The Early Days and with Special Reference to the Indian Fellowship
August 2nd, 2011 by AdminThe Richmond Fellowship: The Early Days and with Special Reference to the Indian Fellowship:
(This is a transcript of an Interview with Ms. Elly Jansen in June 2011 inLondon)
1. How and why did you start RF in the UK way back in 1959?
I once was asked that question by the Human Relations Course students on a one year course (which I had started in 1967 and which ran for 25 years), to which I answered: “Done because we were too many” – surprising myself by quoting the tragic Thomas Hardy novel :“Jude, the Obscure”.
During the second world war when Holland was occupied by the German army, life became very difficult and my mother, who tried to bring up her nine children in addition to some not her own, was always overstretched. I was number six and ten years old when the war started and when my youngest brother was born, and from day one, I started to feel responsible for his wellbeing. My mother was very introverted, an artist, more than a mother or a manager, and although I was never close to her, I worshipped her and tried to help her in any and every way possible. Life during those years was fraught with danger, with lack of food and clothing and during the last week our village was razed to the ground by the allied army.
After the war we had become very poor and the only way I could hope to get into higher education was to become a full time leader of a group of problem children at the ‘Paedologisch Institute’ of the Free University in Amsterdam where I was allowed to attend lectures free of charge. At the start of my second year I was entrusted with the care of a group of 12 boys with challenging behaviour, aged 11- 14. I was terrified of the prospect, but dealt with the challenge by creating a committee structure where every boy had a responsibility and the whole group had to say of how we would use our free time. Without knowing the term, the group functioned as a Therapeutic Community with great benefit.
In 1955, I went to the U.K. to train as a missionary but I soon found that the task of trying to convert people to embrace a fundamentalist version of the Christian tradition – a tradition in which I was brought up – went against the grain. At the same time, I found that Christians left the task of helping people with mental distress to the professionals or to God, but excused themselves from doing their share, and I decided to try and start a Therapeutic Community in the Community.
Such a project was not known as Therapeutic Communities. TCs were operating only in a few hospitals like the Cassell and the Henderson, where all the safeguards of a Hospital were on hand. Initially many concerns were raised about the viability of the project and I myself was threatened with deportation. However, I was still a student of Divinity, was not getting a salary and was not claiming anything other than sharing a house with people who had left Hospital and were free citizens. Within a year Lancaster Lodge, the house I had rented for the experiment, had found such acceptance that Surry County Council offered funds to obtain a second Home. The Richmond Fellowship – so named by others was incorporated and registered as a charity during 1960.
2. How did you take it worldwide?
With difficulty. However it was a natural process. I was asked to undertake a lecture tour to the Colleges of Psychiatry in the USA and during 1967 I spent the summer crossing America from shore to shore. I found unanimous enthusiasm for the establishment of an American counterpart and set the necessary procedures in motion so that by 1968 the Richmond Fellowship of America was incorporated and able to start work.
Having started work in the UK with only £ 100/- to my name, I hoped to avoid the financial struggles I had had to cope with and applied to a Foundation and an individual for a grant. Both applications were successful and I could therefore plan to establish an office in New York which is the heart of the Foundation world. My last lecture visit had been to Johns Hopkins University in Baltimore where the Chairman of Psychiatry, Professor Joel Elkes had promised to act as referee to support any application I wished to make. However, when I was informed that both applications had been successful, I enquired when I was to receive the cheque and found that, instead of supporting my application, a new wording had been substituted, making Johns Hopkins the recipient of the grants and giving Baltimore as the place to establish the first Therapeutic Community with me taking on the task of establishing and leading it as Associate Professor!
And so the work in the USA had to start again from scratch but it was successful and within a few years some ten TCs were operating on the American East coast with a project starting in Montreal, Canada.
Subsequently invitations were received from Australia and New Zealand and from many other countries but, in each case, the work needed to bring together a group of persons able to establish and maintain a viable organisation fell to me in spite of the goodwill and interest found everywhere. It was necessary, whilst working in one country, to be sufficiently informed about details of many other countries to provide a reliable source of consultation and support.
3. What were the obstacles to overcome?
Multiple! Each country is different and, whilst the basic principles and practices of the Therapeutic Community found acceptance everywhere and were effective without exception, approaches to setting up an organisation differed, personalities differ and the culture of each country is unique. It took years of working at a distance, with occasional visits to bring each organisation into existence. In each case, the most important issues were the identification of key Board members who understood the concept and could be relied upon to see things through and the choice of capable staff to invite to the UK for training who would return to their own country and marry the concepts and practices they had learned to the culture and customs of their own country. There never was a quick fix but in each case a careful building up of the required elements, which needed much time, much thought and ongoing patience. The work of funding the necessary grants was uphill, as donors usually expected part of the cost to be provided by the Charity which made the application, necessitating a poverty-stricken budget for the founder. As I have expressed elsewhere, many people saw the expansion of the organisation internationally as a museum gathering treasures, but the experience was more like being in the trenches from which only slow and risky progress could be made.
4. How did you begin operations in India 25 years ago?
Work in India started in 1973 in passing from Australia to the UK to investigate whether conditions allowed the possibility of getting Fellowship work underway. It was plainly possible but would require a great deal of work… So it was not until 1977, again whilst passing from Australia to Austria and the UK, that a further visit was possible. I met Dr. John Henderson of WHO in Delhi and the British High Commissioner and was given much encouragement as the urgent need for work done in the mental health field was obviously extremely evident.. During that visit the first efforts were made to get Richmond Fellowship (India) incorporated. A number of visits followed during the late seventies and the early eighties and I was fortunate in being taken from Ministry to Ministry in Delhi – receiving support and encouragement from all, including the promises of funds relating to some five year mental health plan – funds that never materialised.
In Delhi, the Government had given me the choice of working in Ranchi or in Bangalore and I decided to leave and try and make contacts in Bangalore. However, I wrote and telephoned but was never able to raise any response from NIMHANS. Whilst staying in a Bombay Hotel, close to the airport in 1983 I decided to leave my daughters aged 13 and 11 to the mercies of the hotel staff, and to fly to Bangalore to make contact with NIMHANS. That visit was the beginning of the work in Bangalore. I invited the then NIMHANS Deputy Medical Superintendent, Dr S.M. Channabasavanna, to dinner at my hotel and he introduced me to Mr. Krishna Murthy who owned a primitive farm building which he was willing for us to use to start the first project. The first house “VIKAS” was started in this building in June 1986. From that point onwards I started to raise funds from the European Union and the Overseas Development Agency for a proper building. A new problem arose in that no building could be found that could house both men and women – anyhow a delicate undertaking in India.
Having secured the funding I was set on finding a property and believed I had discovered a suitable site. On our way to a Board meeting at the Murthy farm we had practically to pass the spot and to convince the Chairman, Dr. Narayana Reddy who was willing just to have a look. I saw my chance and when it seemed that he might be interested, whispered a very low figure for him to bid and, to the surprise of everyone, the bid was accepted, and ASHA was purchased. The owner was suspicious that her agent had given us the lowest figure she was willing to accept but it was accidental that we hit the spot”. Thus ASHA was established, and was followed by a number of other new projects: for example, the Work Training project and the College.
5. Was that a difficult time and how did you overcome the problems?
I overcame them with difficulty and by sheer perseverance and refusal to accept defeat – an attitude that was shared by our Indian colleagues: working all hours on a shoestring budget, without conditions that would be thought to be minimally necessary and hanging on in the face of crises, prejudice, criticism and sabotage. Also much patience and diplomacy was needed and willingness to press the importance of certain steps, for example, in the case of the need for services in Delhi which was very reluctantly accepted but then became a triumph for all concerned.
6. What are your impressions of the work done in India by RFS (I) over the last 25 years?
a) One could not have come across a more capable, task-centred, dedicated and determined group than the Bangalore professionals and lay supporters I met. It was at all times a joy to work with them and they made me feel at home. (They also made sure to get the last ounce of time and energy from me!)
b) There is in India a strong emphasis on the family, the work done in ASHA with the families of those in our care is all important. The acceptance of referrals is conditional on parents’ willingness to spend time at ASHA to learn to understand and be of help to their relatives and this “pays off”! (Here in the UK it is equally important to work with relatives. We have in the past been very successful in running group discussions jointly with residents and their relatives, but the strong western taboo against communicating with relatives unless with special permission can complicate the process.)
c) The expansion of RFS (I) is extremely impressive. Although the standard of living in India has gone up with leaps and bounds for many families, many others live still in terrible poverty, and care for the mentally ill has not been a Government priority, making it very hard to make provision let alone expand. In spite of initial reluctance to spread to other parts of India, RFS (I) was embraced by a group of Delhi professionals and lay people and a very impressive unit was built not far from Delhi airport.
Work to build a Care Home and workshop has also been started in Lucknow and, although the funds to complete are not yet in the kitty, the work is progressing. Irresponsible you may say. We believe that the commitment to see the vision into reality and the willingness to pull out all stops will succeed. The Sidlaghatta project, where some 20 villages without any access to psychiatric services now have monthly visits from RFS (I) consultants who provide guidance, give free medication where needed, and assist in the establishment of mutual support groups , has been a life saver.
d) Special mention should be made of the establishment in Bangalore, first of the training for work unit CHETANA, used by both residents of RFS (I) and by those in need of this living with their families and the establishment of a Post-graduate College for Psycho-social rehabilitation. The combination of college learning and the experience provided in the Therapeutic Communities provides an excellent opportunity for the creation of a pool of skilled man power, capable of making a major impact in a field that is seriously under-resourced.
e) There exists a natural (although not admirable) tendency for the managers of a project , once established – often after some struggle and sacrifice – to consider the task done and to resent any suggestion of further expansion or of assisting other areas and, especially, other countries. Yet, RFS(I) went out of its way to emulate the UK mission which gave it birth and to become partners in providing much needed training and information to neighbouring countries where affiliates were being established: Nepal, Sri Lanka, Pakistan and Thailand.
7. The future of Rehabilitation
Where there is no vision the people perish! The UK with its pride about respecting human rights has lost the plot! The Mental Health Act 1959 promised to replace the mental hospital with better alternatives, and it made a good start. But now for most the alternatives are pitiable, either: discharge from hospital after an acute breakdown without further support, or the provision of accommodation with a few social work visits thrown in – fine for those who can manage -, or the revolving door, or the desperate act of suicide. Very few people are given a real bridge from hospital to independent life to negotiate the precarious stages of gaining confidence and impetus whilst feeling supported to enter a new phase, enabling the move forward to taking responsibility, trusting friends and hazarding interviews or training for a job.
In India there is virgin soil. New initiatives are springing up everywhere and new hope is being created even for those who till now have been cast aside by society. India has become a fountain of IT usage and expertise. This is the time for all those who are concerned for the plight of their fellow men who have broken down to take up arms – the arms of technology – to make the case for those and especially with those who need reliable and effective help to get back into the saddle. RFS(I) is in an enviable position to get heard and seen, to bring useful information to a vast population of those who are desperate to get succour to overcome problems too desperate to be resolved without intervention. RFS(I) possesses models that can be emulated, has an organisational structure that can absorb new struggling projects and assist the birth of others, operates a College that can combine academic learning with the practical experience so necessary for those who teach others, and it has a governing Board and senior staff who have vast experience and an attitude that makes joint work truly enjoyable. What is still needed is the recruitment of an army of individual and corporate donors who realise the need and grasp the opportunity to exploit the potential of RFS(I) to bring about the much needed vast expansion of services!
