Better Chances – Mental Health Facility – Porkodi Palaniappan

Through the night or just couple of hours…

Conventional approaches in mental health, it has always been um uh very medical in nature

and when it comes to in-house treatments,  it is still very custodial in nature, you know

So, there is not much of uhm freedom or independence or choices that are given to the person who is suffering.

So, it is pretty straight jacketed programs that are available.

And that, I believe, adds on to the stress of the person who is undergoing the issue, already.

So uh after having spent a lot of time in the mental health sector with various programs

which um directly or indirectly remains still very custodial in nature.

I think I became very tired of it at one point and I wanted to do something which is not custodial in nature, which does not restrict movement of people and which is also very choice uh based and which allows people to express what they want, what they need and

and be able to live a very uh dignified life like any one of us.

10 years ago, we created uh I created Better Chances in Chennai

and um we call it the Wellness Center

So, we kind of redefined mental health in our own way, you know

and with what we are going to deliver to the peoplewbased on how we want to be treated, you know

And so, we call this a Mental Wellness Center

So, what is the difference then between other services and us?

That would be in in a conventional service in mental health,

um they would put the diagnosis of the person in the center

and they will work around uh that diagnosis

and they would call it the multidisciplinary approach.

So, there will be a social worker, a psychologist, an occupational therapist, whoever.

But they’ll all be working around schizophrenia, bipolar disorder and the diagnosis is the highlight, right.

But in our Center uh though we,

when they come in of course they talk to us about how they have been diagnosed

and what has been uh told to them about the diagnosis and everything,

though we do hear them say all that,

Our question to them would be, so what do you do well, you know.

What are the things that you are capable of doing?

And that would actually take them by surprise because

they are all filled with what they are not capable of

They’ve been told enough about what they are not capable of

When you ask them what they are good at,

It takes a little time for them to touch base with how good they were in certain things.

It could even be something like I can make the best tea in the world,

it could be like I’m a very good cook

And at some point, somebody has said I’m a great cook

It could be uh it could be so many things that we would say are very small, petty things that can be dismissed

but for us those are the most we catch on those things

And we say okay so you’re good at this, do you think we can build on it?

So, what we do is, we put the wellness of the person in the middle

and the same multidisciplinary approach, we do it around the wellness of that person

However, this multidisciplinary approach, we don’t really require professionals to come and do it

We use the community people, the community local resources and the family members,

and all these people.

One or two professionals if they are involved within the program, otherwise, it is pretty much uh within the community, with all the community resources

and we focus on the wellness of the person and we work around that.

So, it becomes like a life experience for the person

and not necessarily in a hospital, looked at by many professionals

and uh you know uh pointed out on what the challenges are, difficulties are, etc.

But here, it is more of a life experience for them

So it is learning, you know

Okay I’m doing this wrong, probably I can uh discuss it with this person

and probably find out how else I can do

And so, it becomes a life journey for them and they progress from there

And what I have uh experienced in both these scenarios is the time taken to recover

Uh I don’t believe in the word recovery itself, first of all, I’m more of a healing type of person

But for someone to actually get out of this issue, you know, even to a certain extent

within the conventional framework it takes a longer period

Whereas within this setup that I’m talking about, the wellness paradigm,

it is much faster for them to feel good

because this so-called recovery is all about feeling good about oneself also

such a way that you are even acceptable to other people

So, once you start feeling good in your own skin and acceptable

and you are moving around with people with acceptance

them accepting you also, then what more do we need right

So, I feel this journey for most of them

even if they are coming out of these mental hospitals with the huge stigma and all of that also

their reintegration back into the community has been much smoother and faster over here.

What I realize is uh when you bring someone from the hospital out, right

um you can bring them, you can take them out of the hospital easily

but it is very difficult to take the hospital out of them

So, what is challenging is the idea that you are sick, that you have a very bad illness

that you have uh uh being incarcerated inside the hospital without much movement also

So, it could be really bad to me and the loss of confidence, identity, your capacities,

everything has been so diminished by that one diagnosis itself

So, it’s very difficult for them to get that out of the system

and realize that hey I can be good in something, you know

So, our process is difficult that way but as we progress in that,

we feel that the person is already feeling good

And all they have to do is unlearn whatever has been told to them

and so, we keep it with their choices also

So if they feel the medicines are giving me relief and I feel better with medication

then we uh ask them to continue that, you know

and that would be a fair thing for them to do.

The the group that comes in here on an everyday basis, they are the pure support group

and we are here for each other

and any ups and downs that we uh undergo in life

Like all of us have those ups and downs,

we don’t hesitate to discuss it with the other person.

So sometimes it’s always in a group also,

where we talk about it loudly uh and say I’m having this challenge

and there are there there are people who say like my

my my mother is treating me like a slave

and I want an independent life for myself and all.

and we cannot sit in a hierarchy position and say no you should not feel like that and all

like, who are we to say that?

So, it is the peer group that addresses

because people have undergone these difficulties

and they address it with each other and

and in that way, the it’s a very equal setting

And it is not difficult to accept what a friend is telling, suggesting to you

So, um so that’s the peer group work also that happens here.

This is no home, this is not where you can come and leave someone and go

This is some place where we empower them to live independently

and then they get curious and ask, what you do and all of that

so that’s how we uh kind of get uh people coming here.

But most of our referrals are from these institutions, these homes that are run all over.

You know like places like Scarf, Schizophrenia Research Foundation

then we have places like The Institute of Mental Health, the government run mental hospital also.

Where people once they have recovered, they recovered or they have shown some progress

uh they are shifted to a hostel kind of facility,

they are still attached to the mental hospital though

And then from there we nego – we talk to the mental hospital and then we try to get them

and that’s how more people are coming in.

The paradigm that we have set for Better Chances is that

we work on the mental, physical and spiritual planes, this is the paradigm

So of course, mental is their, the capacities

We are looking specifically at their capacities

and that’s why the wellness center and all that.

Physical, we really give a lot of importance on their diet their exercise

and um it’s not just about, uh it’s definitely not only about medicine or anything

It’s about a lot of stuff to do with the physical body itself

because we find the mind body connection is very important.

And spiritual is not at all religious, it is about them questioning who they are,

and what they would like to contribute

to themselves and to the larger world and all.

So, finding that purpose for themselves, that is the paradigm.

And we have stuck to a few modalities when it comes to delivering our services

So the first thing is, in order to bring people out, you know

Our purpose is to build on their capacities more, you know

Uh build on whatever they already have and a little bit more on that

so that they can use that capacity to survive in this world.

So, we work on skill building, training and employment

So, uh so skill building, training and then when it comes to employment,

earning a substantial amount of money which will help them live independently.

And the second one is pure support,

to have a solid support of people who undergone similar situations

or friends who are able to understand that situation

and not they need not be necessarily uh professionals

it can be people from the community

the the elderly woman in the next door

it could be a vendor outside.

But somebody who is more empathetic to the situation they are in

knowing that they come from the mental hospital and not stigmatizing them,

and willing to accept them in whatever condition they are,

and not afraid of them, etc.

So, so the peer support is a very strong component of our modality.

And the third one is creating inclusive community

So, in this process we enable them to live in the community

So, um so then what happens is uh uh we find homes for them in the community

and the community already knows them

So there is no hesitation in giving these homes

Now that is a big barrier that we’ve managed to break

because uh the stigma around uh people with mental health disabilities getting a home,

we still face that with outsiders

But in this area, we are creating a sensitive community

which will give their homes for rent for these people

knowing very well that they have a mental health problem

and knowing very well that they could be ups and downs.

And this is one of the most forthcoming communities I have worked in

where the acceptance level is really very high.

And we have uh uh managed to integrate about six people into the community.

And there have been a lot of problems,

it’s not always smooth sailing

There have been issues where um uh clients have pushed flower pots from the terrace to the ground

and and you know the community would immediately call me

and I would come rushing here and we would all sit and have a meeting

and they would gently uh um I mean

they would have their own apprehensions as to why they did that

and uh I would also have my own apprehension

But then, they would sit and talk to the girl

and say, uh see there are kids playing downstairs

and if something falls on their head, you know

And when they talk like that, the the person is able to understand that

and it is never repeated again.

So, it’s not like everything is smooth sailing

There are challenges but the community does not stigmatize them

Instead, it tries to understand and sit with me

and tell them how we can handle it better.

So, I feel the community is full of social workers in our project, you know.

In Ms Porkodi’s words,
“Mental health should be owned by everybody. The nearest person should be able to step up, without differentiating and judging. Gradually the community should also accept and support. That’s why we have to create more and more awareness.”