Kedar Banerjee, one of India's only 600 psychiatrists, is developing a preventive, therapeutic, and rehabilitative approach to the growing problem of drug addiction and mental disorders. He is also demonstrating how to reach those most affected–young slum dwellers–starting in North Calcutta.
The New Idea
Kedar is evolving a series of awareness programs that promote community and family participation in organizing mental health services, especially in non-elite neighborhoods. They encourage people to move from embarrassed and fearful reactions that isolate the ill, be they still living in the area or relegated to an asylum, to integrating them in daily life and helping with care and rehabilitation. His work is overwhelmingly focused on the rapidly growing drug epidemic, a plague for which society now has almost no organized response. Kedar believes this epidemic provides an excellent entry point to develop and build understanding for his non-custodial, involving approaches, which he would ultimately like to see applied more broadly in the mental health field.The basics of his idea took shape when he was exposed to psychiatric patients for the first time and was struck by the rejection they had to contend with. An incidental meeting with a few drug addicts during a mountaineering course threw up some more practical problems that they had to face while interacting with society and planted the idea of using outdoor sports activities–which were clearly useful in these cases–as a therapeutic mechanism. As the problems and possible answers began to emerge, so did a clear-cut target group: a door-to-door detection campaign conducted by NIBS (the National Institute of Behavioral Sciences, of which Kedar is a founder) in the slums of North Calcutta revealed that most of the addicts were "young adults"–16 to 35 years old. Furthermore, although lack of funds and family support stood in the way of a drying-out treatment that would allow sustained rehabilitation, many of these young people desperately wanted help.Having found its initial target population and community, and having developed a very low cost approach extending from community work through a simple exercise–intensive detoxification continuing on to community-supported reintegration–Kedar began a series of tests. NIBS launched its first outdoor detoxification camp with 16 patients in November 1987. It has held 12 more camps since then, mostly in farmhouses located on the outskirts of the city. Discipline, repeated strenuous physical activity, fast-paced work designed in part to give these young people immediately usable job skills, and periodic meditation and group discussions compose the camps' main activities. The camps, which now have long waiting lists of applicants, are followed by six months of counseling. These early camps have achieved a 25 percent success rate.
Social segregation rather than integration has been the fate of the mentally ill and rehabilitative efforts have been lacking in punch and impact. Institutionalization rather than community-based efforts have resulted in only a minor percentage of sufferers being reached.Furthermore, the host of agencies working in the field are isolated from each other: the social worker approach is humanitarian but unscientific due to a lack of medical professional help, while medical efforts are divorced from social and economic realities. Kedar proposed to incorporate all these elements into his approach, thereby fuelling the journey towards effective rehabilitation.
Apart from organizing periodic drug detoxification and rehabilitation camps, Kedar has also begun work on awareness programs geared to educate the community on the devastating effects of drugs. Community participation is encouraged in the tackling and resolving of the problem. Relatives of the patients are called during group sessions and are given advice about how they should behave with the patients after they return from the detoxification camp. After a (typically) seven-day camp, doctors and volunteers hold meetings with the patients every day for 15 days and, thereafter, every week for six months. Apart from this formal monitoring, volunteers keep watch on the patients and family members and provide help and advice if needed. NIBS has so far organized more than 200 street corner meetings, awareness programs in eight schools and 12 camps in which 216 patients have been treated. In the near future, it plans to conduct a camp in the hills where the patients will be encouraged to undergo a rock-climbing course, since the results of a pilot study were highly encouraging.Medical Aid Camps will be organized monthly/bi-monthly in rural areas in collaboration with other voluntary organizations and will work as platforms to sensitize medical and para-medical personnel to the enormity of the problem. Outdoor clinics will also be set up for detection, treatment and follow-up and self-help groups such as Narcotics Anonymous will be roped in to boost the effort. Ultimately, a therapeutic and rehabilitative center for mental disorders will be set up, enshrining Kedar's holistic view of the problem.
Kedar has been interested in voluntary social work since his school days. His first exposure to psychiatric patients infused him with a desire to change the way society looked at them, and the result was NIBS. Mountaineering is a pet passion and was, in fact, responsible for sparking the idea of introducing the tang of the outdoors into a traditionally indoor, purely clinical treatment. Committed to his vision, Kedar has categorically refused financial assistance from the government for fear of interference.