Dr. Ramakrishnan is an eminent Neuro Psychiatrist involved in very unique models for rescue, treatment and rehabilitation of mentally ill destitute (homeless) followed up by identification of their families andre-unification with them through his NGO - TRUST - Shanthivanam. AASAI a US based NGO has been working with Dr. Ramakrishnan and his NGO in India to implement projects that are synergistic with the above philanthropic work while providing projects that create agro based therapeutic activities.

1. Please give us some background about the status of mentally disabled persons in India?

2. How acute is the problem? What are some of the issues?                            

As I mentioned earlier the main crisis is Treatment gap. If mental illness is identified and treated early the prognosis is good, recovery is possible. The treatment cost is not very expensive (as little as $5 per month). But there is a serious shortage of qualified medical professionals. As an example  there are some districts and states where there are no psychiatrists at all.

Adding to the existing illness, the so called modern mental illness - stress related disorders, PTSD, Adolescent crisis, generation gap, the evils of social media, student’s burn out due to educational pressure, competition, price, and unemployment - lead to high depression and suicide rates. The suicide rate in India is estimated to be close to 20/100,000 of the population.

Other major concern is STIGMA. Because of this both the families and the persons with mental illness are considered social outcasts. Even though they have recovered now, they cannot get meaningful job especially in cities/ corporates. The siblings’ marriage gets postponed or doesn’t happen at all.

The most acute problem now we are facing is SUBSTANCE DEPENDENCE, mainly Alcohol and Cannabis. Though other stuff like opium, inhalants are also available in cities, alcohol has entered in almost every family.  Substance dependence destroys the family, increases hospital bill, accidents, suicides, homicides, divorce and orphan children.

3. How much is the need for mental health care in India?

There cannot be an overstatement that mental health needs CRITICAL CARE.

Human life and all its system, cardiac, respiration, nervousness, gastric issues, etc., revolves around Bio psychosocial model. Our normal health depends on healthy body governed by mind, and social milieu. There is another Psycho-Neuro-Immuno-Endocrine model that controls the human functioning. If due to stress, calamity, mind is affected then the entire body collapses. Depressed individuals are prone to have more heart attacks and strokes. Unless mental health is integrated into general medical practices, treating other diseases like diabetes mellitus, hypertensions are waste. It will be valuable if physicians and surgeons  show the much needed attention or inclination towards mind concept.

I have already mentioned the lack of adequate number of qualified medical professionals in this area. Other barriers are lack of political will from the government and unclear plan of action and policy. But, some solace can be taken by the National Mental Bill, National mental health programs, District mental health programs and Pudhu Vazhvu (New Life) project initiated by the Tamil Nadu state government.

Another critical area is that the mental health professionals prefer only urban settlements with lack of will to serve the rural area. The government programs also fail to provide enough facilities and adequate remunerations for the rural health work.     

4. What services do you provide?

I am in this mental health field, for the past 25 years. Even as a student seeing the suffering of patients without proper guidance and treatment made me firm to work for people in India. My ultimate aim, life ambition is to improve the mental health service in India. I operate in 3 different ways.

1.   As a Private Psychiatrist giving affordable, compassionate treatment.

2.      With a vision to train more mental health professionals, established the Athma Hospitals and Research Center. This center is composed of a general psychiatric unit with 100 beds and a  de-addiction center with 30 beds.

My team consists of 7 fulltime psychiatrists including myself, 20 psychiatric social workers, 5 clinical psychologists, 2 occupational therapists, 2 yoga therapists. This institute is recognized as Post graduate Psychiatric Institute for Diplomate of National Board (DNB) in Psychiatry, M.Phil in clinical social work and Post graduate course in Psychology.

We offer comprehensive, individualized treatments, counseling, and rehabilitation services.

We also have child guidance clinic, gero-psychiatry, and suicide prevention center.

All our team members are readily available to assist any community projects, besides offering free services to patients from Shanthivanam, and other NGO’s.

3.      As a Founder & Executive Secretary of TRUST - Society and Shanthivanam, I am working through our NGO for the upliftment of mentally disabled. We offer rehabilitation, vocational training and community mental health services. We have rescued more than 350 homeless mentally ill patients and successful in reuniting 208 of them with their family.

4.      I have started another NGO - Athma Education and Research Foundation- through which we give scholarship to poor students, offer training in mental health to para medical support, medicines and medical staff support.  We also organize public awareness events. We are running Athma Special School for Special children, Autism, ADHD, MR, CP, Down syndrome, & Dyslexia.  We have started constructing an innovative residential school for these children.

5.      Could you share with us your collaboration with AASAI?

It is my strong belief that if your work is genuine and sincere, and reach the needy God will send some support. My introduction to AASAI was also an unexpected God sent opportunity.  In the year 2006, Smt. Santha, a middle aged volunteer in our community Introduced to me her brother Mr. Subramanian and conveyed his interest in social service activities. After a detailed in depth discussion about the problem of mental illness in India, we went to Shanthivanam, our residential facility for homeless mentally ill patients. He was very much impressed with our service and promised to do something. He explained about AASAI and about Shri. Raghavan. In February 2007, Raghavanji and his friends visited us and they were very much moved with the miseries of the homelessness of the mentally disabled. Then we had a discussion, on their concept to form self-sustainable projects. A specific project was discussed and the program report submitted to them. AASAI has so for supported us in,

1)      GOSHALA (Cow rearing). Now we have 25 cows. The milk from this unit is used in Shanthivanam. The patients also take care of the cows as feasible, which is a good therapeutic activity for them

2)      GOBAR GAS (Natural Gas) production units, which convert the residue from the Ghoshala into fuel used in the kitchen for cooking at Shanthivanam.

3)      Organic fertilizer production – All bi-products of GOSHALA are converted to pelletized fertilizer for farm use.

4)      PROJECT GREEN - Our unfertile land near Shanthivanam was transformed to a more fertile land through a unique process as advised by the local Agriculture University. Now we are cultivating paddy and fodder for our cattle.

More than that these projects have given agro based rehabilitation, an occupational training to our patients at Shanthivanam, which enhances their spirits; we save fuel cost, produce fertilizers and milk. We are self-sustained and the balance we are selling. Employability, productivity, salability, go-green are all aspects achieved through these projects.

5)       AASAI has supported in our building expansion project at Shanthivanam. One of the floors in our new building is named Srinkanta Smrithi Hall as per the wishes of one of the AASAI donors from Boston area.

6)      AASAI has also sponsored a van for transportation.

7)      Our next AASAI funded project is waste water management.

We are indebted to all members, president, secretary, treasurer and donors of AASAI for their continued support to the upliftment of homeless mentally ill.

6.         What is unique about the support from AASAI ?

       AASAI’s philosophy is “help others so they can help themselves”. True to their philosophy they support projects that give a definite outcome such that in the future the beneficiaries can be independent. In another unique feature, they have linked the beneficiary NGOs, so that one can help each other in any way such as through training, development, resource mobilization. They have succeeded in networking of NGOs, which is an ideal model of growth for social service. The other thing I observed is the continuous evaluation process.  All these at a very low administrative cost of 0.3% of their donation collected. AASAI members take up voluntary works when they visit India. Raghavanji, Mrs. Jothi Raghavan, their daughter Mythili, Mr. Gopalan, Subbu and others have made several visits to our facilities. They ensure to visit their supporting NGOs, appraising, appreciating, motivating and planning for the next budget year. I think this is the achievement of AASAI.

7.         What motivates you do this work personally?

8.         What do you feel on the unmet needs for this service?

Mental health is not a single person’s problem. It’s global. 450 million people around the  world are suffering. But how many reach the service? It’s not only in India, but in USA also, 50% of persons with mental illness are denied access to professionals. It is reported that 200,000 people with mental illness are homeless in USA. We need everything to meet the service – FUNDS, money, Power, Will, Dedication, Leadership, Unity, Volunteers, Access and Media. Unless all these are integrated with a single mission, “Let all the people live happily - Sarve Janaha Sukino Bavantu”, it’s not possible.

We should work hard to popularize social harmony, cultural values, morals, positive mental health techniques from long existing knowledge from India or China, …..

9.         How can people in USA take advantage as well as support these services?

We like to help those in USA as much as we get help from organizations in USA such as AASAI. As I said earlier mental health is a global issue. Hence anyone who has a need can contact us. Myself and my staff will do our best to guide those in need as well as we possibly can. This can be as simple as answering or clarifying any questions one might have about mental health. We can of course care for any one in need in India in our facilities including arrangements for short stay as needed. We can also network or provide contacts for suitable professional support in local areas in various parts of India.

We are also available as a resource for those who wish to expand their horizons in their life experiences. Those who can spare their time and skills can serve as volunteers through our programs. We have a group now from Sweden with us for training on cultural aspects and in anthropology. Simply visiting NGOs like us and others during a visit to India will be an eye opening experience for any one.

Certainly our needs are many. They are supported through organizations such as AASAI as I have described above. Any support to AASAI and other such NGOs is a way to support us. All the water that flows in every river eventually reached the ocean. In our case it is the ocean of unmet needs for the care of mentally ill and their better living.

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We thank K Subramaniam for introducing Dr Ramakrishnan for this interview. A fundraiser for the cause will be held on August 2nd.

http://www.lokvani.com/lokvani/cal.php?stage=1&event_id=11758

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