At The Banyan, Dr Archana Padmakar, Co-director, has worked for 14 years with homeless individuals facing severe mental health challenges. As director of programs and faculty at the Banyan Academy, she mentors teams in delivering acute care, long-term support, and alternative pathways for those without family support.
She applies clinical expertise with trauma-informed care, recognising the varied manifestations of severe mental health conditions within cultural contexts. She emphasises the role of small daily interactions, humour, and shared activities in building resilience and sustaining therapeutic relationships.
Through her practice, she has observed the impact of consistent support, trust, and unconditional presence on recovery, noting that hope can emerge even where options and resources are limited. She underlines the importance of integrating service delivery, ethics, and value-based practice, mentoring younger professionals to maintain a care culture that supports both clients and teams across complex mental health contexts.
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She applies clinical expertise with trauma-informed care, recognising the varied manifestations of severe mental health conditions within cultural contexts. She emphasises the role of small daily interactions, humour, and shared activities in building resilience and sustaining therapeutic relationships.
Through her practice, she has observed the impact of consistent support, trust, and unconditional presence on recovery, noting that hope can emerge even where options and resources are limited. She underlines the importance of integrating service delivery, ethics, and value-based practice, mentoring younger professionals to maintain a care culture that supports both clients and teams across complex mental health contexts.
Follow us:
Website: https://www.outlookindia.com/
Facebook: https://www.facebook.com/Outlookindia
Instagram: https://www.instagram.com/outlookindia/
X: https://twitter.com/Outlookindia
Whatsapp: https://whatsapp.com/channel/0029VaNrF3v0AgWLA6OnJH0R
Youtube: https://www.youtube.com/@OutlookMagazine
Dailymotion: https://www.dailymotion.com/outlookindia
#WorldMentalHealthDay #BreakTheStigma #MentalHealth #FreedomFromStigma #RightToHappiness #EverydayIPrayForLove #IHaveALotLeftInside #DignityForAll #OutlookMagazine
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00:00I've been working with the homeless people with severe mental health issues for the last 14 years
00:10and I'm working as the director for programs at the Banyan and I've also been as a teaching
00:19faculty as far as the Banyan Academy is concerned, one of the sister concerns of the Banyan
00:24institution and also a part of the Aladamara Foundation which is based in Karnataka and
00:32my primary key responsibilities are where I look at mentoring all the program teams as
00:38far as the implementation is concerned and I primarily look at the key focus with regard
00:44to homeless persons and the specific interventions with regard to acute care interventions, also
00:52looking at long-term care options for those who have severe mental health issues and also
00:57looking at scale up of these models of the Banyan because we have three key approaches
01:01at the Banyan, one is the Emergency Care and Recovery Centre, the second approach is the
01:06Centre for Mental Health and Inclusive Development that has alternate exit pathways for individuals
01:12who have stayed at the Emergency Care and Recovery Centre for a prolonged period of time, so we're
01:16looking at innovative approaches for people who would like to get discharged from these
01:20acute care facilities, at the same time they do not have an option to get back to the family,
01:26so it's very important for us to incorporate their options in terms of how they would like
01:31to design their living arrangements, also to look at how they would like to design their
01:35own facility beyond a house-like model or beyond staying with their own biological families.
01:43The third model is a NALAM model, we're looking at continuity of care post-discharge from the
01:48Emergency Care and Recovery Centre, at the same time looking at crisis intervention whenever
01:53a client requires, while this person stays with the community and with the family.
01:58So predominantly I look at these key approaches at the Banyan and also looking at whatever
02:03is possible in terms of scaling up within the context of a particular state across the country.
02:09So we've scaled up all three models across pan-India and we have expanded in about 10 states
02:16into Lamech countries as well. As a clinical psychologist, I also look at mentoring my teens
02:23in terms of looking at trauma-informed care because a lot of our people, I mean we are catering
02:29interventions in terms of looking at how they've been through a specific type of trauma, also
02:35looking at what are the outcomes and the manifestations of mental health issues because severe mental health
02:41issues, it's not just being labelled as schizophrenia and bipolar affective disorder but it does get
02:46manifest in terms of several other forms including trauma which is one part of their lives.
02:52So therefore it's important for us to understand the different manifestations within their own
02:57cultural context and also design interventions specific to the kind of distress that each individual
03:04is going through. So the Emergency Care and Recovery Centre, as I just mentioned, what's important
03:09is we're looking at acute care services but beyond that what at least makes me to look forward
03:14in terms of coming to this place or understanding or conceptualising this as a model is we're
03:19looking at certain light moments which is contextualised within the therapeutic space as well because
03:27as much as we talk about trauma-informed care, as much as we talk about designated spaces and
03:33specific trained individuals, what's important is how you bring in humour as a technique or a tool in
03:41terms of building resilience. At the same time looking at what the small joys are in a day-to-day kind of operation,
03:49also look at what clients would look forward to. For example, the weather today is so much like where it is
03:55probably going to rain but clients are looking forward to it. So in an acute care facility as much as we look forward to
04:01specific designed psychosocial interventions as much as we look at what is the right kind of therapy that
04:08needs to be given to clients, what's more important is to maintain and sustain that sort of a mood and also
04:14to bring in those other aspects of any individual's life, bringing in resilience through humour, bringing in small
04:23joys and celebrate small wins as well. For example, cooking together. So a therapist and a client can also cook together.
04:30A therapist and a client can probably take a walk and understand how this person is probably accessing
04:36this new space, how this person is probably settling down in this new space. And sometimes doing things
04:43together also brings in a great connection between the client and the mental health professional as well.
04:49So we have an environment here, the Emergency Care and Recovery Centre, where we're looking at beyond the therapist's boundaries.
04:55The therapeutic relationship extends beyond whatever the friendship that we have. But it's important that you do it vice versa as well.
05:04We're able to spend that sort of quality time with this individual beyond the label of this person having a severe mental health issue
05:11issue or beyond the label of this person being homeless at any point in life, but rather understand this person as a good companion, as a good friend.
05:19So therefore doing things together at the same time, self-disclosure is also another tool that we use in terms of it's not just they gain strength after coming to this facility only from the mental health professionals.
05:32only from the mental health professionals. But what's important is that we also gain that sort of strength when we are having a bad day, when the team is also probably going through a lot of ups and downs,
05:42or probably a particular individual has had a bad day at home as well. So some of them also look forward to as they come into this facility, as much as many people talk about, isn't it a very draining job?
05:52Isn't it a very exhausting kind of a profile that you're into? It's also important to understand that these are life experiences that people go through in general.
06:01And it's not so specific only to those who are homeless and have a severe mental health issue.
06:06I had a client who lived here for about three years and then she had a doctorate in biochemistry and we struggled a lot to kind of set that base in terms of strengthening our therapeutic relationship.
06:21And over a point of time, we were having a very casual conversation. So for three years, we went back and forth at the same time, she was trying to have that sort of trust,
06:30build that sort of trust in me. And at the same time, in a day or two, it will get completely dissipated. And then she starts from the scratch.
06:39And so we were going through this sort of a struggle. So in a very casual conversation, I asked her as in what makes you think that this place is not an appropriate place for you in terms of to receive care.
06:52And then she said that when you all come into this workplace, when I sit near the gate, when I observe all of you, the one thing that I keep looking at you is you all come as if you're wearing your labels or your designations on your face or on your shoulders.
07:07And I feel it you're looking too heavy as you come into this organization. If only you can drop your labels or designations or the discipline that you belong to probably I can connect with you better.
07:19Now that was a very strong feedback. At the same time, I also understood that she didn't want to see me as a mental health professional or as a therapist or as a psychologist, but rather she wanted to just see me as her buddy.
07:32So from that day, and then we took on a different kind of a note to kind of to connect with her and it really served the purpose because after that, she started connecting with me connecting with my daughter with my family and is still in touch is not in the facility.
07:47Now, she prefers to live alone in the house without any medications. But the one person that whom she calls while she stays in the house and if she needs any sort of support is I and the Banyan team as well.
07:59So sometimes it's important for us to explore the spaces beyond what we theoretically where we've been trained in terms of a traditional way of looking at how mental health care services can be catered to a vulnerable population.
08:14But beyond that, if you only look at those spaces where humor, small joys, small wins, also looking at self disclosure, also looking at exchanging those sort of perspectives in terms of how you look at mental health care and care practices, and also have a very unfiltered honesty in terms of how the care culture can be tweaked further.
08:37Because as much as we would like to do the best for our clients who are accessing our services, it's also very important for us to know whether whatever they're looking forward to in this space is something that will make it probably cheer them up or probably would make them feel a lot more lighter than only talking about medications or only talking about the interventions here or even service delivery for that matter.
08:59Because science is nothing unless and until it's being felt. So if at all you're not delivering your services in a particular way that a person feels very safe living here or a person feels quite happy with the fact that she has somebody to stand by her through the district that she's going through, there's no point in looking at service delivery only from that point of view.
09:20So these are spaces that we need to explore as a clinician as well, where there is connect and also disconnect at some point of time, but over a period of time since I've been in the sector for 18 years, it took some time as well because I've been trained in a very formal traditional clinical setup.
09:43So there there are boundaries in terms of how much you can go further in terms of building that sort of trust and connection with the with the client.
09:52But here at the bank, it's been quite different because you're thrown out in the open. So therefore, being part of the system at the same time distancing whenever it's necessary as a person who is trying to guide and suggest at the same time being part of the process is quite a difficult job to do.
10:10But I think with the support of my mentors here and with the support of my colleagues here and most importantly, my own clients, I think over a period of time, I've learned the fact that there is possibility where you can have those gray spaces as well, because in the beginning, it did take an emotional toll on me as well, to be very honest, because there's hardly any boundary over a period of time because you're good friends, you're also family to each other.
10:38But over a period of time, what we've understood is that this is how it's going to be because as they come, they need that sort of support, they need a huge source of strength and support at the beginning.
10:49And over a period of time, they also find other spaces and other people as well.
10:54So it's important for us to note that as they are gradually looking forward to other sources and other forms of strength, it's important for us also to note that it's a sign of the recovery in their own way.
11:06But you stay here as a constant here and they come back to you whenever they need you because at the same time, you're also making yourself available to several other people around you.
11:16Right. So let it be your own teams or let it be your own clients as well.
11:20So therefore, I have been through swaying between one zone to another.
11:25But I think over a period of time, you do get to learn to how balance that.
11:29And what is very important here is when you go through these sort of intense mind spaces where there's a lot of ambiguity or vagueness as well,
11:39because you don't know what direction this whole therapeutic relationship is heading towards.
11:43I think at that point of time, debriefing with your mentors is also quite useful and that has helped me in a great way.
11:50If at all, I would like to have a visual representation of my life here at the Banyan.
11:56I think it would be like a seashore.
11:59It's vast. It's like an ocean.
12:01It's vast. It's plain. It's blue.
12:06And it's quite glittery as well because of the sunlight falling on the water.
12:13And then you have the reality that's the shore.
12:17So you get a good feel of it, the texture as well.
12:20When the water comes in and goes, it's really smooth on the shore.
12:24And then if you step a little bit away from the shore, obviously, you will feel the heat of the sand as well.
12:30And it's a bit difficult.
12:32But the way I see it is that I think that's what is hope is all about,
12:37where you have waves coming in and going.
12:39And it's not constant, isn't it?
12:42So I think that is how my experience has been in terms of balancing my life at work and with my family as well.
12:50Sometimes it looks very seamless.
12:53Sometimes you prefer one over the other.
12:56And sometimes you would like to have both.
12:59Sometimes you feel that I wish both were not part of my system as well, to be very honest.
13:05But at this moment, I don't think I can think of any other space that I would like to be in,
13:10considering that I've been part of the system.
13:13Both systems, in fact.
13:15And I would like to be part of it.
13:16But the way I see it is where what you get to see today in terms of the intense waves,
13:23in terms of a high tide or a low tide, I think that's how life has been here.
13:29So I think rarely you get to see an integrated service.
13:35Usually what we get to see in mental health care is a very fragmented mental health service delivery,
13:41where you have rehabilitation separately, you have livelihood facilitation separately,
13:47you have the medical care as a separate segment, you have psychiatric care as a separate segment.
13:53Very rarely you'll find organizations or psychiatric hospitals where they offer the entire continuum of care,
14:00right from supporting you through crisis care on the streets to taking you back home or following up on you post discharge as well.
14:10That is your aftercare services as well.
14:12So that's one part of continuum of services, which is a very difficult thing to do,
14:17is something that stands apart as a banyan that I get to see for real.
14:21Another thing that I get to see is that the philosophy and the values in the organization,
14:26that is practiced right from the founder to across every cadre and across client care as well in terms of ethics and client practice.
14:38And also in terms of how clients reciprocate that feeding into the care culture and closing the loop on that.
14:45Now that is something that I don't get to see in many other places where I work,
14:49let it be in Europe where I worked or in a traditional medical system or the system that I work here,
14:57there's a vast difference between what I've seen.
14:59Because a lot of people who go through different points of having hope to not to have hope,
15:08where they've even contemplated suicide.
15:10What they need at that point of time is critical care or when they need somebody to reach out to during a crisis.
15:18But the banyan I've seen that being yourself, making yourself available for an individual in distress is the key thing.
15:26Now I think that pushes you much more than what a person would probably anticipate to expect in life.
15:33Because in these days, even families or even as well established families with good resource system,
15:39I have never seen them being available for anybody.
15:43But what I've gotten to see in people is where they've fragmented their roles,
15:48let it be a family or let it be a workplace.
15:50But here at the banyan what I've gotten to see is where you're rendering that sort of support in a very unconditional manner
15:57and at the same time explaining to the individual in terms of what is possible.
16:02So therefore this is something that I have observed and I think these services being catered in such a way
16:10itself is a very special part of the banyan.
16:14So for me to start off with, I think it was important for me to understand how values are being practiced
16:21because values cannot be taught through a PowerPoint presentation or through a theoretical paper or through a lecture.
16:29So when I met the founders for the first time, they also spoke about the value deck of the organization
16:36and the philosophy of the organization.
16:39Rather than talking about, though I was trained in many therapeutic approaches
16:45and I've been exposed to a lot of clinical work, what I got to see was how value can be transferred into practice.
16:54So for that I had to go through certain experiences and also understand from different individuals
17:02who are already accessing the services here.
17:04So I think I got into this role not knowing what this role would require.
17:09So I got into this organization thinking that it will be like any other job, just that I wanted a job in Chennai.
17:17I think that's how I came into the banyan.
17:19And I had a friend of mine who was already working here and then she suggested that yes, please apply.
17:25And then I came here.
17:26But I wasn't too comfortable with the environment here to be brutally honest about the kind of spaces that was completely shared.
17:36So when you come from a traditional clinical system, it's also very where you have designated spaces between people who receive care.
17:47And at the same time, there is also a strong representation of people who also provide care.
17:52So here you have another category where the service provider and the person who's using the service are all the same.
18:00So it took a while for me to understand where that's coming from.
18:04How is it being practiced?
18:06So I think I watched a lot of other people were doing the actual job.
18:10So for me to observe and a lot of experiential learning helped me to be the person I am today to get more accustomed to this sort of a care environment.
18:18Because right from the founders to my colleagues and to my mentors in the past where I've seen people have shown me in terms of how you can transfer value based practice into real life experiences as well.
18:33It's very hard to kind of transition from that sort of value system into real life transitioning of how you feel about another individual, how you feel about yourself and also have that sort of trust and sense of belongingness building as a fraternity.
18:53Because medicine and science doesn't mean anything if you don't bring if you don't bring on that sort of a build on that sort of a fraternity where there's a lot more hope and connection between individuals because at the end of the day, despite the kind of designation you have or the kind of clinical training you have, you may be whoever or whichever title that you hold.
19:13If you don't feel hopeful at the end of the day, if you don't feel hopeful at the end of the day, it doesn't mean anything.
19:16When you look back, you would like to have a group of individuals to back you up to support you to cheer you up, isn't it?
19:22So if that's not mental health care, and I don't know what else could be.
19:26So here I can give you a couple of examples where I felt that truly I am probably drawn to this place because this is I think this is destiny for me is where I was going through a personal trauma in my life.
19:41And so as I spoke to you earlier about self disclosure as a as a tool, which I usually use in my practice to feel better.
19:51So I was telling one of the service users here was also a good friend of mine, and I was selling I'm going through this.
19:58And then finally, it happened to me where I also did tell her over a period of a year or two that this happened to me.
20:05Remember, we spoke about this. And then she said that yes, I'm so glad that this happened to you.
20:11And then she also added very casually saying that do you know that for two years, I went to the temple praying for you on every Friday.
20:19So that hit me really hard because if it were me, I think I would have gone and told several people about what I'm doing for another individual and being very loud about it.
20:28But this but this person very in a very casual way and she wasn't even looking out for any acknowledgement from my end, but said it very quietly saying that yes, I was praying for you for your family.
20:40And I've been doing this fasting prayer for two years now. And then and then I understood the depth with which people also build that sort of connection and trust with you.
20:52Because when you're going through a personal trauma, it's easy for people to just hear it, empathize and then leave it at it.
21:01But there was somebody here who's also looking at how else she can do from her end in terms of whatever strength and resources that she had, she was able to bring it on to the table.
21:11Another example that I can give you is where I was having a very tough conversation with one of the clients here where this person had a very difficult childhood and also had a difficult set of parents as well.
21:28And there was also abuse by one of the primary caregivers in the family. And unfortunately, because she had the trust in me when she would have these traumatic flashbacks, she would see that parent in me.
21:42So back and forth, we would have a lot of disconnectedness because she would see her father in me. Therefore, she would say a whole lot of things.
21:52And it was very difficult for me to kind of tackle those situations because situations were really challenging because I totally get what she was getting into and also to understand what she was going through.
22:05And she told all that she could tell her father. So this person kept through her flashbacks, kept telling me what happened to her in great detail.
22:15And that's when I understood the intense of trauma that she was going through because many times it goes unsaid during a very formal session, formal therapeutic session.
22:27But what she lived through is something that she narrated in great detail during that flashback. So in those sessions over a period of time, what I also got to understand is there was a lot of sense of belongingness and also in those flashbacks, she was trying to anchor herself somewhere.
22:48So over I think a three year period at least she came back and then she was saying that now I feel a lot more lighter in terms of what I've been through because many people have given up on me.
23:01So I have told, I have shown a lot of anger, hostility, a lot of bitterness towards people whenever they tried attempting to help me or support me, all that I've done is to push them away to probably to push them to an extent where they'll never come back to me.
23:20But I think here in this environment with you and with other people supporting me as well, I saw people just coming back to me unconditionally, whatever happened.
23:31So that helped me in terms of looking at life a little bit differently than what it was, because I could never go back to that past where I felt much more confident about myself, but at least had the opportunity to talk about it because it was my father.
23:46It was very difficult for me to tell people and convince people that it was my parent who did this to me.
23:53And she also had a metaphor to this.
23:56So I thought it was like any other client who's telling you that, you know, that she's feeling hopeful, she's feeling better.
24:03She also, she would use the word impure that because this happened to me, I feel very impure and dirty within me.
24:11After this three years of regular sessions with her, what she would come up with the metaphor is, I feel like a baby when I'm with you.
24:20So can I walk into your stomach, walk into your womb, become your child, come back to this world in a pure form.
24:30So this took some time for her to kind of connect with the kind of descendants that she was going through, where she felt that a father in a traditional family doing it to her is something where she all kinds of hope and the all kinds of dreams that she had about herself was completely wiped out.
24:52Till today, she struggles with that.
24:54It's not like we've reached out where she is working outside or she's earning money or she is socializing with other people.
25:03I don't think those are the indicators to define how a person's recovery is.
25:08But what's very important is if you're able to share those moments and also look at how people can be kind to you at the same time, being non judgmental in so many ways, not for the fact that only when you're hostile, somebody is non judgmental.
25:25No, even when people are saying things that differ so much from your value system, that differ so much from what the world believes in, it's important for us to believe in that individual because that is what is going to bring in that sort of trust and connection between two individuals.
25:43So in this situation, I also understood that why it's important to be kind because sometimes you leave it at it thinking that probably just telling them a few suggestions or helping them in terms of guiding their own sense of recovery is important.
26:00But what is important here is to be very kind to the kind of the painful trauma that they've been through.
26:07And at the same time, also to go through the fact that you're trying to be there for them, despite all the odds.
26:14Now, I think that is something, whether you're a mental health professional or not, whether you're a family member or not, I think this is what something that at least I look forward to in life.
26:23And that is what instills hope in me as well.
26:26So why not for any, any other person who's been homeless, who's been through so much of trauma has been abandoned by the family, by the entire world for that matter,
26:36and labeling them for the fact that they have not been given love and taken care of, but rather labeling them with labels of schizophrenia or bipolar affective disorder or people who do not have housing support.
26:49We can call them however and with whatever terminologies that we want.
26:53But at the end of the day, there are individuals like you and me who have been through a very rough and tough life.
27:00So we here at the Banyan as a mental health care team, I think it's important for us to be with them through all the ups and downs.
27:09And that's a very tough call as a clinician, as a practitioner.
27:14It's quite a tough call because it also, you need a lot of strength as you give yourself away, as you give yourself and walk along with them.
27:24Taking down that path is a tough call, but it's worth it all. It's completely worth it all because the way or the lens through which a person also feels or also sees hope is so strange.
27:39It doesn't have to be the way how it is linear. In fact, where you have an option that doesn't mean hope, but rather when you don't have any options, when you don't have people around you and you don't have any sort of source of strength.
27:54If you see a tiny ray of light in somebody or in somebody's gesture or in somebody's presence or the overall feeling of where you're being taken care of.
28:06I think that's what we need to create as far as mental health care is concerned and also look at how you can build that sort of care culture and also mentor younger professionals to build that sort of resilience in terms of sustaining that sort of care system.
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