My experience as a counsellor in Swasti’s i4we schools’ program over the past year has been rich and filled with dynamic roles that were not limited to counselling alone. Our target demographic came with a compelling yet challenging milieu.
The i4we school’s program works with adolescents hailing from low-income communities of South Bengaluru. The project operates in collaboration with the school management by offering life skills sessions, support groups for students and teachers and individualised psychotherapy to students and teachers.
It is well known that adolescence is a turbulent phase marked by several biological, psychosocial and cognitive changes. Additionally, the lack of resources makes these adolescents vulnerable to physical and mental ill-health. The national mental health survey of 2016 reveals that nearly 9.8 million adolescents (aged 13-17) are in need of active mental health intervention [1]. A specific study also revealed the prevalence of mental health disorders in Bangalore Urban adolescents as 13.9% [2]. While the prevalence rate and need for intervention are so high, the treatment gap for common mental health disorders is estimated to be 95%. The Ministry of Health and Family Welfare recommends focused programmes to be developed and strengthened in adolescent mental health care.
The i4we schools’ program was conceptualised with three primary goals: to instil life skills in students that help them communicate better, problem-solve and make better decisions despite their susceptible environment. It functions on a multi-tiered system wherein the first level of intervention offers comprehensive support to all students in the form of Life skills and awareness sessions; the second level focuses on targeted support that is provided for groups of individuals (students, parents, teachers); and finally, the third level of intervention offers individualized support to meet the unique needs of each student who is showing a particular concern or problem in the form of psychotherapy.
The program as a whole aims to function as a barrier between students and the different kinds of abuse they are susceptible to be victims of. It aspires to create a safe and holistic environment in schools where students grow past the taboo of seeking mental health support.
At the outset, mental health awareness in the schools was minimal to nil. The teachers viewed us as interruptions to their lessons and certain school managements were not keen on us exposing sexual and other harassments that students face fearing the reputation of their schools. A lot of our time and efforts went into educating the students and school management, fighting stigma, busting various myths, creatively problem solving and coming up with new strategies every week.
A crucial learning from this experience is that a major component of promoting positive mental health among the urban poor lies in the primary task of educating and incorporating mental health dialogue in their community organically. It is not only adolescents who need mental health awareness and support but also the important members of their social environment.
It was clear that this ambitious goal required further resources in addition to our team of counsellors. We needed members of the community who can function as ambassadors carrying out our news. Thus, community members were hired and titled as Life Skills Trainers.
Life Skills trainers (LST) are community members who have been trained to administer the Problem Solving Intervention also known as the ‘Problem-Option-Do it’ (POD) framework. This methodology was adapted from our collaboration with the Goa-based organisation Sangath.
Selecting community members to carry out the intervention has allowed the i4we program to build capacity within the community which will help create a holistic environment and sustainable model of mental health care without depending solely on mental health professionals or prior knowledge of psychology.
Introducing lay people to psychological concepts has resulted in other profound benefits. The Life skills trainers notice a perspective alteration within themselves. Empathy has found a way into their way in a stronger form. Anitha Purre(LST) says “Earlier I used to hit my daughter whenever she is naughty, now I sit her down and try to understand why she behaved the way she did. I try to communicate with her in a gentler manner. I used to think children have no problems but now I know better. I have a lot more respect towards children and their problems”
The LSTs also confided how ‘problem-solving’ as a skill has helped them grow more confident and face their struggles more practically then they used to. Noore Saba (LST) opened up about how she has grown as a person through this experience. She says “I have learnt a lot of patience. Learning about the sexual and physical abuses that children go through changed how I see them. Now I understand there are reasons behind their behavior that everyone cannot see. So, I am much better with my temper now and I try to understand them”
Thus, it is apparent that involving community members is an efficient way to spearhead our goals of mental health for the community. Anitha’s daughter and Saba’s family now have an accepting and well-informed family member about mental health and that is a wonderful place to start.