Manas Mental Health Units at Residential Homes for Care & Protection

From its inception Manas has echoed that disadvantaged populations have the twin burden of increased mental health problems and insufficient access to mental health services. Socio-economic deprivation has been found to correlate closely with the onset and exacerbation of mental health concerns. Individuals who hail from urban slums or have been displaced into underprivileged circumstances and Homeless have been seen to have a bidirectional relationship with mental health issues. A study conducted at a North Indian psychiatric hospital reflected that 90.7% of the homeless persons admitted were identified with some psychiatric illness, and 55.7% had more than one psychiatric diagnosis (Tripathi et. al. 2013). This reflects that resource-poor or socio-economically deprived communities experience several types of stressors that adversely impact their mental health.

To counter the same, in the year 2010, we began catering to the needs of many such individuals in partnership with the Department of Women and Child Development, (DWCD) Govt. of NCT of Delhi who reside in residential homes under the mandate of Delhi Juvenile Justice (Care and Protection) Rules, 2009 which directs provision of mental healthcare to juveniles and children in government custody. We have found that factors such as psychological and physical abuse, low education and awareness, weak social support, familial discord and previous exposure to traumatic life situations gravely impact their mental health and lead to adverse consequences such as self harm tendencies, emotional regulation difficulties and impulsive decision making, oppositional defiance, verbal and emotional bullying, blurring of bodily-boundaries, difficulties in relationship building due to insecure attachment style, dwindling sense of self worth and more. Furthermore women constitute an additionally vulnerable group in this regard as they are often given secondary status when it comes to socio-economical, legal and human rights issues.

Within these residential complexes by the DWCD the Mental Health Unit by Manas Foundation undertakes an intensive psychological evaluation with every resident in order to determine the individual’s psycho social needs and a personalized management plan is prepared for them. This aims to fulfill short-term and long-term goals, and is formulated in consideration with their context, corresponding ongoing legal process and in tandem with the overall management plan formulated by the government for residents of these homes.

Our services include individual counseling sessions, psychiatric consultations, group therapy, post-restoration and family counselling and crisis intervention. Psychologists also conduct various workshops with support staff regularly to sensitize them on mental health and adjustment issues to be able to cater to needs of the residents with empathy and understanding.   Over the course of working with these homes we have innovated and designed intervention strategies which not only rely on the traditional therapy models but employ practices such as Dance Movement Therapy, Art Therapy, Drama Therapy, Art of Living Practices, Yoga, Gardening etc which cater to their mental health continuum; from redressal of mental health concerns to promotion of positive mental health.

  • NirmalChaaya Complex – In 2010, Manas Foundation started an MHU at Nirmal Chaya Complex, a state-run care home for underprivileged women and children with 500-600 short and long-term residents that we cater to through the Mental health Unit every month.
  • Children Home for Boys, Lajpat Nagar – Our MHU at CHB, Lajpat Nagar was started in 2011.  This MHU provides services to 500-550 individuals per year, implementing innovative psychotherapeutic interventions with boys aged 6-18 years.
  • Village Cottage Home, Lajpat Nagar – Village Cottage Home is a children’s home in Lajpat Nagar housing children aged 5-10 years. Coming from backgrounds of poverty and abuse,  Manas is involved in preventive and promotive activities in order to ensure their mental wellness and holistic development.

Embedding Mental Health Services in Civil Society Organizations

It is indisputable that positive mental health allows people to not just realize their full potential but also cope effectively with stressors in life, work productively and make meaningful contributions to their community. Yet many Civil Society Organizations (CSOs) attempt at tackling the issues of health, education, childcare, gender equality, livelihood, women empowerment etc without catering to the embedded mental health needs of their disadvantaged target groups. This happens many a times due to a lack of expertise, necessary funds, infrastructure or it could be a restriction of their programme design. We identified this far-reaching vacuum and designed a comprehensive three tiered approach for CSOs that blends research, training and direct community services to address the socio-emotional impact on their target populations thereby maximising the impact of their in-house interventions.

Our model comprises of the following components:

  • Direct service delivery via operationalizing plug in mental health units at partner CSOs: Within the infrastructure of the partner CSO we initiate a mental health unit through which our team members provide all customized mental health services on a daily/weekly/fortnightly/monthly basis depending upon our agreed terms with the CSO.
  • Capacity building of frontline CSO workers as barefoot counsellors: Manas has designed an intensive, impactful and tested model of training service providers in partner CSOs (such as trainers, social workers, health workers etc) in basic counselling skills which enables them in identifying mental health red-flags, providing mental health first aid and crisis intervention, creating a referral network when required as well as managing milder mental health issues of their beneficiaries effectively within their existing scope of work with the CSO.    
  • Preventive work and awareness generation: During our period of association with the CSOs we organize awareness drives, organized and targeted group work as well as leverage on their ongoing events/celebrations/programme activities as modes of mental health sensitization, promoting positive mental health, demystifying mental health issues and encouraging help seeking behavior within their staff members as well as beneficiaries.

Some of our key Mental-health plug in Programmes with CSOs have been:

  • Mind Map: Mind Map, a “Mental Health Program to Build Leadership & Employability for Disadvantaged Youth” was initiated by Manas Foundation in October 2010, with the support of Jamsetji Tata Trust. It’s wasa scaled up 3 year programme, that blended research, training, direct community services and advocacy to address the mental health needs of urban disadvantaged youth. It also analyzed key issues of urban youth from a psycho-social lens and enhanced the overall capacities of community youth to map their inner worlds, understand and develop their own mental health, and connect emotionally with their own potential for leading a social change. We implemented this programme in 10 CSOs across Delhi NCR (AmanBiradiri, Chatanalaya, Deepalaya, Don Bosco Technical Institute, Literacy India, Samuel Foundation, Shanti Devi Charitable Trust, Shine Foundation, Udayan Care and Vidya and Child)
  • MSM Groups at high risk of contracting AIDS: Implemented by Manas Foundation with the support of OXFAM (2007) was an intensive psychological skill enhancement and intervention programme with MSM groups (men who have sex with men), whichcatered to stress, its manifestation, shame and stigma attached to MSM groups, resolving conflicts, understanding avoidance and other maladaptive coping patterns. Anger management, addictions and developing a positive self-concept also formed an integral objective of our overall intervention.
  • RCH: INTEGRATING MENTAL HEALTH INTO A STATE-RUN REPRODUCTIVE AND CHILD HEALTHCARE PROGRAMME: Manas Foundation partnered with the Department of Women and Child Development, Govt. of NCT of Delhi and two CSO partners, NavShrishti and Prerna, in running a mental health plug in programme catering to the CSOs initiative for the cause of reproductive and child healthcare in the semi-urban areas of Delhi.
  • Career Counselling: Manas developed a career guidance manual in partnership with Youth Reach foundation for an intervention with youth and adolescents who have either dropped out of school or have taken to vocational education in place of the regular school. This manual has been developed in consonance with the needs of this group and is implemented with over 6000 youth through support of Sir JamsethJi TATA Trust, where we provided career counseling to these youth directly. Apart from building capacities of partner CSOs in implementing the manual in their organization, Manas has also directly implemented the programme with organizations such as Aga Khan Development Network, Vidya and Child, PREF etc. 

AWARENESS CAMPAIGNS

Lack of awareness about mental health, and the stigmatization of psychiatrically ill persons are two barriers that still consign many people to continuous suffering, which is potentially remediable.

However at Manas we believe the need is to have a more humane and holistic approach towards well-being of the individual and the community where mental health needs can be viewed from the lens of positive psychology. In light of the same, Manas initiated an awareness campaign called ‘Caring for a beautiful mind’ in 2006 which has since then been an ongoing endeavor.  Our initiative focuses on positive mental health and working towards enhancing psychological competencies in people, enabling them to become happier, more satisfied and to realize their potential, and to prevent psychological and emotional difficulties from becoming disabilities.  Our mass level campaigns year after year aim at establishing that anyone can experience mental health problems and we all as individuals, organizations and communities need to take positive steps to promote mental health. Manas works intensively through media, artists, photographers, NGOs, bureaucrats, local campaigners, musicians, sports personalities and actors for public advocacy of mental health to be integrated into all aspects of public life and personal well-being through our awareness campaigns.

WORLD MENTAL HEALTH DAY

With the aim of addressing the increasing need for mental health care and awareness in the country, Manas organises a week-long Mental Health Awareness Campaign from October 7-13, to provide people with the much needed guidance about the different avenues for seeking help with mental illnesses and about basic positive steps for mental well-being. Events such as Mental Health Camps, Seminars, Photography and Art Exhibition, Poster Campaign and Cricket match have been organised at various locations in Delhi to reach out to a large number of people to improve public perception and awareness about mental health

  • CELEBRATING WORLD NO-TOBACCO DAY: In partnership with the WHO, Manas has been engaging with masses with special focus on youth and adolescents who have either fallen for the lure of the tobacco menace or might do so in the near future. The focus of this campaign is to bring about an attitudinal change in the target group and thus prevent the initiation into smoking or motivate stopping of smoking behavior. More than 15000 individuals have been addressed during these campaigns through our fake tobacco kiosks, awareness drives in shopping malls, auto rally, nukkadnataks etc.
  • WORLD SUICIDE-PREVENTION DAY:  Suicide rates, especially between young Indians are at an all-time alarming high. We all sadly happen to know someone who took their own lives or who is a survivor of suicide, it is safe to say that no one has been left untouched by suicide. There are significant correlations between suicide and other mental health concerns. At Manas on the world suicide prevention day every year, we engage in multi-media campaigns to help people understand why some people give up on their lives and what all can we do to prevent it from happening. More recently we partnered with the MILESTONE DENTSU a digital marketing and advertising agency to raise awareness on suicide via a three-part video series about stressors that may lead a person to end their life while offering solutions and services to those who maybe affected.
  • One Billion Rising: One Billion Rising is the biggest mass action to end violence against women (and those who are subject to gender-based violence) in human history. The campaign began as a call to action based on the staggering statistic that 1 in 3 women on the planet will be beaten or raped during her lifetime. With the world population at 7 billion, this adds up to more than ONE BILLION WOMEN AND GIRLS. Manas has been actively participating the OBR since its inception in India. OBR is one of the significant platforms where our mental health work with women and other target groups directly converges with our efforts in the space of gender sensitivity, safety and equality.
  • STREE SHAKTI CAMPS: Stree Shakti camps are organised by the Govt. of Delhi through its Bhagidari scheme. Manas foundation also participates in them to create awareness among women regarding inter-linkages between gender and mental health and enabled them to access mental health services easily and in their neighbourhood.
  • International Human Rights Day Celebration: On the occasion of International Human Rights Day, a program Celebrating and Defending Human Rights in South Asia was initiated by SANGAT, an NGO working towards development of social justice, peace building strategies and programmes in South Asia. Manas had put up a photography exhibition with life size black and white pictures depicting rights of those with mental illnesses. Another event followed as celebration of South Asian Women’s Day for Peace, Justice, Human Rights and Democracy which included a silent presence with many colourful banners and candlelight and it was held at the Central Park, Connaught Place.

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