Caring in Crisis
An intersectional road to mental health and well being during the pandemic
2020 has brought about an unprecedented crisis in human history with the spread of the novel coronavirus. Covid, has not only caused a public health crisis but brought a time where humans have become living artifacts of trauma, pain, insecurity, in a constant state of uncertainty. It's a well-documented fact that quality mental health has largely been a rich person’s right, with therapy sessions of half an hour starting at Rs 1000. Juxtapose this with the image of a female daily wage laborer who earns as low as RS. 105 a day. While it's being said that the pandemic hasn't discriminated amongst the rich and the poor, people have been affected in varying degrees. The poor and the marginalised have suffered the most, financially, physically and mentally. With the lack of access to affordable mental healthcare, their life has become a living ‘state of emergency’. Sparsely documented, the Indian government has not just failed to evaluate the pandemic’s impact on mental health, rather, their responses like the ‘overnight lockdown’, have played a major role in catalyzing this ‘mental health crisis’.
The Great Depression
The impact of Covid-19 on our collective mental health can be divided into two phases. The first phase was the acute phase, which coincided with the lockdown, where people are afraid of dying or a loved one contracting the disease and being isolated. And the second phase unfolded and continues to unfold in the months ahead, where the economic fallouts of the pandemic start to dig deeper into people’s everyday lives. These fears, when added to the very ‘real’ everyday struggles of hunger, poverty, unemployment, domestic violence, abuse, discrimination can only lead to a full blown ‘mental health pandemic’. Our understanding of what constitutes mental health is still ‘emerging’ in India. Mental health and wellbeing, refers not just to chronic mental health conditions and common mental health disorders, but even pangs of anxiety, everyday interpersonal interactions and distressing circumstances. And our models of mental health are still not designed to address the various forms of social injustice experienced by a large section of people across the country.
Covid-19 has irrevocably changed the concept of ‘home’ along with the ideas of safety and stability for many individuals. Many were not secure even though they were safe from being exposed to the virus. Staying at home might have saved some from the virus, but not from the abuse and violence, they became victims of. For homes that had 9-10 members of a family sharing a small room, social distancing was a far fetched luxury. A large population of the country was on the streets, and were either homeless or walking thousands of miles in the scorching heat, to get back to their villages and towns. The failure of the government to provide adequate and timely relief to them, led to the biggest reverse migration in India since the Partition in ‘47.
Various disadvantaged caste groups and tribes’ mental health has been impacted by systemic injustice. While Bihar’s already disadvantaged Musahars ( one of the most marginalised tribal-turned-Dalit communities) were excluded from relief packages, several tribal groups displaced from their lands have found it impossible to access welfare schemes. The loss of a sense of self in a land that can’t be called home, has led to deteriorating mental health amongst them. When the provision of public health amenities has been disproportionate, their inclusion in conversations around mental health well-being has been all the more scant. In homes where even a smartphone is a luxury, adolescents (especially girls) have struggled to adapt to online forms of education, with many dropping out. There has also been an increase in suicides amongst young people struggling unable to cope and pay the rising fees across colleges. Religious minorities have been stigmatised and discriminated against by the media as the CAA and NRC protests segued into the pandemic, where Muslims were blamed for spreading the virus in the country.
With a hike in unemployment rates, family sizes have increased with people returning home or constantly being home throughout the day. This has significantly and disproportionately increased the burden on women who have been the prime caregivers for the elderly and children, house managers, and absorbers of distress caused by unemployment. Gender-based violence and domestic abuse have increased with changing patterns of dwelling and cramped homes which provided no space for any movement.
Individuals who lie outside the heteronormative setup of the family, such as queer people were thrown back into the same homes that they had escaped, to live freely, beyond binaries. There has been news of forced conversion treatments of many queer folks, leading to death. And beyond interventions that address this extreme violent homophobia in families, one cannot ignore how ‘queerness’ is still stigmatised and considered a malady, even by many practising in the field of mental health. Avenues of work came to a standstill for trans sex workers and beggars. With public health focusing on Covid-related support, many HIV positive individuals from these margins could no longer access treatment. For those living with existing mental illnesses, the pandemic disrupted their access to not just mental health services but also medicines needed for treatment.
In the absence of state support, it was frontline workers and collectives who have held the mantle of ‘care’ and dealt with the unforeseen mental health crisis during the pandemic.
Democratising Mental Health At The Grassroots: Atmiyata, Gujarat
The Centre for Mental Health and Law Policy started ‘Atmiyata’ (shared compassion) in 2017 in Mehsana district, Gujarat, which is a rural community-led intervention, that has been successful in bridging the mental health care gap by training grassroots level community volunteers (Champions) to identify, support and reduce distress using evidence-based techniques. The intervention uses a volunteer-led approach of Champions and Mitras to provide mental health and social care. With the pandemic, the programme had to undergo changes. While the ‘Champions’ could no longer go from door to door to identify distress, the field coordinators, who manage a team of 35-40 champions, faced the challenge of not knowing what was happening inside the villages on a daily basis. They shifted operations to the telephone - where all beneficiaries and potential beneficiaries were reached out to. In such a period, it also became imperative to train both the champions and the coordinators on “self-care routines”, to reduce burnout. Atmiyata witnessed a surge in cases of gender-based violence, alcoholism and unemployment amongst men. A disproportionate-care burden was reported by many women, as family sizes changed, with reverse migration and the breadwinner having more dependents to take care of. In a space where gender-based violence could not be spoken about over a phone call, Pavan Ba, a Champion, told us that she would urge women to come with their children for height and weight checks to the Anganwadi centre. This allowed women to step outside the house and communicate their distress even during the lockdown. Jasmine Kalha, Atmiyata’s co-lead, Program Manager and Research fellow, told us about the impact of the pandemic on lives: “Since Atmiyata had built a foundation in the community before the pandemic, the Champions became the frontline response for providing evidence-based mental health care and support.” Atmiyata relies on social capital, the champions’ lived experiences and community relationships which enables them to provide local solutions to distress. By intervening at initial stages, the champions prevent the distress from turning into severe mental health conditions.The Atmiyata Champions are trained and empowered through simple tools like short films loaded on smartphones to start conversations on mental health, to ‘de-pathologize’ the subject and identify ‘signs’ to pick up symptoms of distress. They identify and offer evidence-based interventions with ‘low intensity counselling’ (which involves fewer face-to-face sessions, often done over the phone during the lockdown) for people with common mental disorders, interventions happen at their doorstep, and in more severe cases they refer people to the nearest district mental health centres. Complementary to the public health sector in its approach, it serves as a support system in rural heartlands to bridge the ‘care gap’.
Empowering Caregivers To Reach Out : Monon , Assam Cares, Assam
Launched on June 15, 2020, Monon, Assam Cares, is an example of what state support and commitment to mental health can do. Led by Dr. Mythili Hazarika, an associate professor of Clinical Psychology at Guwahati Medical College, a team of counsellors started reaching out to Covid-19 patients in Assam through a portal using the Assam government’s 104 Saarthi helpline. Often, people weren’t even aware that what they were feeling wasn’t necessarily normal. Counsellors found that patients faced many psychosocial and mental health issues, which were compounded by issues of erratic food supply, unavailability of medicines for pregnant women, and panicking citizens who couldn’t reach their family in Covid wards. Apart from detailed conversations about their feelings, relaxation techniques, debunking Covid myths, providing reading and drawing material for children in the quarantine centres, they also helped connect people to relevant services in cases of hospitalisation and food shortage.They also provided basic training on mental health to the frontline workers in Covid wards. Their timely interventions in people’s lives, often averted crisis situations from becoming far worse. Once when a counsellor realised that a patient was suicidal because he had no money, they immediately alerted the workers through the Monon portal, who addressed the situation. The helplines received diverse issues, so their counsellors were rigorously trained with guided, personalised techniques to be able to engage with large numbers of requests. They were trained by the best practice guidelines developed by Dr Mythili and her team which was approved by experts and subsequently by the government to train the counsellors. Those with social science backgrounds were chosen and trained, and thus was built a network of 406 voluntary counsellors, who lent support. Each person was allotted to call at least 15 Covid-19 patients per day. On an average, 80-85 patients were dealt with every day and their details were documented in the portal. These professionals were also responsible for developing treatment and rehabilitation programs based on their assessment of patients’ mental health status. Police personnel asking for help in sparking conversations on suicide amongst the public, is a clear testament of the volunteers’ efforts. Even the Covid ward workers, realising how these interventions aid recovery, have begun to talk to patients, and use techniques to calm them down. Dr Mythili explains, “ This is a unique kind of a programme, where the mental health professionals are calling those who might need help rather than just waiting for them to call us!”
Peer Support To Ride The Wave : You’re Wonderful Project (YWP), New Delhi
YWP started in 2014 with the underlying philosophy that everyone needs to know that they are wonderful. What started out as a suicide prevention online platform turned into a holistic approach to mental healthcare along the way. Driven exclusively by voluntary efforts, they now work on four key areas: awareness, acceptance, prevention and intervention. The peer support team noticed an upsurge in cases of domestic violence and anxiety due to unemployment and extreme isolation. Apart from training a higher number of support providers within the organisation, they also connected therapists providing pro-bono services with people in need. As the country went through phases of gradually lifting the lockdown, they organised a webinar series called Talks to Unlock, featuring people from various backgrounds, and initiated conversations on mental health. For their own team, they started a 15 days ‘mental health leave system’ that members could take and created a ‘buddy system’ where each member would look after another person and ensure they remain connected.
Detoxifying 21st Century Media : The Correspondent, Tanmoy Goswami, New Delhi
Based in Delhi, Journalist Tanmoy Goswami has lived through his own long journey with depression and anxiety, and in 2019, he quit his 15-year career as a business journalist to become the world’s first ‘sanity correspondent’, working with the Amsterdam-based publication, The Correspondent. In December 2020, he started Sanity by Tanmoy, an independent platform dedicated to the politics, economics and culture of mental health. Tanmoy believes prevention of mental illnesses must get primacy over cure. Society focuses too much on medical cures for maladies like depression, he says, but it is critical to address the socio-economic causes that lead to mental health challenges in the first place. From his long career in Journalism, Tanmoy knows that the role of the media in this is often ignored. During the lockdown, when suicide became the largest cause of non-pandemic related deaths in India, he set out to sensitise fellow journalists about the stigmatising and sensational language in which the media often reports about suicide and create awareness about the intersectional nature of the psychological distress that often pushes people to the brink. “When a farmer dies by suicide, do you only interview their family? Or do you also approach local government officials and authority figures in that area who oversee the macro-level factors that contribute to farmer suicides?” Through his work, he has attempted to bring the genre of human interest stories, which would usually be buried in a Sunday supplement, to the fore, and place people’s lived experiences at the centre of the mental-health conversation. He asserts, “Given the myths and misinformation on mental health, journalists working in this area need to adhere to the same ethical standards that doctors follow - the sacred Hippocratic oath, ‘First, do no harm’ “.
The Aam Aadmi Model Of Psychotherapy: Mindpiper, New Delhi
Simplifying the language around Mental Health to make it more inclusive as a common man’s (aam aadmi) experience of distress is often expressed through somatic symptoms.
Mindpiper is a team of mental health and development-sector professionals comprising psychologists, psychiatrists, and human-centered designers. The social enterprise is co-founded by Siddhant Khurana, a trained engineer whose tryst with mental health in his late teens drove him to initiate his work in the mental and emotional health domain - aimed at reducing stigma and creating spaces for conversations and compassionate care. Their main goal is to bridge the care gap by providing dignified, economical, quality therapy and counselling in disadvantaged neighbourhoods such as homeless shelters and their clinics in Daryaganj and Jamia Nagar, New Delhi. Their model of care is tailored around the common man’s (aam aadmi) experience of distress often expressed through somatic symptoms- ‘neend nahi aa rahi ’ (Cannot sleep), ‘pairon mein dard ho raha hai ’ (Feet hurt), ‘achha na lagna ’ (Don’t feel good), ‘bechaini ’ (Restlessness), ‘ghabrahat ’ (Nervousness). Siddhant explained that in therapy, the language used must correspond to the words used in their day to day life and use of references and examples which have a strong correlation with the citizen's interests and motivations, when working in the vulnerable neighbourhoods. While words such as empathy and compassion are well understood by ‘well to do’, verbally ‘expressive and eloquent’ clients, with their clients from lower-socioeconomic strata, building acceptance in language through commonly used terms, like ‘man-mazbooti ’ ( strengthening the mind), was imperative. With the onset of Covid-19, their clinics had to close down but the team launched the ‘Covid-Response’ initiative in mid March - offering mental health and psychosocial support through helplines in collaboration with 11 state governments and other mental health organisations. They developed a model for crisis intervention, which was an amalgamation of the RAPID model of crisis counselling, trauma informed coping strategies, and basic counselling skills. This model focused on helping an individual restore some sense of control, to ensure their safety and promote overall stability. The goal was to provide emotional support and concrete assistance and help to problem-solve and assist individuals in engaging with available resources. They were primarily supporting people from low-income backgrounds, who were unable to cope with the sudden change, and answered over 20,000 calls in the first 2 months itself. The reflections that guided their work with the helpline were: What does one say to a family that cannot reach home? How can volunteer counsellors rooted in empathy and compassion support people in the times of instability and crisis ? How can Covid-19 positive patients be assisted while they’re being isolated in public facilities? Siddhant shares, “We received calls about multiple challenges and thematics. Basic sustenance was endangered. Many didn’t have the mandated government ID proofs; and had to go to shelter homes and stand in long queues just for a single hot meal. If you’re a child or an elderly, you were dissuaded from standing in the queue. And if you’re away from the waiting line for even a short while, in many reported incidents you could only rejoin the line the next day. We worked with the government to have their team members work closely with us, so that when a distress call came in, they could address it from both a basic sustenance and mental health lens.” Siddhant recalls an instance of a young girl (10th grade) who was separated from her family for 2 months as the family had travelled to Bihar for a wedding. She used to call the helpline almost daily out of fear of being separated. The counsellors engaged her in conversations about her daily routine- about her homework, what she ate, what she did at school. She became a regular caller with the helpline and these conversation about her routine and taking one step at a time, calmed her down. Care became synonymous with acknowledging the reality people were facing and making them feel heard and understood with the marker that they are not alone, there are people with training in counselling and government institutions who wish to come forward and actively support them in the crisis situation.
Handling tough situations…One Step at a Time. One day at a time
Making The Journey From Communal Violence To Rehabilitation : Voluntary Relief Efforts, North East Delhi
Danish, a marketing manager in a cosmo derma company covering North East Delhi, witnessed firsthand the destruction caused by the pogrom earlier in February. Seeing the horrors of burnt homes, displaced families in cramped relief camps, he started providing first-aid and initial medical relief. On noticing a lady at the Idgah relief camp going through piles of dirty donated clothes - he realised how victims, beyond fear, were feeling helpless and dependent on voluntary donors and state relief. So along with friends, he created a system where riot victims could pick up tasks locally like packing washed clothes, barbers giving haircuts, small shops selling ration, women delivering milk packets to others within the neighbourhood and camps - generating a small income in return. This restored some livelihood, and also made them self-reliant. People experienced how they needn’t be dependent on help from others, and could take charge of their own healing and those around them. Support circles were organised where Hindus and Muslims shared their trauma and listened to each other. There were others like Sabah Siddiqui, a psychotherapist, who in her pro-bono counselling sessions during the pandemic, addressed the rise in people facing mental health issues related to Islamophobia. Psychoanalytical psychotherapist Zahra Mehdi was flooded with messages from people across small towns. A boy in Bihar wrote to her about his fears of losing his childhood friends to hate. Today, when people are still recovering from the trauma of the Partition, the ‘84 Sikh riots or even the ‘92 riots in Mumbai, we can safely say that the effects of the North-East Delhi violence will last some, a lifetime. And interventions that ‘walk with people’, become necessary to build a road to recovery.
Addressing The Conflict Of Faith And Sexuality In Militarized Zones: Sonzal Welfare Trust, Kashmir
Sonzal was started in 2017 by Aijaz Ahmad Bund, a professor and a LGBTQUIA activist, after years of filing many petitions in the Human Rights Commission. Their aim was to provide mental health and sexual health facilities for LGBTQUI individuals, who are considered ‘invisible’, and faced multiple layers of oppression, of being Kashmiris, Muslims, Queer and living in a conflict zone . Prior to the pandemic (and the Abrogation of Article 370), their focus had been on building a supportive institutional framework ensuring dignity through ‘Inclusive Sexual Health Clinics’ with pharmaceutical sectors providing subsidised medicines and contraceptives. With the pandemic, the clinics became dysfunctional and people struggled to get access to hormone therapies and counselling services. While the pandemic did not change the circumstances much, as the abrogation of 370 had already brought a curfew, many months prior to the lockdown, the small community spaces and livelihood options for trans folks were suddenly all gone: “Pura system baith gaya hai, shaadiyaan nahi ho rahi hain since the last 14 months…”. (The entire system froze, marriages have not been taking place for the last 14 months). Most members of the transgender community depend on street work or performances at marriages and other ceremonies to make their living. Since March, they have had no source of income and no means to earn a living. Sonzal mobilised crowdsourced funds, identified 150 transgender families and provided dry ration kits worth Rs. 2500 to each for 2 months. They organised online and offline mental health counselling and were often faced with cases where queer people were suicidal as they were forced into heterosexual marriages. Queer affirmative therapy, and helping queer folks reconcile the clash between their religious and sexual identity, building their self-confidence, became paramount for Aijaz. Due to overt religiosity, transgenders in Kashmir are unable to publicly congregate, and don’t live in well formed matrilineal family systems like the rest of the country. So a large part of Sonzal’s work has been supporting trans communities to build these alternative families, which could act as support systems. To plug the care gap during the lockdown, they trained trans members in psychological aid, so that they could reach out and counsel their own communities. In addition to that, they’re also working towards influencing policies to promote government-sponsored transposing of Transgenders ( a hormone replacement therapy and sex reassignment surgery) along with skilling the community to earn their livelihoods. Aijaz shares that for trans rights, much more needs to be done. “Working on these issues, where there is armed conflict, social issues get overshadowed. People disappear, get tortured, and many human rights violations happen on a daily basis. Working in such situations, is and will always be challenging. Not having proper internet makes it hard for us to even communicate. You don’t know when you step out and might get shot by a bullet. As a part of a global LGBTQUI community, we’re constantly in touch and learning from organisations in the Middle East, who have a common context of armed conflicts.''
Democratising Queer-Affirmative Care For The Youth: Ya-All, Imphal, Manipur
Ya-All meaning ‘revolution’ in Manipuri was founded by Sadam Hanjabam, a queer youth activist, to bring about a revolutionary change in queer-youths’ mental health in Manipur, after he survived two drug overdoses . Unlike urban cities which have numerous options of private clinics, health networks and hospitals, Manipur does not have adequate mental health care services and the ratio of mental health professionals to the general population is 1:2,000 (National Mental Health Survey Report 2016). Having faced his own struggles with substance abuse, his queer identity, and the inability to find mental health care services with dignity and respect, Ya-all was close to Sadam’s heart. His motive was to create a safe space for youngsters who are queer and are coming to terms with accepting themselves. A first of it’s kind peer network in Manipur, Ya-All creates a support system for access to information and services on health, education and skills for adolescents and youth identifying as queer, and living with HIV and psychological disabilities. It provides safe, informal, co-working and networking spaces. Ya-All builds a peer-network and helps young people destigmatise conversations on mental health, sexual and reproductive health, drug abuse, empowering them to be leaders. They have also recently started the first trans-men football team. The pandemic altered Ya-All’s initiatives. The need of the hour demanded more than was already being done. They diversified into other spaces too and initiated a crowdfunding project called Khudolto to provide food, health and hygiene to people living with HIV-AIDS, daily-wage labourers and children. 100 volunteers provided for 2000 families and individuals with 1000 health kits, 6500 sanitary napkins and 1500 condoms. The mental health team also started a helpline so that people in distress could reach out to them. They addressed 300+ crisis calls within 3 months. The diversified and Inclusive efforts of Ya-All to assist the vulnerable key populations was acknowledged by the UN Envoy on Youth and listed among 10 Global Initiatives led by queer individuals in the world in its IDAHOBIT edition. Sadam constantly wanted to go beyond his personal capacity to provide for people. He knew what it felt like to be alone when he needed help the most. He did not want others to go through that. These helplines were soon recognised by the state government that trained mental health professionals to deal with the pandemic. Covid-19 patients from 3 districts were followed up by them for 3 months. And now they have partnered with the Manipur Commission for Protection of Child Rights to provide online counselling and psycho-social support to children and adolescents.
The Dignity Of Work For Those With Mental Disorders : Kaitley, Lucknow, U.P.
The liveliness of a tea stall used to rehabilitate people with mental illness as opposed to the loneliness of a mental institution.
Ambareen Abdullah did her Masters in Mental health from TISS and was disappointed with the lack of projects on the same in her hometown, Lucknow. During her Masters in Social Work, she identified a social stigma around people with mental disorders. To train and empower individuals recovering from chronic mental illnesses , Ambareen co-founded Kaitley Foundation (Kaitley means tea-pot) with Fahad Azim, to help them start their own independent tea carts . “These low-cost, easily executable tea carts acted like micro-spaces. They help people with mental illnesses revive their social interaction skills, some of whom have not even moved out of their rooms for years. This initiative not only tackles stigma associated with mentally-ill people and provides a source of sustainable livelihood, but also helps increase the attention span of people with mental illnesses. From 8-to seconds, they are pushed to stay attentive for 15 minutes, the time required to make one cup of tea. To see a mentally ill person going out doing their work and earning their own living is very satisfying.” In a country with very few rehabilitation initiatives for people with mental disorders, and asylum-styled ‘paagal-khanas’ (madhouses), Kaitley provides not only basic human rights of respect and dignity but also vendor rights to individuals. Ambareen stresses that without any avenues, most people with mental health illnesses, often end up spending their whole life locked up in a mental health institute. “ In the language of psychology it is called '' the revolving door syndrome”, when, where a person who enters a door, is always skidding around it, not being able to exit. I noticed how the people coming into these institutes were ageing in the institutes.” Kaitley wants to leave an impact on individuals’ lives by coming up with solutions best suited to their needs and qualities. As the pandemic began, the stalls were shut down. But the work, with volunteers’ efforts, was designed and adapted into a helpline, ‘Poocho toh Jaano’ ( Ask and You Shall Know) where callers could find a compassionate counsellor to speak with. The idea was to walk together and not alone. She narrated a case about a person with severe mental distress, struggling in the confines of his household due to COVID. In such times, remedial home based interventions provided constant support. These interventions and counselling encouraged him and his brother to explore his good memories, his happy place. The team learnt that he was an avid kite flier, and used to fly them as a child. They were mesmerised by his knowledge and vocabulary about the art. They came up with a solution and encouraged him to open a kite shop at home.
When Mental Health Champions Social Justice: Anubhuti Trust, Maharashtra
Anubhuti Trust (to experience and empathise) was founded by social activist Deepa Pawar in 2016. Coming from the Gadiya Lohar, a nomadic denotified tribe in India, she realised that her mental distress, and that of the women around her, was caused by the struggles that come by virtue of their identity and a lack of language to describe these struggles. “Any group oppression begins with mentally oppressing members into feeling weak; this is sustained over decades, and eventually normalises discrimination and violence inflicted upon marginalised communities.” Her organisation created community driven mental health models, and organised ‘Mann Mela’, a grassroot youth led mental health fair providing accessible mental health literacy, counselling and strategies to deal with mental distress. They have designed special games to identify and address mental health issues and coping strategies. In the pandemic, the condition of vulnerable nomadic and denotified tribes worsened due to the societal stigma they face, coupled with poverty and starvation. The team at Anubhuti Trust pre-empted that this would have a disastrous impact on their mental wellbeing, especially the women. In the absence of on-ground activities, they started tele-counselling with the youth and women, and also contributed towards financial aid. They have been training youth leaders in the communities to carry out relief work in the lockdown and provide round the clock counselling. These leaders have also taken it upon themselves to spread awareness about Covid-19 amongst those with mental illnesses, and to protect them from mistreatment and exploitation. The compassion in these communities has shone through as they have managed to keep themselves alive with no resources, and have kept going through challenges like discrimination from the society, and neglect at the hands of the administration. Community leaders, who themselves have limited resources, have taken charge and shared whatever little they have. Deepa was moved when an old woman chided the team for travelling with relief packages and endangering themselves during the pandemic. Many women would pass on the last bag of rations to someone they thought needed it more than them. While labouring on to provide short-term relief, Deepa’s team has also been planning sustainable long-term responses for the community’s needs, including scholarships for girls, equipping schools with counselling and community-led disaster and emergency response centres. ”I coined the term Mental Justice (taken from mental health and social justice), to widen the scope of mental health beyond treatment, counselling, of individuals, to include the need to work on all social, political, administrative indignities, challenges being faced by ground communities. Without this we cannot achieve their Mental Justice.”
Advocacy For Mental Health At The Workplace: One Future Collective (OFC), Mumbai
One Future Collective is built on the idea of building a world on social justice through nurturing and caring communities. Started by Vandita Morarka, activist and lawyer, OFC works in the field of gender justice, mental health and feminist leadership. They do this work through knowledge, advocacy and community building. They train professionals and grassroots workers, run a leadership fellowship, develop resources and manuals with open source content, along with interactive tools such as games. They also have two centres: FemJustice Centre - offers training, courses and workshops for rights-based changes for survivors of gender based violence; and Queer Resource Centre provides queer-affirmative resources on healthcare, education, housing and legal services and develops queer leadership. Morarka believes social justice must be embedded in a way that we see access as a matter of right and not as dependent on certain groups deciding whether you are ‘deserving or not’. During the pandemic, while their on ground training came to a halt, the FemJustice Helpline was running pro bono legal and counselling services for people from diverse socio-economic backgrounds across India. A lot of her work is about embedding social justice practises and ethos into educational, civil society, corporate and governmental spaces. During the pandemic she noticed a rising recognition across sectors, offices, corporates, institutions, of the need to have an internal ‘mental health policy’ and a mental health practitioner onboard. “I can't go to young college students and say that mental health should be a priority, if the college does not have a policy and service provision that understands the MH needs of students in the first place!”. OFC believes in order that for there to be true change, one must work with those pushed to the margins, at the levels of individuals, communities and organisations that are representative of state and private players, and ensure their voices are heard. Morarka has been passionately working on youth social leadership for youth at global and national fora, pushing for more resources, access and decision making.
Funding, Collaborating And Providing Queer-Affirmative Courses: Mariwala Health Initiative (MHI), Mumbai
MHI is an initiative for mental health started in 2015 with the idea to make mental health accessible for all. They fund and partner with projects existing in urban, rural and remote parts of the country. MHI’s own pivotal contribution to the field of mental health has been through queer affirmative counselling and a certification course taught by queer and trans mental health professionals. Pooja Nair, a Faculty at QACP states, “How does your sense of self develop when everyone denies it? How will you experience your own self when everything around you is denying your existence, your identity?” They partnered with a national helpline called iCall in collaboration with TISS Mumbai, which provided support to callers during the pandemic on a range of issues from psycho-social wellbeing, to care for caregivers, loneliness, panic and anxiety, amongst other things. In a time when there is a global economic downfall, MHI has been funding and supporting over 50 organisations in the area of mental health across the country. During the pandemic, they continued to support their partners, saving many from shutting down. Together with their partners they were able to address the most vulnerable populations through community-based initiatives (sex workers, trans persons, People with disabilities, HIV positive person, people living on the streets, persons incarcerated (mental hospitals / jails), Notified and Denotied tribes, LGBTQIA+, Dalits/ Bahujans, marginalised religious communities, geographically inaccessible). They funded 30 such grassroots organisations across 17 states, that weren’t even necessarily registered groups and were struggling during Covid. They also supported the government through SNEHA in Mumbai, CMHLP Atmiyata in Gujarat, Bapu in Pune, Iswar Sankalpa in Kolkata - who all worked to provide relief and psychosocial support in slums, night shelters, streets and rural areas. Gearing up for a ‘mass mental health crisis’ in India, MHI’s role in empowering, funding, training and holding national collective spaces for organisations working on mental health will go a long way in building sustainable practises and reaching out to millions in the country.
Mental Justice For All
In an area where the challenges sometimes outpace the solutions, what keeps the wheels turning? What is it that makes people invest energy, time and money into mental healthcare for others, that doesn’t promise linear, or even visible, recovery? And will these efforts continue to survive beyond the pandemic?
Talking about Mental Justice - a term coined by Deepa Pawar, the founder of Anubhuti Trust, we must ensure that mental health is an inalienable right afforded to everyone, and that our understanding and practise go beyond treatment. It must encompass the need to address all aspects of individuals’ lives, so that their lived challenges and the deep rooted historical injustices they’re subjected to, can be overturned.
There is a widely recognised need to start from the ground up and build a mental health landscape for India that works for people across the divides of caste, class, religion, and urban or rural backgrounds. People have taken charge of community support and have gone out of their way to support each other's mental health. A retired old man, holed up at home, begins to visit his farm and spends time looking after cattle when he sees that someone from his community is checking on him. Groups of adivasi and bahujan women meet every evening, and confide in each other about their troubles ranging from domestic violence to caste discrimination. Nomadic artists and cultural activists ]organise nukkad nataks (street theatre) to tell stories of caste atrocities and the lived mental trauma caused by it. Queer people are building spaces for themselves in smaller communities and fighting hard to create queer friendly and queer centred practises in mental health. These people’s psychosocial skills are enriched by their lived experiences, and can’t be taught in classrooms. The government needs to learn from these and place them and their experiences at the centre while making policies on mental health.
As Raj Mariwala, Director of Mariwala Health Initiative says, “ To tackle the mental health crisis in the country, we need a paradigm shift in how we view mental health – to understand mental health in psychosocial rather than solely biomedical terms. This necessitates an intersectional approach, rights-based approach which looks at how structural and systemic discrimination affects people and communities. It is as critical to link mental health to other development issues such as livelihoods, education, physical health and justice - policy and implementation must be psychosocial & address the social & economic conditions that affect mental health. Poor mental health is both a cause and consequence of poverty, compromised education, gender inequality, physical ill-health and violence.”
As Deepa Pawar asserts, “Only when we care for everyone equally and make mental health accessible to everyone can we ensure that the values and rights of the Indian Constitution reach every last person in the social hierarchy, maintaining their mental dignity.”
Mental Justice (taken from Mental health and Social Justice) is a term coined by Deepa Pawar, the founder of Anubhuti Trust.
We would like to thank the fantastic individuals and organisations who took the time to share their stories with us, supporting us in curating this story.
Dr Soumitra Pathare and Jasmine Kalha, Centre for Mental Health Law & Policy, Atmiyata, Gujarat,
Aijaz Ahmad, Kashmir, Sonzal Welfare Trust,
Vandita Morarka, One Future Collective, Mumbai
Ambareen Abdullah, Kaitley Foundation, Lucknow
Siddhant Khurana, Mindpiper, New Delhi
Tanmoy Goswami, The Correspondent, New Delhi
Akash Saxena, You’re Wonderful Project, Delhi
Dr. Mythili Hazarika, Monon, Assam
Danish, Relief volunteer, North East Delhi
Priti Sridhar, Anam Mitra and Raj Mariwala, Mariwala Health Initiative, Mumbai
Deepa Pawar, Anubhuti Trust, Maharashtra
Sadam Hanjabam, Ya-All, Manipur
Sweta Pal, Sangath - Mann Mela, New Delhi
Written by Nida Ansari, Radhika Kannan and Snigdha Bansal
Illustrated by Sandhya Vishvanath
Art Direction by Pooja Dhingra