Mental healthcare is a neglected need in India
An estimated 12% of Indians suffer from clinical depression[1]. In August 2014, the world was shocked when Hollywood comedian Robin Williams committed suicide after battling severe depression for years[2]. About a year earlier, Bollywood actress Jiah Khan allegedly committed suicide, depressed over her career and relationship[3]. Many other Indian celebrities have fought depression and emerged strong – the most recent case being that of actress Deepika Padukone, who shared the story of her battle with depression in an interview to TV channel NDTV in March 2015
Another psychological disorder that affects many Indians today is Bipolar Mood Disorder. It is estimated that 1% of Indians suffer from severe cases of bipolar disorder, and 5-6% may be suffering from milder forms of the illness[4].
It is not only the affluent class in India, who are prone to depression and bipolar disorder. In an overview of Indian research in depression, it was found that depression is more common in people from poor economic background and with poor nutritional status[5].
With the prevalence of mental disorders like depression and bipolar disorder being high, India also has a high requirement of trained psychotherapists. However, it is estimated that there is a shortfall of 8500 psychiatrists, 6750 psychologists and 22600 psychiatric social workers in India[6].
While the affluent can access and afford psychiatrists and psychologists for one-to-one therapy, those from low-income families not only have difficulty in accessing mental healthcare, they also cannot afford expensive psychotherapy sessions. The result is that many Indians suffering from depression and bipolar disorder never undergo treatment, while those with more severe mental illnesses such as schizophrenia end up in one of the frightful mental hospitals in the country or approach traditional ‘healers’, where they are often ill-treated, physically abused and tortured[7].
Making mental healthcare affordable: therapeutic communities
Therapeutic communities are structured treatment programmes for the mentally ill, where the relationships, structure of the day and different activities are deliberately designed to help in the treatment of the community members[8]. The group relations and the community itself, rather than any single element, form the primary therapeutic agent[9]. Trained therapist(s) act as facilitators to plan and move through the activities each day and to provide specialised support to any of the members as per requirement.
[Source: Haigh, Rex (2013): The quintessence of a therapeutic environment]
In India, the oldest therapeutic community (TC) centre – the Athma Shakti Vidyalaya (ASV) – was established in Bangalore in the year 1979 by Father Hank Nunn SJ, a Canadian Jesuit priest. In 2013, Father Hank Nunn’s contribution was recognised by the Times of India, as he was adjudged one of the finalists of The Bangalore Mirror’s “Bangalore Heroes”[10]. Father Hank Nunn continues to be a part of Athma Shakti Vidyalaya and is respectfully known as “Dad” of all the members of ASV.
The Hank Nunn Institute (HNI), named after Father Hank Nunn, has been established by Anando Chatterji and Shama Parkhe. Anando is a Philosophy graduate, has been trained as a psychotherapist and worked at ASV for over a decade. Shama holds a Masters Degree in Clinical Psychology from Christ University, Bangalore and works as Clinical Director of HNI, Bangalore.
HNI is the first initiative to take the TC model of treatment to rural areas of India, and Anando and Shama have set up treatment centres in Uttarahalli, Off Bannerghata Road, Bangalore and in Dharwad, Karnataka. Our projects are a mix of Day TCs (where members come from home in the morning and go back at the end of day) and fully-residential TCs.
The Uttarahalli project, which is a Day TC, has been running since May 2015 and currently has five members under treatment. The members – four young boys and one girl – are from different parts of India and suffer from a wide range of mental disorders including schizophrenia, mild autism, personality disorder and bipolar disorder. We charge only a nominal amount, 10% of the costs, from the members who are undergoing treatment at the centre, and the Uttarahalli project is run with support from the trustees of HNI and other private donors.
For the Dharwad project, a trained psychotherapist has already been identified. We plan to set up two other centres – one in Penukonda, Andhra Pradesh and another in HD Kote, Karnataka. This initial crowdfunding project is to help setup the Penukonda project.
HNI Penukonda Therapeutic Community: India’s first rural therapeutic community
HNI has partnered with Stree Sanghshema Trust (SST), a local NGO to set up the Penukonda project. SST was set up in 1987 by Chandra Kanjilal, a dynamic single lady who moved from Delhi to Penukonda to work for empowerment of rural women. The NGO has been running successfully for more than 25 years, training women from 20 villages in Anantpur district on financial literacy and helping them financially by manufacturing and selling cards, herbal soaps and medicines and organic products and by renting out the 5 acre training centre owned by the NGO. In collaboration with SST, we now plan to set up India’s first rural therapeutic community centre at the SST training centre, catering to the villages in and around Anantpur district of Andhra Pradesh. The SST farmhouse in Penukonda is located at a distance of 142kms from Bangalore.
In September 2015, we had organised a three-day workshop on therapeutic communities at the SST farmhouse for students of Psychology Department, Christ University, Bangalore. The building needs repairs and electrical work, for which we plan to organise another three-day residential programme at the farmhouse, taking 20 volunteers from Bangalore. These 20 volunteers will be given a brief immersion into the therapeutic community experience and will also be involved in carrying out the repair and restoration work.
We hope that with your support, we can set up India’s first affordable rural residential therapeutic community centre at Penakonda, Andhra Pradesh and help us take a step towards a new model of affordable healthcare for the mentally ill in India.
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[1] Source: http://indiatoday.intoday.in/story/cover-story-increasing-depression-terrible-secret-among-youngstars-ignorance/1/419877.html
[2] Source: http://www.hollywoodreporter.com/news/robin-williams-autopsy-confirms-death-746194
[3] Source: http://www.thehealthsite.com/diseases-conditions/i-am-broken-inside-lessons-from-jiah-khans-death-and-suicide-note/
[4] Source: http://www.telegraphindia.com/1120916/jsp/7days/story_15982265.jsp#.VhFcRHqqqko
[5] Grover et al (2010): An overview of Indian research in depression: Indian Journal of Psychiatry: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146226/
[6] Source: http://indiatoday.intoday.in/story/cover-story-increasing-depression-terrible-secret-among-youngstars-ignorance/1/419877.html
[7] Source: http://www.dw.com/en/mentally-ill-suffer-a-horrible-fate-in-india/a-17007499 and http://www.ndtv.com/india-news/harsh-conditions-found-in-indian-mental-health-facilities-for-women-708087
[8] Source: http://www.therapeuticcommunities.org/what-is-a-tc/
[9] Source: http://www.therapeuticcommunities.org/definitions/
[10] Read the report here: http://www.bangaloremirror.com/heroesshow/25601968.cms
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