The Banyan model

Published : Aug 31, 2016 12:30 IST

Vandana Gopikumar.

Vandana Gopikumar.

FOUNDED in 1993 as an individual’s reflexive response to the plight of a half-naked, mentally ill woman out on the street in Chennai, The Banyan has since grown to address the two critical underlying issues, poverty and homelessness, that impede appropriate, and holistic, treatment of the mentally ill.

The 23-year journey of The Banyan can be divided into four stages: one, the experimentation and learning process that lasted about a decade; two, firming up and course correction based on the theory it developed from its on-field experiences; three, reaching out and collaboration—with State governments, other NGOs/community-based organisations, universities and capacity builders—during which the organisation brought in fresh perspectives and added newer dimensions in understanding mental illness; and the current phase, which is that of integrating all its experiences to address the issue of mental illness from multiple angles, as opposed to the overemphasised medication route, for effective treatment of mental illness so that the recovery can be sustained over a long period of time. Married into the new approach is the important question of poverty alleviation and the alarming issue of homelessness, both of which contribute hugely to the burden of untreated cases of mental illness in India.

The Banyan’s projects have directly impacted the lives of over 5,000 people by providing services to support them in reaching their definition of recovery. “Through the years, those whom we cared for, our best teachers, taught us what it meant to be poor, sad, alienated and hopeless. Their insights guided us as we developed a whole array of services and demonstrable models that helped reduce or alleviate distress,” said Vandana Gopikumar, co-founder, The Banyan & BALM, and Professor, School of Social Work, Tata Institute of Social Sciences.

The five projects At the field level, the impact is thanks to its five major projects: Adaikalam, a transit care centre for women rescued from the streets; the community mental health project, which offers mental health services in urban and rural settings in multiple locations in and around Chennai, Tiruvallur and Kancheepuram districts; the community living project, a solution for residents needing long-term care; BALM (Banyan Academy of Excellence in Mental Health), which works on the academic and in advocacy and research; and a shelter for the homeless run in collaboration with Chennai Corporation.

Adaikalam was the first project and remains the most visible of The Banyan’s operations because it handles mentally ill, destitute women rescued from the streets. The recovery achieved by many of them is often remarkable, and when a reunion happens it resembles a fairy tale. In one case, a resident, who had drifted from Pratapgarh in Uttar Pradesh and landed in the streets of Chennai, was reunited with her family a decade later on the day of her daughter’s wedding! For every fairy tale, there are a dozen stories of rejection by their own families, a large number of them middle-class households according to a casual survey of The Banyan’s experience with reintegration. The poor and urban slum dwellers have largely been welcoming and are even ready to take responsibility for the general well-being of and the administration of medication to the reintegrated member.

BALM is the theoretical hub that links knowledge and practice by providing training, research and advocacy. BALM organises knowledge sessions for professionals in the field based on The Banyan’s extensive work and networks and communicates the need and solutions across the mental health development sector. It is also home to four graduate courses run in collaboration with the Tata Institute of Social Sciences and VU Amsterdam. “A centre such as BALM seeks to school a cadre of passionate mental health professionals using constructivist pedagogy—grappling with the complexity of real-world problems through active programme-level placements, rigorous social science research to test fresh approaches to care and the exploration of social constructs such as alienation, group cohesion, social inclusion and participation would perhaps pave the way for reforms at a systemic level,” said Vandana Gopikumar.

The Banyan’s advocacy goes beyond bringing out reports and holding consultations. It plays an active part in getting policymakers, policy drivers and implementers to work with NGOs in the sector and also address cross-sectoral challenges. A good example of this is the homeless shelter initiative, where the Chennai Corporation, The Banyan, the police, the district administration and the State’s Department of Health work together, in cohesion, to drive change. Heeding to a suggestion put forth by The Banyan, the Chennai Police have adopted a more humane approach towards the homeless instead of the usual practice of considering them a menace and potential thieves.

“Structural barriers such as caste, gender and poverty result in amplifying vulnerabilities and influencing not just one’s well-being but one’s trajectory of life itself. Collective wisdom and responsibility tells us that these deprivations and segregations on the basis of one’s depleted social capital need to be addressed with a sense of urgency. Justice cannot be served if differences are not embraced, and diversity is not appreciated and supported. Thus, there is the need for affirmative action to ensure the protection of one’s agency, citizenship, personhood and rights. Only then can one aspire, dream, create and be a part of a vibrant and equal community that chases capabilities,” said Vandana Gopikumar. The Banyan’s inclusive living options won the Grand Challenges Canada Global Mental Health Grant in 2014. The potential for the results from this to influence the mental health care system both in India, other low and middle-income countries and other higher income nations is significant. These cutting-edge approaches have placed The Banyan on the radar in the front line of innovation in mental health and development practice. The larger strategy is to improve access to care for those with mental illness and to provide integrated support services to the client and his/her family. In The Banyan’s experience, these are the reasons why the mentally ill become homeless and families come under so much pressure that they are unable to provide adequate care where required.

The Banyan and BALM are now at a crucial phase of their evolution, and the hope is that the experience gained so far will convert into generating fresh breakthroughs in the mental health sector, especially in the expansion of services in low-resource contexts. Through collaborations with a wide range of stakeholders, The Banyan hopes to overcome structural and physical barriers to serve people in distress in all situations.

R.K. Radhakrishnan

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