A West Bengal-based organization is working to integrate mental health into India’s public health paradigm

India has come a long way in alleviating mental health problems. Over the years, our society has become more open to moving the conversation forward when it comes to struggling with issues like anxiety, depression, and many others. At the same time, several initiatives working in the field of mental well-being have come to the fore.

While significant progress is being made, bridging the class and gender gap is the urgent need of the hour. Many people in the lower strata of society are excluded from mental health treatment because of their stigma. According to a report by The New Indian Express in 2020, depression and anxiety are twice as common in women, with over 25% suffering from it. Nor can you seek help for this due to the lack of support and misconceptions in our society about seeing a therapist.

The situation in psychiatric institutions in India is even worse. A report from Human Rights Watch in 2014 stated that women are easy targets of human rights abuses and harassment in such institutions. Since they are “treated worse than animals”, many of them are forcibly institutionalized by their family members in order to “get rid of” them in time.

With the advent of COVID-19, the problem has worsened. As more people understand mental health, more work needs to be done to raise public awareness. With this in mind, many organizations and groups are helping the Indian healthcare system to become more capable and inclusive to deal with such crises. One such example is the Anjali Mental Health Rights Organization.

alleviate a major problem

The organization was founded in 2000 by a clinical psychologist by training named Ratnaboli Ray. It was named after a mental health activist herself; Ray witnessed her family members struggling with mental illness. Aside from family stigma and ignorance, the state psychiatric hospitals were in a state of disrepair with no adequate methods for dealing with patients. From isolation cells to appalling food quality and constant physical abuse, the institutions worsened the mental health of patients.

Speak with The logical Indian, Debatri Das, the organization’s senior operations officer, explains: “Ratnaboli Ray’s primary drive came from her personal connection to mental illness. Because of her previous experience in the development industry, she felt the need to partner with the state to transform human cells from state mental hospitals into spaces of care and compassion for the people being treated there.”

It wasn’t an easy road for Ray. She faced rejection in the first three months after presenting her idea to the Commissioner for Human Rights. At the same time, the meager amount of resources became a mammoth hurdle. “The initial challenges were limited resources and a lack of awareness found among people of mental illness. The other challenge was to bring about a change in the deplorable condition inside the hospital – from the abolition of the isolation cells to the tonsure of women, physical abuse, overdosing of residents with medicines to poor food quality, inadequate health care, unsanitary condition of the wards and demeaning attitudes of hospital staff,” adds Das.

‘Anjali’ had her work cut out for her. With thorough research, they found that in 2018 West Bengal only had 2000 beds in state psychiatric hospitals for over 1.25 million mental illness patients. Therefore, working with the state government was essential for Ray’s initiative to thrive and make a difference.

Inclusivity and Livelihood Opportunities

Before continuing, the organization spoke to the patients and listened to their stories. “The initial efforts to develop a relationship with the female residents consisted of talking to them informally, listening to their stories, drawing and making crafts. When these women were given the chance to tell their life stories, Ratnaboli had the chance not only to talk to them about their identity as a person and not as a patient, but also to understand the situation inside the hospital,” explains Debatri The.

As comfort increased, more and more women joined to tell their stories. Despite initial fears, staff and doctors also came on board to support Ray’s efforts to humanize and raise awareness of patients’ fundamental rights. Das adds, “We are working to ensure large-scale systemic mental health change by making such institutions and communities intersectional and inclusive with the West Bengal Government, the media and other civil society organizations.”

In addition, “Anjali” invented livelihoods to give patients economic and social freedom. Known as “Voices”, it is a program running in the four psychiatric hospitals of West Bengal, namely the Pavlov Mental Hospital and the Lumbini Park Mental Hospital in Kolkata, the Berhampore Mental Hospital and the Institute of Mental Care in Purulia.

“This is a program that aims to achieve the social inclusion of people with psychosocial disabilities, to make them full citizens of this country, with their full, informed participation in its life. This is ensured through arts and crafts sessions, capacity building and livelihood projects that bring them closer to economic and social independence,” continues Das The logical Indian. Some of the projects include “Cha Ghar” on the premises of Pavlov Hospital, where patients ran a canteen. Also, a laundry service called “Dhobi Ghar” launched in 2016, along with a block printing unit and a bakery, offering a lucrative opportunity for patients.

Raising awareness at grassroots level

A key part of Anjali’s work is raising awareness of mental health issues in rural areas. The community initiative is called “Janamanas” and is carried out in cooperation with the local communities. “The program trains women in support groups to understand mental health and its intersecting issues such as poverty, gender and sexuality, alcoholism, domestic violence, etc. and to become lay professionals in their communities with a focus on creating safer communities for women,” said Debatri Das .

Her work has also continued during COVID-19. This speaks to Anjali’s work during the pandemic: “With operations at the hospital temporarily suspended due to the nationwide lockdown, we have been providing telepsychosocial support to the residents of the hospital as well as those who have been reintegrated. We provided personal protective items to the 4 hospitals and staff, donated medical equipment such as oxygen cylinders, concentrators, oximeters, PPE kits, provided seed capital for reintegrated individuals who lost their jobs and were able to start small livelihood initiatives, ran a community kitchen and also provided dry ration support and financial support to the people.”

A paradigm shift

Twenty years later, Anjali works tirelessly to give mental health the attention it deserves in the Indian healthcare system. Das proudly states: “More than 1,300 recovered residents of state mental hospitals have been reintegrated into their families. In cooperation with the municipalities, about 400 women have been trained in the Janamanas mental health curriculum. To date, more than 450 clients have been referred to various places for employment opportunities.” Alongside this, many of them were employed as clerks, tailors, school assistants, housekeepers, etc., securing basic voting rights for patients.

However, your work is not finished yet. With the support of the state government, Anjali wants to continue working on this and strengthen the rights of patients with psychosocial impairments. “Although Anjali’s sincere efforts and hard work have borne fruit, it recognizes the need to work on its growth strategy. In addition to being a service provider, the work horizon can be gradually broadened by expanding public-private partnerships into a resource organization to support governmental and non-governmental organizations in transforming mental health facilities across the country,” concludes Das their conversation.

With their efforts, Ratnaboli Ray and the team of “Anjali” want to raise public awareness of people with mental illnesses. Their efforts are already successful, which is a glimmer of hope for the country.

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