The philosophy behind starting a programme like UMHP in low-income group communities encompasses understanding the dynamics of living in an urban slum.

In a research paper released by the United Nations – Understanding Slums, Case studies for the Global Report on Human Settlements 2003, it was estimated that about one third of the population of Kolkata lives in slums. Space crunch, big families, and poor sanitation coupled with the majority being engaged in the informal sector with average monthly earnings between 500 and 1700 rupees; some three-quarters of this population is below the poverty line.

These pre-existing conditions contribute to the high illiteracy of this population which consequently leads to very limited options for raising the standard of living, and thus creating a vicious cycle of poverty, unemployment and illiteracy.

This scenario further intensifies the poor knowledge and information disseminated amongst these communities and leads to a low level of health awareness amongst our target population, regarding general health care, and an even lower awareness on mental health care.

According to World Health Organisation (WHO) estimates, the worldwide prevalence of mental health conditions is, approximately –

• 1% major mental illness,
• 4-5% minor mental illness,
• 3-5% substance dependence

This implies that about 10-12% of a given population at any given time has a mental health condition. Apart from that there are many more who are suffering under stress, distress and anxiety, without it ever reaching a disorder level – and prolonged living with such feelings of mental discomfort contribute to a poor quality of life.

Given that in West Bengal, mental health service is largely medically driven, with tertiary and specialized hospitals providing mental health services, UMHP aims at integrating mental health and wellbeing at the primary urban health care centres in Kolkata. They are both more localized and easy to get to, for the slum population, and are the first point of access to many who cannot afford private practitioners and long waiting periods at hospitals.

Additionally the team aims at knowledge generation and awareness building and sensitization in the community, to engage many people in sharing their stories and seeking support through psychosocial interventions.

Shruti said, “Ami ar kichu korte parbona, ami eka eka erokom korei thakbo.” (“I am worthless, nothing positive is possible for me. I will live alone like this”). 16 years old, sitting stiffly on a chair in the ward health unit, and speaking so fast, that it was difficult for the Counsellor to grasp everything she said.

She often repeated that, “Ami normal noi, ami fail korchi.”(I am not normal. I am a failure).

Shruti liked to keep to herself, and did not have many friends. She did not like participating in school events, and was unable to recollect what she had learnt during school at the end of the day.  At home, she tried to concentrate and study, but had difficulties doing the same. When she failed her final examination, she suffered a setback, and ended up having a breakdown. Shruti withdrew further into herself, and would often try and hurt herself. Her family finally brought her to the UMHP team, after the team visited them during a door to door campaign.

Maybe Shruti found a listening ear, which kept bringing her back to the health unit. She gradually started venting out, sharing her insecurities, her dreams, hopes and difficulties. Her wish to hurt herself gradually stopped, and she started working towards dealing with her negative feelings and actions.

Shruti gave her final examination again – and this time she passed! She now has 3 new friends  and does not like missing her classes. She has started engaging more regularly in art work, as it provides an outlet for her feeling, and the creativity helps her hope. She understands her family’s poor financial condition and thinks about how she can make herself financially independent, one day in the future. During one of her sessions, she shared with her counsellor that,  “Amar na notun boiyer gondho khub bhalolagche” (“Now a days, I am loving the smell of new books”).

A new hope, and dreams for a better future.