As you read this Biennial Report, the 6th we have published since we began our journey in 1996, you will have gathered that these past two years have been momentous ones for us. Three major events have left an indelible mark during this period. First, we won the prestigious MacArthur Foundation's International Prize for Creative and Effective Institutions, a recognition of our pioneering work in mental health. Second, we reorganised our management systems and, after a brief trial with two Directors, we finally settled down with appointing a full-time Executive Director and Senior Administrator. We were fortunate that Gracy Andrew, who has been a leader of Sangath from its humble beginnings, chose to leave the Managing Committee and her career to take up the responsibility of Executive Director. Third, after a search that has lasted many bumpy years, Sangath finally found a property to purchase in north Goa which was within our budget (which had been considerably enhanced thanks to the Prize), very close to our current offices and large enough to accommodate our needs. We now have the exciting task of renovating the property and building a new block to house our training centre; this will need more funds, and our team is gearing up for a major fund-raising campaign to achieve our targets.
Over the past two years, we have been blessed to enjoy the contributions of immensely talented and diverse service providers. Our new courses, such as the Leadership in Mental Health, attract students from all over the world. We have strengthened our partnerships with old and new collaborators, notably the London School of Hygiene & Tropical Medicine, the Public Health Foundation of India (through the South Asia Network for Chronic Diseases), Parivartan in Maharashtra, Vidya Sagar and SCARF in Chennai and various departments of the Government Goa, notably health and education. Above all, we have been fortunate to enjoy the support of major funders in Goa, and elsewhere in India and abroad, who have committed generous resources to support our mission. Sangath is now poised to consolidate its work in Goa and to expand its vision to other parts of the country.
At the heart of our vision lies the ‘treatment gap’ for mental disorders, i.e. the gap between the number of people with a mental disorder and the number who receive care for their mental disorders, is large in India. A major barrier to closing this treatment gap is the lack of affordable specialists in settings where people with mental health problems access services, whether in schools, primary health care centres or other community settings. Apart from our ongoing projects on experimenting with community health workers to deliver care for depression and schizophrenia, Sangath will launch its ambitious new PREMIUM program this year which will design a systematic process to develop new psychological treatments which can be delivered by lay health workers. We are also planning to develop interventions for promoting mental health amongst impoverished agricultural communities in Vidarbha (Maharashtra) in partnership with local livelihood and health agencies. We are developing a new program of work on dementia in old age, starting with focusing on extending a home based model of care in south Goa. Our mental health activities will be extended to other chronic diseases (such as diabetes) with the launch of a new community based program to study how these conditions affect one another and to develop household based interventions; this new project will be carried out in collaboration with the Public Health Foundation of India. Our work in child development and adolescent health is also poised for some exciting new initiatives. We have established collaborations with leading groups around the country to set up a network on neuro-developmental disabilities in childhood; this group will launch coordinated studies on the burden, impact and unmet health needs of families with a child with such a disability. This will lead on to the development of new community based interventions to support these families. As the state nodal agency under the National Trust we are initiating a number of programs in collaboration with special schools in Goa. Our flagship school health program has already gathered growing support in Goa and partnerships to extend our expertise in school based counselling and evaluation of school health programs to schools around the country.
Sangath is widely considered as one of India's leading innovators in child development, adolescent health and mental health for its efforts to provide care for these issues at a low cost in routine care settings. Our ultimate vision is to see our models of care not only evaluated thoroughly, but to become an integral part of national health programs. We thank our service providers, partners, collaborators, funders and friends for their unstinting support and faith and look forwards to our continuing journey with you in the years ahead.
Vishram Gupte, Amit Dias, Nazneen Sarosh-Rebelo, Mrinalini Sahasrabhojanee, Ashwin Tombat, Kalpana Joshi & Vikram Patel.