Emergency Care and Recovery Centres (ECRCs) offer multidisciplinary, person-centred hospital-based care for homeless people with mental health issues to recover and re-enter stable housing and community living arrangements where they may pursue fulfilling lives.

Personalised Hospital Based Care

ECRCs attempt to re-imagine structures and processes of hospitals for mental health as geographies where service users can exert their ownership and participate in co-creation of a therapeutic community where people can reconnect with themselves and make personal journeys towards lives of their choosing. Crisis intervention, health services and social and psychological therapies are offered in tandem with individualised care plans that are delivered through a case management system.

THERAPEUTIC COMMUNITY

User-led initiatives such as a café, a beauty salon, a fish and vegetable stall, welcome the broader community to transact with the hospital. Children of service users and staff run around the premises, after school or during holidays, leaving imprints of their joy and companionship. Animals walk into this ecosystem sometimes, either at the behest of an interested human carer or by themselves.

RETURNING TO THE COMMUNITY: AFTERCARE

In this social architecture, as people recover, they make choices about returning back to families or communities of origin so that lives disrupted by homelessness may resume. Therapeutic relationships continue to anchor necessary continued care support post these transitions from ECRC. These include clinical continuity, cash transfers, familial relationships and social role re-formulations and so on, both at the individual and household level to arrest descent into ill-health, homelessness or re-institutionalisation.

HOMELESS COLLECTIVES

ECRCs are a space for weekly meetings among people living in or with histories of homelessness. These meetings of homeless collectives are an exercise in solidarity and shared identity which are used to initiate actions including advocacy such that their entitlements across citizenship, livelihoods and housing can be secured.

PARTNERSHIPS AND REPLICATIONS

ECRC has been recognised by an evaluation team from National Institute of Mental Health and Neurosciences (NIMHANS) in 2003 as an effective service to address needs of homelessness in mental health. The approach has been replicated through capacity building or collaborative implementation partnerships with state and civil society organisations.

Ashadeep in Assam through a capacity building partnership initiated ECRC-like facility in Guwahati. Karuna Trust in Karnataka were supported to start up a service in the city of Mysore.

The Shelter, a 30-bed service for homeless men with psychosocial disabilities, run in collaboration with the Corporation of Chennai and HCL Foundation under the National Urban Livelihoods Mission (NULM) extends the ECRC approach to operate in a closer to community format with street-based outreach, homeless collectives and wide transactions with the neighbourhoods in vicinity. ECRC has been replicated by the National Health Mission, Government of Tamil Nadu by integrating services within five District Hospitals. The initiative funded 100% by the state adopts the value deck and service norms of The Banyan’s ECRC approach in an attempt to bring integrated mental health inpatient services closer to the community. Additional ongoing support is offered to the ECRCs at Walajapet District Hospital and Tiruppur District Hospital.

In collaboration with the Government of Kerala, ECRC has been operationalised in Guruvayur.

The reintegration and aftercare components of the ECRC approach have been replicated collaboratively with the Government of Kerala across state-run psychiatric hospitals to help reunite long-stay clients with their families.

Impact

2500
people with mental illness and histories of homelessness have accessed ECRCs
75 %
have moved back to live with their families or independently in the community
80%
of people reintegrated return to work, either household occupational roles or paid employment
92
days is the time homeless people spend on at average at the ECRCs before making a choice of pathway to exit the hospital facility
80%
of people reintegrated in the last five years remain in continued care to assist them in sustaining their recovery and prevent a lapse back into homelessness

Story of L

After escaping from a bonded labour arrangement as a child, my life was dominated by homelessness. I did not have the opportunity to educate myself and lived in constant fear of being caught again. The ECRC environment allowed me to form relationships, take up work and also once in a while things like breaking into a dance at whim. I am now well, I have started a vegetables business. I also enlisted the help of my friends to help the venture take off, they together as a team source the produce, set up and market to ensure sales.

Locations

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