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Burans Project


India, South Asia  Show on interactive map

Active from:

Jun 2014

Implementing organisation(s):

Emmanuel Hospital Association (EHA) HOPE OPEN SNEHA

Contact persons:

Jeph Mathias


Project Burans


Burans in the North Indian state of Uttarakhand aims for community mental health competence. This means communities understand what mental health disability is, have resources (knowledge, skills, treatment options, partnerships for action) to prevent and treat it and accept and include people with psychosocial disability (PPSD)into their communities.
This is all in a context with multiple factors that create or exacerbate mental health disability (poverty, poor education, stigma, multiple belief systems, poor government infrastructure and commitment to mental health, almost absent services, tenuous supply of medications, no counsellors etc etc).
Burans is a small co-rdination team that works with 4 implementing partners in different locations of Deheradun district.

Objectives of the intervention:

Community Mental Health competence in poor communities of Dehradun district, Uttarakhand and combined with improved mental health resilience for adolescent youth.
The innovative project, placing most of the responsibility for improved mental health in the community rather than with (almost non-existent) psychiatrists and health services, also aims to explore models which can be used elsewhere.

Why was OM chosen?

The complex, multifactorial nature of 'the problem' and the unclear and unexplored nature of the possible pathways was clearly not amenable to a preplanned or modular approach so the logical framework planning tools (as the implementing organization usually uses) were unlikely to be successful.
The OM way of thinking- map the development space and then work with multiple critical actors at different but coherently related points of the space- seemed ideal suited to an exploratory intervention like this.
Also conceiving or success as changes of behavior attitude policy and especially relationship gave a way into a wicked problem.

How was OM used?

Burans has 6 boundary partners:
Community leaders (religious leaders, panchayat and other)
Community based government staff
Government mental health services
Young people

Each has an outcome challenge, progress markers and strategically chosen activities to contribute to their outcomes.
The heart and soul of Burans is community workers who visit PPSD and their carers and work on a "recovery star" of moving towards wellness on multiple axes from medical to psychological to social. These community workers also build relationships with community and religious leaders, are skilled in counseling and work with primary level government health services on their confidence and skills in treating PPSD. Burans has also developed many resources to support behavior change in all these boundary partners. The community workers also work with youth resilience, working with small groups in the areas where they live.
Simultaneously other staff work from "other directions" with the same boundary partners and with other boundary partners on strategically chosen activities to contribute to strategically chosen behavior changes.
Burans, despite its tiny size tries to research and publish in order to get its ideas out in the wider international mental health world.
Monitoring uses outcome stories and tries to make the link between project activities and changed attitude behavior and relationships.

What was the experience of using OM?

There have been considerable successes with Burans. Many PPSD and their caregivers have much improved life and livelihood, moving out along their recovery star. There are many stories of PPSD and caregivers who now. have jobs, who are invited to e.g. marriages in the community etc.
There is also much wider understanding of mental health in the community and treatment options. Things like a local shopkeeper who refers mentally unwell people to the primary health centre are great success stories. Other important relationship changes are things like caregivers of one PPSD taking another PPSD to the government psychiatric hospital.
So to changes at government level with trainings for government providers and improved supply of basic drugs to government clinics.
Burans has become a respected and valued part of community health, with communities advocating to government to include it in their schemes.
Burans is also becoming known in more widely in India as a recent invitation to train a large organization that has 5000 projects throughout India attests.
Burans youth resiliency groups are realy successful with some groups independently identifying and taking action on community issues (e.g. Dengue)

There are of course many obstacles and frustration:

Out there in the “sphere of interest” there has been little evidence of PPSD and caregivers advocating to government on their own, income generation for caregivers remains a major issue and many government policies are not well implemented.And the actual issues are huge for a tiny team, with increasing substance abuse adding to an already huge burden of psychosocial disability. In India's highly privatized health system few professionals will dedicate themselves to poor parts of India. Nearly all choose to work privately in wealthy India or emigrate to rich countries. it is hard to see this changing any time soon.
Within the project it is always a struggle to get staff, trained in activity based thinking, to strategically focus what they do on behavior change.
Monitoring and making meaning of the information gathered requires a huge amount of work and skill. Funders, often activity and outcome based, each require their own reporting formats, struggle to accept outcomes and often fund infrastructure over staff salaries. Time and space for reflection and continuous adaptation of a project that has 4 widely distributed implementing partners is always difficult and suffusing lessons and success stories between implementing partners is not easy.

In summary OM is a really good entry into this problem but requires enormous skill and co-ordiantion, continuous reflection, great data collection and management and creative management.



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