Day Centre for providing Psychosocial interventions.

On 5th December, 2009 Shri Goutam Mohan Chakraborty, Commissioner of Kolkata Police, inaugurated a Drop-in-Rehabilitation Centre (DIC), officially named as the Dr. K. L. Narayanan Rehabilitation Centre, at a space provided by the Kolkata Police within the premises of Hastings Police Station – the first of its kind in the country.

Run and maintained by

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Iswar Sankalpa, the DIC is a therapeutic day-care centre for the physical, emotional, psychological and social integration and well-being of homeless persons with psychosocial disability.

The DIC focuses on providing overall resettlement and habilitation opportunities for Iswar Sankalpa’s homeless psychosocially disabled clients, in an effort to help mainstream them as productive members back into society. This is achieved through facilitated participation of the clients in select occupational and vocational activities, as well as supervised pharmacotherapy and psychotherapy, all of which ultimately aim in restoring the client’s self-confidence, self-reliance and independent living.

From April 2013, the Dr. K. L. Narayanan Rehabilitation Centre has graciously received a one year funding grant from the Paul Hamlyn Foundation to sustain its rehabilitative efforts in this regard. It is hoped that with a steady source of funding, the centre would be able to improve upon its facilities and activities which have been in play since the commencement of the program in 2009. Sustainable funding allows for the growth and development of a more structured and stable habilitation program at the DIC, which can in turn lead to more tenable practices and futures for the beneficiaries concerned.

PHILOSOPHY

A lot of these men and women have created spaces for themselves on the streets where they live, in the vicinity of some community. However, there is an absence of physical and mental health care, hygiene facilities and rehabilitative activities and a dearth of government or private day care centres or shelters which will provide them with these services.

The philosophy behind the creation of the Drop-in-Centre is to thus, to provide a safe haven and a physical shelter throughout the day as well as opportunities for habilitation – to recovering homeless men and women having psychosocial disabilities.

The infrastructural support provided within the Hastings Police Station premises cannot be emphasized enough: the mere presence of this support from the Kolkata Police does not only further consolidate Iswar Sankalpa’s work premise, ethics and beliefs, but also strengthens the clients’ beliefs in themselves. Here, they know and can feel that they are safe, that they are supported, that they are part of society – Here, these men and women are no longer invisible.

They spend their days productively away from the greater risks of homelessness. This is done through a structured daily program tailored to fit the needs of each individual, which in turn facilitates the re-learning of simple and other more complex skills required to live life in a dignified manner. The focus is primarily on the physical and mental restoration of these individuals, and includes both vocational as well as therapeutic outcomes. They are individuals who, due to their psychosocial disabilities have been unable to function completely and independently, and are homeless and living on the streets. It is hoped that through continued rehabilitative efforts, these men and women would be able to relearn and reemploy certain life skill sets, which will eventually enable to live an independent life, a life of dignity.

Over the years, the DIC has seen various shifts in its occupancy registry. Prior to the opening of Sarbari – Shelter for the Urban Homeless, both men and women clients from the Naya Daur – Outreach Program would participate and attend the DIC regularly. However, with the opening of a women’s shelter, most of the women clients shifted to the 24 hour residential shelter; nonetheless there are still a few resettled Outreach women clients who still choose to attend the DIC intermittently. At present, there are between 5 to 8 men who attend the DIC on a daily basis throughout the working week.

CARE DELIVERY MODEL

Every weekday in the morning, clients are brought to the drop-in-centre by an Iswar Sankalpa ambulance. Trained social workers attend to the clients and interact with them, and once at the DIC, they are provided with and receive food, and hygiene care. Additionally the clients also receive counselling services and medical checkups conducted by the Iswar Sankalpa team of psychotherapists and psychiatrists, respectively.

In addition to this basic care, rehabilitative efforts are made with the clients through their involvement in various vocational and occupational activities. For this purpose, vocational and occupational therapists attend to the group, and interact with them through the course of the day via participation in various activities, aiming for an eventual re-orientation in social living skills and towards promoting independent living. Chores and duties are also shared amongst all the clients according to their choices, preferences and abilities – this is done to enhance basic life skill functionality. At the end of each working day they are escorted back to the community, to return the next day.

Vocational and Therapeutic activities at the drop-in-centre include:

1. Gardening:

There is a small gardening plot in front of the drop-in-centre. The clients use it to engage themselves in gardening activities. They are made responsible for the upkeep and usage of the gardening plot, and its bounty and harvest are their fruitful rewards to cook and eat.

2. Eatables/Snack Production:

The clients partake in the creation of various homemade traditional Indian snacks, which are relatively easy to create, have a long shelf life and require basic, locally available ingredients. Production items include, but are not limited to, sweet puffed rice balls, sweet coconut balls, nimki and gajja (savoury and sweet, flour based fried snacks), papad and bori (dried lentil snacks), seasonal fruit and vegetable pickles and jam/jellies.

3. Detergent Making:

In this category the clients partake in the creation of various materials used in cleaning, such as detergent powder for laundry washing, dish washing detergent powder, soap for hand and body wash, and germicidal phenyl cleaning liquid.

4. Art Therapy:

Our clients often become lost and somehow arrive in Kolkata; they hail from different parts of India and speak in different dialects. Verbal communication is often difficult because of these language barriers. Through colour and craft therapy, these individuals have the opportunity to express and communicate to the outside world their perceptions, thoughts and feelings by painting, drawing, clay modelling, etc. Thus, attending sessions of art therapy allows them the space to explore and express themselves in the world of colour and creation.

5. Play Therapy:

Clients are engaged in different neuro-cognitive games, activities and interactions in order to improve upon their neuro-cognitive abilities of memory, logic, reasoning and problem solving.

6. Functional Literacy:

Orientation is given to the clients in functional literacy, particularly to those who express an interest in it during group interactions. They are taught how to spell and recite words, letters, alphabets, and numbers are familiarized through phonetic learning.

7. Counselling:

Each client is counselled by a psychotherapist regularly, for a continuous assessment of their mental health status and to facilitate their ability to cope with the existing hassles in their daily life.

8. Health Check-up:

A psychiatrist conducts regular health check-ups and provides medicines accordingly. The physical health care needs of the clients are also looked into simultaneously.

OUTCOMES

The DIC has been operational since December 2009. At that time, 16 clients who lived near Sealdah station (14 women, 2 men) would visit the DIC regularly. Each person would have a doctor’s check-up once every month.

In the beginning, the DIC was a place where the clients could get respite from the changing weather elements in the day, and get two square meals a day along with facilities to bathe and was clothes and maintain their basic hygiene. Slowly, the DIC developed into a place which provided a holistic intervention contributing towards the over well-being of the client, and helping them to live their lives with dignity.

  • 2010-2011
    • Number of sessions for different therapeutic interventions every month-
      • Dance Movement Therapy (DMT) – 3
      • Gardening – 4
      • Arts and Craft – 3
      • Total number of sessions per month – 10
    • One doctor visit every month

Number of Clients Participating per Month

DMT

Gardening

Art and Craft

Total Participants Enrolled

April

3

4

2

15

May

3

4

2

17

June

3

4

2

18

July

3

4

2

18

August

3

4

2

18

September

3

4

2

18

October

3

4

2

18

November

3

4

1

18

December

3

4

1

21

January

3

4

6

15

February

3

4

6

13

March

3

4

9

15

 

  • 2011-2012
    • Number of sessions for different therapeutic interventions every month-
      • Dance Movement Therapy (DMT) – 4
      • Gardening – 7
      • Games – 3
      • Arts and Craft – 3
      • Total number of sessions per month – 15

Number of Clients Participating per Month

DMT

Gardening

Games

Arts and Craft

Total Participants

April

4

4

3

4

12

May

4

3

3

5

13

June

4

6

3

2

14

July

4

9

3

4

14

August

4

9

3

5

13

September

4

8

3

4

12

October

4

5

3

1

13

November

4

9

3

4

14

December

4

9

3

2

16

January

4

8

3

5

12

February

4

9

3

5

11

March

4

9

3

5

13

Inflow and Outflow

Entries

Exits

April

0

2

May

0

0

June

1

0

July

0

0

August

0

1

September

0

1

October

1

0

November

1

0

December

2

0

January

0

4

February

0

1

March

2

0

Months

No. of Doctor visits

No. of Clients checked

No. of Counsellor visits

No. of Clients counselled

April

1

6

2

12

May

0

0

2

13

June

2

8

2

14

July

1

5

2

14

August

1

6

2

13

September

1

6

2

12

October

0

0

2

13

November

1

5

2

14

December

1

6

2

16

January

1

6

2

12

February

0

0

2

11

March

1

5

2

13

 

  • 2012-2013
    • Number of sessions for different therapeutic interventions every month-
      • Dance Movement Therapy (DMT) – 4
      • Gardening – 8
      • Games – 3
      • Arts and Craft – 2
      • Total number of sessions per month – 15

Number of Clients Participating per Month

DMT

Gardening

Games

Arts and Craft

Total Participants

April

4

8

3

5

11

May

4

9

3

3

12

June

4

9

3

0

11

July

4

8

3

1

10

August

4

10

3

1

11

September

4

7

3

1

9

October

4

8

3

1

9

November

4

9

3

1

11

December

4

8

3

4

12

January

4

9

3

3

13

February

4

6

3

3

15

March

4

8

3

4

13

Inflow and Outflow

Entries

Exits

April

1

1

May

0

0

June

1

0

July

0

0

August

1

0

September

0

1

October

0

0

November

1

0

December

1

1

January

1

0

February

0

0

March

1

0

Months

No. of Doctor visits

No. of Clients checked

No. of Counsellor visits

No. of Clients counselled

April

1

6

1

9

May

0

0

2

10

June

1

6

2

12

July

1

5

1

8

August

1

5

2

7

September

1

5

3

9

October

1

4

2

7

November

1

6

1

5

December

1

5

1

6

January

1

3

1

6

February

1

5

1

5

March

1

7

1

9

 

  • 2013-2014
    • Number of sessions for different therapeutic interventions every month-
      • Stitching and Sewing – 4
      • Detergent Making – 4
      • Gardening – 8
      • Cooking – 12
      • Arts and Craft – 4
      • Total number of sessions per month – 20
    • Maximum Number of Clients at DIC in last one year: 7
    • Minimum Number of Clients at DIC in last one year: 5
    • Average Number of Clients at DIC per month: 6
    • Total Number of Doctor Visits: 14 in one year
    • Number of Clients assessed by doctor: Maximum 5, Average 5.

Number of Clients Participating per Month

Stitching and Sewing

Detergent Making

Gardening

Cooking

Arts and Craft

Total Participants

April

9

9

8

12

9

13

May

8

7

7

13

8

14

June

8

9

8

11

8

14

July

7

7

6

10

7

13

August

7

8

9

12

7

14

September

7

9

9

13

7

14

October

10

7

10

12

10

15

November

8

9

11

11

8

15

December

8 6 7 7 7 14

January

6 7 7 6 6 15

February

7 8 6 7 7 15

March

7 7 7 7 7 14

Inflow and Outflow

Entries

Exits

April

0

0

May

2

0

June

0

0

July

0

1

August

1

1

September

1

0

October

2

0

November

1

0

December

1 0

January

3 1

February

1 0

March

0 0

Months

No. of Doctor visits

No. of Clients checked

No. of Counsellor visits

No. of Clients counselled

April

NA

8

1

7

May

2

9

1

8

June

0

0

1

7

July

1

5

1

6

August

1

7

0

0

September

1

8

0

0

October

1

10

1

8

November

1

9

2

9

December

1 10 1 10

January

1 12 1 12

February

1 12 1 12

March

1 10 1 10

CHALLENGES

The setting-up and regular functioning of the Drop-in Rehabilitation Centre within the premises of the Hastings Police station is testament to the efforts being made for a continuous collaboration between Iswar Sankalpa and the Kolkata Police. It is a sign of mutual growth and dependency, where the ultimate aim is to rightfully and respectively partake in the care and well-being of the people we work with.

Nonetheless, in order to ensure a smoother and more sustainable operation, the following challenges still remain to be resolved:

  • Greater degree of police awareness, sensitization, liability and involvement, regardless of ward and/or district area:
    The Kolkata Police needs to be further involved at the policy-making level, to ensure the sustainability of projects such as these. These policies then need to be successfully circulated and imbibed within each and every police station and hierarchical subdivisions, irrespective of locality, to ensure greatest trans-city coverage and application.
  • The Drop-in Rehabilitation Centre is a day care services delivery model which needs to be replicated in other areas of the Kolkata Metropolis in collaboration with the government and general public in order to target the lack of similar facilities in both the public and private health care systems.
  • Sometimes, the clients get carted off by the Vagrancy Department street raids to the city vagrancy home, where they are left to suffer in anonymity, silence and indefinitely. Due to the gap in coordination between different departments and laws which do not uphold the right to self determination of such individuals, all the work and progress made by the individual gets affected, often leading to relapse in their mental health state.
  • Even when some of the individuals show potential in partaking in certain rehabilitative and vocational activities, due to the issue of continued homelessness, it becomes a challenge to get them sustainable jobs. The continued living on the streets makes them vulnerable to violence and abuse, leading to the question of the safety of the money they may earn and their own health as well. It is important to look for safer
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