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Healthcare

Chandana Sharma

Ashadeep has been running rehabilitation homes for homeless persons with mental illness wandering on the streets since the year 2005. Our aim is not only to provide a shelter to this group but also to provide them with holistic care that will encourage them towards recovery. Our main objective for them who until recently had no place to live in and nothing to call their own, is to rehabilitate and re-integrate them back with their family / community. From our experience, it has been observed that about 10% of this group cannot be reintegrated and hence remain with us. Majority of such persons become functional and become capable of taking care of themselves and they do not deserve to remain in institutional care. 
 The 'Shared Housing' approach is aimed at offering mental health care and social services care for persons with mental health issues, who have been sucked in Ashadeep's Rehabilitation homes over an extended period. Usually five men or women reside in these homes, and they live a life like anyone of us. Most of the residents of these shared homes are earning a livelihood through varied engagements. Individual who have recovered or being symptom free or enjoying high/normal functionality levels of disability are eligible for living in the 'Shared House'. The residents in these homes do not have any restrictions in movement or interactions, they decide on what to eat, wear and many of them are employed in different settings. 
 The major outcomes observed in the residents living in the Shared Homes areØ Development in residents interpersonal and social skills and increase in the level of functionality for example communication and work.Ø They develop a good bonding among themselves (sister’s / brother's relation) and also start visiting neighbours and maintain a good relation with the community peopleØ Their psychological health and the quality of life becomes much better than beforeØ They take part in household work and a few of them start cooking in their respective homesØ A few residents who never go out of the campus start working outsideØ Some residents are employed internally and start earning like a normal beingØ Few of the residents have been successfully reintegrated

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Initiated in the year 1996, Ashadeep was established with the vision of achieving a life of better quality for persons with mental disorder and their families. During this time rehabilitation services pertaining to mental health were very much limited in the region. Since its inception, every intervention facilitated by the organization has evolved keeping in view the ‘contextual needs’ of persons with mental illness and individuals with intellectual disability and associated disorders. The core area of Ashadeep consists of being a service provider in mental health interventions for one and all in the community. The stakeholders as such not only consists of persons with mental disorders and their families but also members of the community such as professionals in various fields, school and college students, civil society organizations, multi purpose health workers in rural areas, health practitioners, police personnel, and state machineries. A brief description of various interventions by Ashadeep which covers directly or indirectly the above mentioned groups of stakeholders are as follows-·        ‘Day rehabilitation centre’ for individuals with intellectual disability and associated disorders and persons recovering from mental illness. At this centre, individual and group therapy is provided to individuals recovering from mental illness and lessons imparted on life skills and other social skills and special and conventional education to those who are mentally challenged. For the youngsters in the centre, sports is given special emphasis, all the students have been registered under Special Olympics Bharat and Assam Mountaineering Association.To ensure a life of dignity for these individuals skill building through pre-vocational and vocational training with an emphasis on income generating activities forms a major component of rehabilitation process undertaken. An important element of the activities undertaken here is the sheltered workshop which not only acts as a part of the rehabilitation process but also acts as an income generation activity for persons recovering from mental illness. The interventions of this centre also extend to the caregiver groups as they are provided with family counseling from time to time.·        ‘Navachetana’ Rehabilitation homes for homeless women with mental illness- The prime objective of this project – ‘Navachetana’ is to provide care, treatment and rehabilitation measures to these women and to eventually re-integrate them with their families. Psychiatric and other medical treatment and care; Psychological and other social rehabilitation services are provided at the ‘Navachetana’ residential facilities by a team of qualified personnel including psychiatrists, psychologists, counselors, social workers, and trained health care staff. A unique feature of these homes is the fact that scientific tools and approaches such as Growth Chart, Mental Status Examination, Positive and Negative Symptoms Scale, Indian Disability Examination and Assessment Scale and Global Assessment Functioning are used in a homely environment instead of a hospital like set up. Once the women are reintegrated with their families, follow-up support in terms of treatment, counseling, and free medicine supply are provided to them on regular intervals. Till date 770 women have been provided with these services of which 742 have been reintegrated in various parts of India including Arunachal Pradesh, West Bengal, Bihar, Madhya Pradesh, Karnataka, Orissa, Jharkhand, Gujarat, Andhra Pradesh and Karnataka.·  UDAYAN Rehabilitation Home for Homeless Men with Mental Illness To extend mental health interventions to homeless men with mental illness Ashadeep in collaboration with Social Welfare Department, Government of Assam has initiated rehabilitation home for homeless men with mental illness in Bamunigaon, Assam since July 2013. Along with provision for admission, care, treatment and reintegration of these men, livelihood generation activities are also a part of this intervention. So far 262 men have been rescued and admitted at this home out of which 234 have been reintegrated with their families in various places viz. Assam, West Bengal, Tripura, Maharashtra, Andhra Pradesh, Telegana, Madhya Pradesh, Bihar, Jharkhand and Nepal.·        Outreach Mental Health Camps in which along with free distribution of psychiatric medicines and consultation, capacity building of local NGOs was also undertaken. 131 camps were organized in 8 different districts of Assam during 2006-12, wherein staff of 5 local NGOs and 2 Government run PHC/CHC were empowered on the issues of mental health. Over 1800 patients with mental illness were intervened in these camps. ·        Outdoor Psychiatric Clinic - undertaken once a week within the city. This clinic benefits not only past residents of Navachetana but also caters to socially, economically and geographically marginalized population residing within the city as free consultation on mental health is provided by a psychiatrist and other trained staff members of Ashadeep. So far 1373 patients have been registered in this OPD. ·        Resource Centre - The prime activities under this particular endeavour are Sensitization; Orientation &amp; Training; Research &amp; Documentation and Advocacy on issues of mental health. Creation of awareness generation material is thrust area of the organization, a training manual on mental health and book named ‘Hidden in Full View’ was published along with pamphlets, posters and hoardings on mental health. Since 2018, the Resource Centre has initiated a Certificate course on Mental Health and Behavioral Sciences. The Programme / Projects of Ashadeep facilitate the scope of practical exposures at ground level for the students seeking a career as Mental Health Professionals. The modules of this course have been designed so as to provide the finishing touches to those students who aspire to work on the issue of Mental Health, through substantial practical exposures.·        “Ability” is the Vocational Unit of Ashadeep and is also a sale outlet of the products created at all the facilities under sheltered workshop of the organization.·        Community Mental Health Program -Initiated in 2013, Community Mental Health Programme is a more intensive approach of Ashadeep’s outreach intervention aimed at empowering the community as a whole on mental health. The major objectives of the programme consists of identification of persons with mental illness, their referral to primary health centre, treatment through provision of medicines, follow- up to ensure continuation of medication and facilitation of income generation activities amongst persons recovering from mental illness. These community based intervention were implemented in Sipajhar block of Darrang District and Mayong block of Morigaon District during April 2013 to December 2016; in Boko block of Kamrup (rural) during June 2013 to June 2017. A total of 1906 persons in these rural areas had been intervened through this programme in the three blocks.Currently Community Mental Health Programme is undergoing in Rangjuli block of Goalpara district and Bhurbandha block of Morigaon district in Assam and Chumukedima in Nagaland since June 2020. ·        HOME AGAIN – Independent Shared Housing in the community for residents of Navachetana and Udayan -Ashadeep has been providing institutional care to homeless persons with mental illness for more than a decade. Although the recovered patients are taken back home to re-unite with their families, about 10% of the residents cannot be re-integrated for various reasons. Till now, such women and men were living under the institutional care in spite of recovering sufficiently and becoming functional. Since January 2017, Ashadeep initiated the ‘shared Housing’ program by doing away with the Navachetana (Rehab) facility and setting up 6 independent homes by paving way from the institutional pattern of rehabilitation to a more inclusive community setting. Each ’shared home’ accommodating 5 residents together with a ‘health worker’, five for women and one for men, three each in rural and urban settings. The residents in these homes do not have any restrictions in movement or interactions, they decide on what to eat, wear and many of them are employed in different settings. By the end of first year, we have seen tremendous changes in the functional level of most of the residents. Out of total 30 residents in the Shared Homes, 6 women are employed in a packaging unit, 11 are employed in Ashadeep’s facilities, 3 men are engaged in the Coffee Shop and Nursery outlet of Ashadeep indicating 67% are having employment.The observations indicate the efficacy of the ‘shared housing’ concept. Economic independence is important for all people, more for those who are not with their families. Awards and RecognitionAshadeep has always thrived for the cause of mental health which has often more than not been neglected from the broader spectrum of health care in most of the developing nations. These efforts were given recognition when prestigious awards like India NGO Awards, Edel Give Social Innovation Honours, CSO Partners Outstanding Annual Reports were conferred to Ashadeep.Recently, the following awards were extended to Ashadeep and its members-Ø In February 2012, Ashadeep was jointly awarded the first prize by The EdelGive Foundation, Mumbai under its Social innovation Honours under the category ‘Health &amp; Well Being’.Ø Dr. Anjana Goswami, Director &amp; Founder Member of Ashadeep was honoured by the National Women’s Commission at a function held at New Delhi in March 2012.Ø  ASHADEEP received the CSO Partners Outstanding Annual Reports Award 2010 at New Delhi.Ø India NGO Award Winner-First in Eastern Region in 2010.Ø Dr Anjana Goswami, Director, Ashadeep was conferred the Roshan Phukan Award by Eastern Women’s Association in Guwhati, Assam on 16th November, 2013.Ø Ashadeep Day Rehabilitation Centre was conferred The De Rozio Award for Education and Human Enrichment in the category of 'Special Education' for the year, 2013 by Council for the Indian School Certificate Examinations. Hon'ble Governor of Karnataka Dr H.K Bharadwaj presented the award to Dr Anjana Goswami, Director, Ashadeep at the presentation ceremony held in Bishop's Cotton Boys' School, St Mark's Road, Bangalore on 8th January, 2014 during the Annual Conference of the Association of Heads of Anglo Indian Schools in India.Ø Mr Mukul Chandra Goswami, Founding Member &amp; Secretary, Ashadeep was conferred the Padma Shri Award for Social Work in 2014, announced by the Government of India on the eve of Republic Day.

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