Sudipta Basu

Support from the Sir Dorabji Tata Trust and the JRD Tata Trust is helping two institutions in Mumbai lend a caring hand to the mentally disabled and the elderly

Twenty two-year-old Ramesh Chadda’s seemingly normal family life was, in fact, so abnormal that it made him schizophrenic. Ramesh, who comes from a middle-class family, was not inclined towards formal education, although he had a strong artistic bent of mind. His parents, however, pushed him hard to achieve adequate grades at school. But they pushed too hard, and he gradually began isolating himself. His innate desires bottled up within, he unwittingly developed a split personality. His parents took him to doctors and counsellors, and medication was administered, which he was reluctant to take.

"We realised that he was looking for a creative outlet. We encouraged him in his endeavours and hoped to find opportunities for him," says Priya Deo, counsellor at the Mental Health Centre, Mumbai. "He was encouraged enact small roles on stage that helped build his confidence." He started emerging from his shell gradually. The Mental Health Center undertook the sale of his canvases, the proceeds of which were handed over to him. Today he owns a printing press and is economically independent. One of his paintings adorns the entrance of the center.

Thirty eight-year-old Kanta Pandey’s life hit rock bottom when her marriage failed and her parents refused to take her back. Being conservative north Indians, they were not very keen to support a daughter who had a failed marriage behind her. She came from a family that seemed to have problems maintaining healthy relationships. "They spoke to each other loudly, used rough language openly and frequently verbally abused each other," says Deo.

Kanta had carried the images of her past life into her marital home. She was known to have hit her husband and mother-in-law on several occasions. Her problems with relationships grew much deeper, and she slipped into schizophrenia.

She was referred to the centre and after a series of counselling sessions came to terms with the fact that her family was dysfunctional. Therapy was slow, as she continued to live in the family that was the cause of her trauma. Fortunately for her, her brother slowly became sensitive to her situation. He encouraged her to go out and take up small jobs to support herself. Today she is a data operator for a private company.

Sheelatai’s story did not end as satisfactorily as the other two, though. Sheela evoked awe among the residents of the chawl in Lower Parel where she lived. She was uneducated but ran a dabba service, which ensured her financial security. However, this did not last long. Her health failed and her business began to dwindle. Her son did not do much to contribute to the family’s expenses. He was an alcoholic and continued to extract money from her. She eventually also became a victim of physical abuse.

"In a complicated family life with financial difficulties, physical abuse is very common," says Alpa Desai, counsellor, Family Welfare Centre. "Children hailing from such families are often caught stealing and when the situation worsens, the legal system gets involved. It then becomes very difficult for voluntary service groups to make any intervention." Sheelatai eventually passed away lonely and penniless.

Her life is a lesson for voluntary welfare agencies using the services of self-help groups and creating awareness in the community to establish a senior citizens’ protection group. Desai believes that in Sheelatai’s case, if the neighbours had intervened to mitigate the frequent bouts of quarrels in the family, she may not have died in such a desperate state.

The Family Welfare Centre has made a difference to the lives the socially marginalised. Along the gritty lanes of BDD chawls in Lower Parel, Mumbai, are two small but squeaky-clean quarters abuzz with activity. In one of them, mentally challenged persons have gathered to participate in the activities of the day, while at the other, senior citizens from the neighbourhood have assembled for a casual heart-to-heart. The Mental Health Centre and the Centre for the Elderly are twin chapters of the Family Welfare Agency (FWA). Funded by the JRD and Sir Dorabji Tata trusts respectively, they have been instrumental in forming support groups for the elderly and the mentally disabled in the city.

The Mental Health Centre was earlier known as the Association of the Friends of the Mentally Ill, an organisation working in the field of mental health in the BDD chawls. It was officially amalgamated with the Family Welfare Agency in 1991. With the financial support of the JRD Tata Trust, the Mental Health Centre Project of the FWA was initiated in 1997.

In its first year, the old structure was renovated with the assistance of the funds donated by the trusts, and education programmes such as sewing classes for girls and work for mentally challenged children and adults was initiated.

Currently, approximately 15 clients attend the day-care centre daily. Fifty new clients have been inducted over the last three years. A psychiatrist, occupational therapist and social worker screen each client before planning their rehabilitation programme. Regular meetings with members of the family are set up and the progress of the programme is discussed.

Deo says that the most common psychiatric illnesses they deal with is schizophrenia and problems related to the stress of urban living. Clients at the day-care centre are counselled individually and their rehabilitation plan reviewed regularly. Families are counselled to equip them with better management skills and create and identify realistic and attainable goals to help the clients integrate into the mainstream faster.

Group sessions are held daily for an hour in the afternoon. A social worker and counsellor preside over these sessions to initiate discussions in a fun, open way. Popular topics in the past have been theatre games, voice modulation, creation of impromptu songs, group discussions on topics such as epileptic fits, electric shock therapy etc. "In the last three years, ten of the centre’s recovering clients who had been diagnosed as having psychoses have taken up full time employment. One works as an office assistant, another as a peon and a third as a housekeeper," says Deo.

For the future, the centre plans to offer home-based rehabilitation services and orientation visits by other NGOs. Deo envisions the agency branching out across the city, and in the distant future extending its services across the state as well.

Over the last two years the centre has started its community outreach activities. As part of these initiatives, awareness camps are held in several parts of the city. An awareness exhibition at the Tata Institute of Social Sciences was held during the 'Mental Health Week'. Exhibits on topics such as schizophrenia, depression, obsessive compulsive disorder etc were displayed. This was followed by the screening of A Beautiful Mind on campus and a discussion was held thereafter.

The Family Welfare Agency was instituted in 1947, a time when not many NGOs were working with senior citizens. The agency was set up to help senior citizens cope with the set-backs of migration following the partition of the country. The centre was formally inaugurated in 1950. "There were many childless couples who visited the centre then. This prompted the agency to work on issues of adoption. Simultaneously, it brought issues pertaining to youth and women into its fold," says Desai. Over the years the centre realised that the elderly, who had worked for the Independence of the country, were being neglected. A survey was done on the needs of senior citizens of the BDD chawls in 1979-80. This led to the creation of the Centre for the Elderly, which was later amalgamated with the Family Welfare Agency.

The Centre for the Elderly, or the project for senior citizens as it is more commonly known, has over 200 members. Members spend time with each other, share their worries and generally have a good time away from the pressures of home and family. Desai blames Sheela tai’s gradual degeneration on the apathy of the community. "Senior citizens are routinely abused and society turns a blind eye to their distress. The Centre for the Elderly has volunteers who help intervene in times of dire need or help run errands for them," says Desai.

The agency aims to enrich the lives of the elderly by providing opportunities for growth and self expression, to create a positive attitude towards aging by sensitising the community about the special group’s needs and problems, to organise self-help groups that enable senior citizens to draw support from peers and to create a model centre for extending life enrichment services to the ageing, one that can be implemented in other areas and settings.

Workshops with the elderly and their families are routinely organised to make both parties understand the needs and problems of the elderly. The centre also provides services to meet specific needs like medical and nutritional provisions, psycho-social counselling, social and recreational activities, financial and legal planning.

"The long tenure of the agency has been full of strengths and limitations," sums up Desai. "The FWA has worked on three levels – preventive, promotional and curative – within the community and nearby areas. The agency has thus progressed from offering remedies to therapy and now has broadened its approach with social development. This integrated developmental approach will be instrumental in enhancing the quality of life and people's participation to achieve the same."

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Uploaded on October 2, 2004