on the streets, in hospitals (transit care centres), in open shelters and in the community and arrive at designs that take into account diverse needs, including long-term care, which is a growing problem in mental health care globally. With self reliance and personal recovery as goals, most models are geared to promoting exits from institutionalised care to foster an environment of choice and social mobility and build an ecosystem of social mixing, capabilities promotion and inclusive development.

In 2005, when The Banyan was discussing issues in the sector at multiple levels, the Tata Institute of Social Sciences (TISS) was also seized of the same issues. The Banyan and the TISS, realising that mental health issues were largely dealt with by psychiatrists and treated with medicines in the country, wanted to address the treatment gap. “Mental health issues can’t be solved by correcting serotonin and dopamine levels [in the brain] alone, distress can be a result of structural barriers and these have to be addressed,” says Vandana Gopikumar.

The need to address multiple, complex, inter-related issues in a structured manner resulted in The Banyan setting up an academic centre, The Banyan Academy of Leadership in Mental Health (BALM). The TISS found in BALM a partner that worked on the same set of objectives: BALM was founded with the aim of forming standard operating protocols and sharing this body of knowledge with other interested stakeholders to expedite care for the mentally ill and close the treatment gap. Effective human resources, trained in an ecosystem that is representative of the real world, was crucial in this vision. The TISS-BALM collaboration currently offers three Master’s programmes through three schools and a diploma programme for community health workers in mental health. The Banyan Academy also hosts three centres—for Health and Mental Health Policy Research, Inclusive Development and Social Innovation (in collaboration with Vrije Universiteit (VU), Amsterdam, the Harvard School of Public Health and the Global Psychiatry Department at Massachusetts General Hospital, Boston) and Mental Health and Marginality.

TISS and its collaborations

This is at the heart of what the TISS does and what it has become in the past decade with S. Parasuraman as its Director. With a clear mandate from the Governing Board to reach out to the unreached and chart new pathways in social work, Parasuraman began building partnerships with institutions and non-governmental organisations (NGOs) across the country. The TISS is strong on theory. There were hundreds of organisations across the country that were great on the field and had redefined multiple areas of social work. If the TISS had to retain its position as a “go-to” place in social work theory, research and practice, it needed to build strategic linkages, work on the glaring social issues and hand-hold multiple partners even as it remained focussed on socially relevant research and interventions.

Parasuraman is very clear why he began partnerships such as the one with The Banyan: “They can articulate a theory [on the intersection of mental health, poverty and homelessness]. So basically I said that there are many more organisations doing much better work and we can join hands with them. We are theoretically strong, we have the ability to work with other people. Let’s join hands.”

Parasuraman says this was an important decision. Aware that mental illness was set to oust most other communicable and non-communicable conditions to position itself as one of the highest contributors to the global disease burden by 2020, the TISS began its collaboration with NGOs in Kerala or Bihar or Tamil Nadu. These have added value, knowledge and depth to its work. The TISS invited Vandana Gopikumar into its faculty as a Professor in its School of Social Work, soon after she was awarded a PhD for her work on “Mental Health and Marginality” from Vrije Universiteit, Amsterdam. This is unprecedented in Indian academia, a fact that was not lost on many, including Professor Vikram Patel, Professor of International Mental Health, London School of Hygiene and Tropical Medicine. “This is nothing short of a miracle,” he remarked at a function in Chennai, in which the professorship was awarded.

BALM in Chennai

The TISS wants to develop Chennai’s BALM as a Centre of Excellence in Mental Health. BALM is ready, too, says Vandana: models, approaches, strategies and direction are all in place to scale up mental health services, develop human resources and build and lead a community that talks mental health.

The TISS goes beyond linkages to cater to needs across the country, be it in Ladakh, Nicobar, or the Rann of Kutch. It does not abandon an area for want of financial resources to support a project. TISS professionals stay on each field-action project on a long-term basis.

For instance, when the Ladakh Autonomous Hill Development Council was established following a 1995 Act, the idea was to involve the local people in the development process. The Council approached the Tata Trust, which turned to its trusted solution for social and development issues, the TISS. The institute was tasked with preparing village development plans and train community workers, community members and government officials on how to implement the plans. The other part involved making local people competent to handle the tasks on their own in a sustained manner. So, the TISS conducted a year-long diploma programme on sustainable development. It also undertook the painstaking job of doing micro-level planning of all villages in Ladakh. This is hard because villages in the cold desolate desert of Ladakh are far away from each other. “We took about one and a half years to do the micro-level planning,” Parasuraman said.

When the need to develop a perspective plan—ahead of the Twelfth Five Year Plan—came up, the TISS made available the data gathered from the area under the Council at the block-level office and the village-level office. The TISS has also trained councillors and panchayat leaders to use the data for planning, which was useful for implementing the Twelfth Plan and the perspective plan.

The TISS and the Council also developed the Ladakh Vision 2025 document, which Prime Minister Manmohan Singh released in May 2005. The exposure of elected representatives to alternative settings, thoughts and ecologies has been an integral part of the TISS training. Soon after the TISS began its work in Ladakh, panchayat leaders were brought to Mumbai every year. Late last year, it organised a visit for 120 women who were preparing to contest panchayat elections. They were taken on exposure visits to Rajasthan and Kerala after a one-week-long training programme in Mumbai. The programmes began with the very basics: what a panchayat is; what the powers of the leaders are; how they can plan; how panchayats have the power to demand the services and support from the state.

The TISS responded to the severe floods in Ladakh in 2010 by initially engaging in relief work and then taking charge of reconstructing one large village that had been destroyed. The initial funding for reconstruction came from the Tata Trust; funds for training and capacity building from NDTV; and funds for village development from IDBI Bank.

In Nicobar Islands, the TISS was requested to help out after the 2004 tsunami. The major task at that time was to establish the identity of the people affected. The Nicobar people, like many Indians, do not have any identification papers, without which the government machinery found it difficult to extend resettlement/rehabilitation provisions. The TISS, which commenced an assessment of all the households in the islands, found that most of the elders in the hamlets had been killed. It then decided on a training programme for the residents and conducted a leadership development programme for over 100 people over three months. “Now every village has two-three people who are trained. And they have become the leaders now,” Parasuraman said.

After most organisations left the islands, the TISS stayed back to create an early warning system, organise village knowledge centres and work on livelihood promotion plans. It also got involved in social issues. It entered into a long-drawn-out engagement with the local and Central governments, insisting that action be taken against officials who illegally sold liquor in the tribal hamlets. The officials retaliated by denying TISS experts and scholars entry passes to the hamlets (these are required to go to the non-tourist islands). The TISS responded by securing permission letters from the Union Home Ministry.

Holistic approach

The TISS brings a holistic approach to bear on its engagements. In the fragile Himalayan ecosystem of Ladakh, for instance, it looked at the basic questions that planners face: What sustainable development would mean in that cold desert; and how much tourist inflow it could support. In the Nicobar Islands, too, the TISS looked into these planning issues. The questions to which it sought answers included: What has been changing? How have the lands changed? What does sustainable development mean in a remote island?

The TISS’s work in the arid and semi-arid regions of Kutch, undertaken from its Thuljapur campus, explores the possibilities of sustainable development in the dry terrain. “We get in because the government and the people want us to come, we provide the support that is needed—intellectual, research, policy advocacy—we also conduct research on some of the fundamental issues such as water, sanitation, health, ecosystem, carrying capacity, sustainability—a whole range of issues are explored. We will make available all the data to all researchers,” said Parasuraman.

TISS in Nepal

On April 27, aoon after the earthquake hit Nepal on April 25, the TISS sent a team of two doctors and a psycho-social health care professional to Kathmandu. This team, working with groups there, identified the needs which were not being fulfilled and sent in a report a week later. Soon after the May 11 convocation at the TISS’s Mumbai campus, 15 students, all qualified medical doctors who are also disaster management graduates, left for Nepal to support the TISS relief work. On May 12, another group of 20 reached Nepal. “These are the people with skills. And they know it is not an easy job. There is no comfort. But they understand the ethics of relief and rehabilitation and the process of doing it. That’s what we do,” Parasuraman said.

The TISS is also committed to helping Nepal through a 2005 arrangement. That year, the Hindukush—Himalayan Region Universities’ consortium—was formed. While working in Ladakh, the TISS realised that it had no experience of working in a Himalayan desert but many institutions located in the Himalayan region had. So it linked with the a United Nations institution, International Centre for Integrated Mountain Development, Kathmandu, considered the best in mountain development in the region. The Centre and the TISS jointly conducted the training programme in Ladakh. Soon after this came the idea of a consortium of universities in the region. As many as 40 universities in Afghanistan, Nepal, Bangladesh, Pakistan, China and Bhutan are now part of this consortium. Universities from other parts of the world working on the Himalayan region were added as associate members. This has now emerged as an enormous knowledge resource for any issue in the Himalayan region.

In times of natural disasters, there is no time to think about funding. After the earthquake in Nepal, the TISS decided that it had a responsibility to help. Parasuraman sent the team without waiting for the money to materialise and thus avoided procedural delays. So it invested upfront and is hopeful that this will be made good by the organisations that have come forward to help.

The TISS gets involved because it is aware that if the institute does not do it, then that part of the work will not be done. In the case of Nepal, the TISS’s role is to provide psycho-social health care, an aspect of disaster management that the TISS specialises in and has pioneered in India. Now it has become a mainstream work in disaster areas. The TISS will train people in Nepal on psycho-social health care and provide support until such time that the professionals there can run the programmes on their own. “We have gone to Nepal, but we will be there for another 10 years. Where will we get the money? That’s not very difficult once you have established the need for work, the work you are doing. Then money comes,” Parasuraman said.

Be it Nepal, Ladakh, the Kutch or Nicobar, the work is not easy. In Nepal, for instance, even in normal times the roads are bad. After the earthquake, even those roads are gone. Helicopters are not able to land in some places. Many of the areas near the epicentre have barely been reached. Psycho-social health care seeks to help survivors address their trauma. “How you rebuild your life is a very important component. You can treat an injury, but how do you treat an injury to a person’s confidence? To emotions? That is what psycho-social health care does,” Parasuraman said.

Field action projects

A unique feature of the TISS is its field action projects (FAPs). As many as 33 FAPs address a range of issues including violence against women, the rights and rehabilitation of persons being processed by the criminal justice system and children in conflict with the law, homelessness and beggary, child and adolescent mental health, tribal and Dalit youth empowerment, health care in rural and tribal areas, corporate social responsibility, sustainable livelihood, food security, adult education and health.

One FAP is located close to the Deonar landfill. Deonar, a Mumbai suburb, is the country’s biggest waste dumping site. It is situated in a polluted locality that is home to a host of industries and refineries. The FAP is “Transforming M (East) Ward” and is anchored in the School of Habitat Studies.

Located on the north-east edge of Mumbai, M Ward is its ghetto with about eight lakh people living in its 256 slums and 13 large resettlement colonies. “The M (E) Ward in Mumbai is a microcosm of the city: it is an extreme example of skewed development in the metropolis, with virtually all indicators showing an urgent need for action that is multi-dimensional, comprehensive and strategic to serve its burgeoning population,” notes a 2015 TISS report, “Social Economic Conditions and Vulnerabilities: A report of the Baseline survey of M (East) Ward, Mumbai.”

The 2011 ‘M’ Ward initiative brings together TISS students and faculty and the stakeholders to work on elements that can transform the locality. “The project seeks to create linkages between ideas and resources for positive change and ensure their deliverance to communities in the ‘M’ Ward. The ‘M’ Ward is not the universe of change, but it is hoped that making a beginning with an area that represents the maximum challenge will also make a positive difference to policies pursued in the rest of the city and create a model for such work in urban areas of the country,” the Annual Report says.

Koshish, an even earlier project that caught the attention of multiple State governments, was started in 2006 and is now operational in Mumbai, Delhi and Patna. The Annual Report says that it “was started with the primary objective of repealing the draconian beggary prevention law, which fails to recognise the circumstances that force people towards destitution and criminalises poverty and acknowledges the historical and contextual realities like resistance and exclusion faced by de-notified communities, transgender community, persons with mental illness, those affected by leprosy…”.

Socially relevant professional education

As natural disasters become common, disparities grow and state support dwindles, the TISS tries to train more social workers and send them out to the field. Parasuraman’s preferred phrase for them is “social protection professionals”. In 2014-15, student enrolment stood at 4,029 across all campuses of the TISS, says the Annual Report for 2014-15. “Seventy-eight years ago, the first TISS campus was set up as Asia’s first graduate school of social work. It was established to produce socially relevant knowledge, and its stated commitment was to create an inclusive pathway for nation building.... Solving inequalities and discontent within a context of rising aspirations and possibilities will not be possible just through your efforts, it calls for a very high degree of collaboration between industry, corporate, NGOs and the local government,” says S. Ramadorai, Chairman, Governing Board. “The role of TISS ambassadors on the ground is to inform public policies, strengthen people’s entitlements, and empower communities,” he reminded them at the 75th convocation on May 11.

The TISS continues its work across a spectrum of identified priority areas despite the fact that money for social science research and action is dwindling, a fact that both Parasuraman and the chief guest at the 75th convocation, N. Ram, Chairman, Kasturi and Sons, highlighted.

“One of the characteristics of India’s system of higher education, which has been widely remarked on, is its lop-sided concentration on engineering and technological education at the expense of the basic sciences and, in a more pronounced way, at the expense of the arts, humanities, and social sciences, which are often treated as soft subjects. Thanks to the flourishing, against the odds, of a few major institutions of learning such as the Tata Institute of Social Sciences, we can entertain some hope that the imbalance can be redressed,” Ram said. “Let us remind ourselves that the challenge has to be met in the context of declining resources available to universities, a situation that presents a stark contrast to the tremendously increased public resource support given to institutions of higher learning in China during the same period. Against this backdrop, it is commendable that the Tata Institute of Social Sciences has pushed ahead in the last decade to stand out among leading universities and social science institutions as an institute of excellence explicitly committed to developing and applying knowledge ‘in pursuit of social justice and human rights for all’,” he added.

There was some good news for the TISS in the first week of June: the Union Ministry of Human Resource Development decided to release funds to the institute after effecting a 5 per cent cut in its annual allocation. In 2013-14, the TISS received a total of Rs.50 crore from the UGC. The Ministry wants to reduce government funding to 50 per cent. The crux is the government’s blinkered view on ensuring compliance with 12B rules of the University Grants Commission Act of 2015-16, which lays down the criteria on which a university or a college can receive government funding. The Economic Times had first reported on the issue in late May this year. “The TISS has been in the grip of a financial crunch after the HRD Ministry and the UGC framed a new policy for funding deemed universities and chose to withhold funds. The TISS had to get bank loans in March and April and dip into reserves—essentially funds generated through consultancy work—to pay salaries and keep the institute running,” the paper said.

The TISS campus, inaugurated by Prime Minister Jawaharlal Nehru, has been a fully government funded institution since 1964, when it was declared a deemed university.

Parasuraman says that the institute expanded despite the financial constraints. The 2014-15 Annual Report notes that the social sector had expanded in the last decade with Central and State government funding. But, “it is unfortunate that organisations and individuals with influence and capital do not see Social Science education and human development as a priority.... Our task has been very difficult and considerable effort has been devoted to motivating the State to professionalise the social protection sector, open up employment opportunities for graduates with degrees in interdisciplinary areas of social sciences, and secure funds for expanding research,” it adds.

The TISS’s expansion under Parasuraman has been dramatic and has significantly impacted the social sector in India unlike any single institution in the country from the time of independence. Sustaining this rate of growth, ensuring quality of work and remaining relevant in a fast-changing world will be the main challenges for the TISS at one level. At another level, the question of funding remains. Even though most people in the City of Maximum Greed look the other way, a few show up unfailingly to support the TISS, never mind that they are not from Mumbai. Some, like Ramadorai, an optimist, believe that the CSR funds from corporates will be a new source for TISS social action projects, if not for the TISS itself.

A lot now depends on how autonomous the TISS remains. It has a Governing Board, which is headed by and has significant representation from the Tata Trust (together with representatives of the Union Ministry of Human Resource Development and representatives of the State government). The Director of the TISS is selected by the board after an elaborate process, and the selected candidate is appointed by the UGC.

The TISS is a deemed university funded by the UGC. Nevertheless, it has innovatively used the space available to it to achieve a great deal, with the support of the Tata Trust. But as the TISS steps out into the unexplored terrain of a multi-campus university which works with unconventional but proven NGOs and a variety of other stakeholders, it needs more autonomy and independence, which can only come with the formal recognition of it as an institution of national importance.

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