“You can’t stay in your corner of the forest waiting for others to come to you. You have to go to them sometimes”
~ A A Milne, Author of Winnie The Pooh
Across India, less than 5,000 psychiatrists and fewer psychologists are responsible for providing mental health care for more than a billion people. This effectively means that a large proportion of those with mental health problems does not get timely and adequate care. The founders of Sangath recognised that reaching out to those unable to access mental health care by using available resources could bridge this yawning treatment gap.
Established in 1996 to provide clinical services to the local community, Sangath soon expanded to developing creative ways of making mental health care more accessible and affordable to the wider population. Now in the 18 year of our wonderful journey, we present the ninth biennial report (2012-2014).During this period, our staff strength has gone up to more than 150 members, we have started five new projects while concurrently running 12, and through all of these efforts, have made a difference to hundreds of lives.
Over the past two years, we have continued to respond to the changing health needs of the community, to innovate, and to develop new interventions to close the treatment gap. We are now working in a number of states across India, including Goa, Bihar, Assam, Karnataka, Maharashtra and Tamil Nadu through networks and alliances spanning government agencies, hospitals, other non-governmental organisations, trusts, corporate houses and educational institutions.
The past two years have been especially memorable as we have moved to our very own new centre in Goa, which now functions as our administrative and research hub, with a training centre, library, offices and clinic, all under one roof. Funded by the John T and Catherine D MacArthur Foundation International Prize for Creative & Effective Institutions 2008, the centre in Soccoro (Bardez), houses large project office spaces, meeting rooms, a well-stocked library, clinic and training hall with state-of-the-art technology. With a centre to call our own, we have re-launched the Sangath Clinical Services for children, adolescents and adults. A new revamped website has also been thrown open to the public.
Through our core services in child health, youth and adolescent health, and adult mental health, we have surged forward with innovative programmes for families of children with autism; students in schools; and people suffering from alcohol problems, trauma, depression, anxiety, severe mental disorders and post-partum depression among others.
We started our new INFORM project to scale up evidence-based care for children with neuro-developmental disabilities using a mobile health (or m-health) platform. A three-year project called SPRING for MDGS evaluating a home-based intervention targeting pregnant women through to the first two years of a child's life has also commenced in New Delhi.
Our successful adolescent programme in Goa has now moved to Bihar as SEHER, a randomized controlled trial which will be implemented in schools to strengthen the evidence base on school-based interventions to promote youth health.
Sangath also introduced a new dimension on Chronic Disease and Ageing REsearch (CARE) to tackle issues faced by older dependent people and their carers. DIL, a project aimed at promoting the well-being of older adults by exploring the possibility of preventing depression in late life, was started this year.
Our Parent-mediated intervention for Autism Spectrum disorders in South Asia (PASS) has been so successful that we are now looking at starting a programme in Maharashtra with added modules addressing varied unmet needs of families affected by autism. We are also starting a new project, Community Oriented Non-specialist Treatment for Alcohol Dependence (CONTAD), which aims to develop an intervention to address the acute care needs related to alcohol detoxification and relapse prevention.
All of these emphasise research, empirical knowledge and a model of care called ‘task-sharing’ in which we empower lay people through appropriate training and supervision to provide care for people with mental health problems and thus, achieve the goal of contributing to reduce the treatment gap.
As a part of our vision to see our models of care become an integral part of state and national health programmes, we regularly conduct training courses and workshops to introduce people to our leading innovations in mental health care. Our courses, such as the Leadership in Mental Health programme, the Five-Step Method workshop and Cognitive Behaviour Therapy workshop, attracted students from across India and other parts of the world.
We continue to strengthen our partnerships with various collaborators, including the Centre for Global Mental Health (London); the University of Cape Town, the University of Liverpool; the London School of Hygiene and Tropical Medicine, Kings College London, University of Pittsburgh; the Public Health Foundation of India and its South Asia Network for Chronic Diseases; Parivartan, Prakriti and Watershed Organisation Trust in Maharashtra; mental hospitals in Pune and Tezpur; Vidya Sagar and SCARF in Tamil Nadu; dozens of schools and colleges in Goa and Bihar; and various departments of the governments in Goa and Bihar.
Sangath is also a partner in global networks of institutions in Africa (Ethiopia, Uganda and South Africa), Asia (Nepal and India), the World Health Organisation, and six countries through the South Asia Hub for Advocacy, Research and Education on mental health (SHARE). We are also proud to continue serving as the state nodal agency for the National Trust to promote activities aimed at inclusion of people with disabilities.
Through all of this, it has been the unstinting support and faith in our vision from our general body, service providers, collaborators, partners, funders and friends, that continues to drive us to fulfilling our promise of working towards an inclusive world without boundaries, where stigma loses definition and care is accessible to all.
~ Amit Dias, Smita Naik, Vikram Patel, Mrinalini Sahasrabhojanee, Nazneen Sarosh-Rebelo, Ashwin Tombat & Isabel Santa Rita Vas