The Banyan, founded in 1993, originated as a project to rehabilitate homeless women with mental health issues, evolving into an organisation dedicated to providing health and mental health care for those in poverty and homelessness. The organisation, headquartered in Chennai, Tamil Nadu, strives to enable access to care through comprehensive clinical and social approaches embedded in a well-being paradigm. The Banyan Academy of Leadership in Mental Health (BALM) was established in 2007 as a sister organisation of The Banyan. Its work is intricately linked to the mental health services and programs delivered daily by The Banyan. The Banyan and BALM work together to understand and address distress, deprivation, and exclusion from treatment and care and to foster meaning, independence, family, and human rights.
BALM was established with a vision to build pillars of research, education, training, and advocacy to influence policy change and augment stakeholder collaborations in mental health and social sectors. It began as a knowledge hub to disseminate research on mental health and document best practices of The Banyan. The broader vision was to build a cadre of mental health professionals through training and education, inform policy & implementation programmes through research, and run pilot programmes to find scalable solutions through social action. Through BALM, The Banyan effectively hosts five health research centres with academic staff and active research portfolios focused on social action and research, transdisciplinary research, participatory action and research, trauma studies, and homelessness and social vulnerabilities.
BALM’s mission includes:
The key objectives of BALM are centred around research, scalability, sustainability, and understanding the experiences of socio-economically disadvantaged groups in accessing mental health care.
Central to The Banyan and BALM's approach is the empowerment of the communities they serve, focusing on a decentralised model of health care based on their “people’s health in people’s hands” principle. Through a peer-led model, individuals with shared experiences are trained and supported to take on leadership roles and contribute to research. This inclusive approach fosters equitable knowledge exchange by ensuring that the voices and perspectives of service users are integrated into decision-making processes and research.
The Banyan’s participatory approaches continue across its programmatic and organisational activities. This includes involving service users in decision-making processes, gathering their feedback through independent audits, and actively seeking their perspectives to shape the organisation's direction. Participatory approaches ensure that the services provided are aligned with the actual needs and preferences of the users.
One of the key research objectives of The Banyan and BALM is to develop and implement scalable models of mental health care, recovery, and rehabilitation. BALM’s activities and findings feed into a wide range of social action and public policy initiatives at The Banyan and beyond. The academy has served as the Secretariat for the Movement for Global Mental Health, using this broader global network to ensure that local narratives from the Global South contribute to the diversity and richness of global understandings of mental health, ensuring support networks traverse systematic barriers to build more inclusive ecosystems of care.
Notably, BALM's programme strategy remains independent of funders, who primarily support the organisation's governance and financial operations. Grants are selectively accepted based on alignment with the mission, fostering partnerships characterised by humility and respect. Funders contribute to BALM's capacity without exerting influence on programme direction.
Successes include initiatives like the Home Again model, where service users have adapted the organisation's programmes in their communities, showcasing the potential of community-driven initiatives. Challenges include reintegration of individuals into families and limited community understanding of research practices. Lessons learned emphasise the importance of integrating users into staff roles, customising participation approaches for specific sectors, and ensuring fair compensation for individuals with lived experience in research activities. This model is also recognised by WHO among the best practices from around the globe in the WHO Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches, where it is recognised as one of the 4 best practices for Supported Living Services for Mental Health.
Additionally, BALM provides training to community-based mental healthcare workers known as Nalam community wellness mobilisers (Nalam means well-being in Tamil), who provide aftercare services to individuals with mental health issues as part of The Banyan’s NALAM program. These mobilisers also work with the general population to promote mental wellbeing, identify at-risk individuals and groups for mental disorders, offer preventive services, and identify and refer individuals with symptoms of mental illness to specialist services. They also offer ongoing social support, including assistance with accessing employment, ID cards, and entitlements. This approach aligns with BALM's mission of holistic mental health care, fostered through a user-led approach to tailoring services to individual needs and creating a supportive, community-oriented ecosystem of care.
Involving individuals with lived experiences in mental health research poses evolving challenges, including limited community understanding of research practices and ensuring meaningful engagement across all research levels. As one staff member explained:
“The process of involving individuals with lived experiences in research, particularly in the context of mental health, is complex and evolving. The challenge lies in ensuring meaningful involvement across all levels of research, from senior researchers to junior associates.”
BALM applies specific strategies to address these complexities, including collaborative agenda-setting, involving peer researchers, conducting recorded consultations in local languages to overcome barriers like memory impairments and language differences, and offering tailored courses and training in research.
While The Banyan initially had an institutional care model, they faced challenges with reintegrating clients back into their families. Sometimes families hesitate to take back the client, or the client hesitates to go back to their families or there are challenges in tracing the family. As a response to this challenge, Banyan and BALM developed the Home Again model of community living, which trains clients to be integrated into a staff role over time, ultimately promoting a participatory and sustainable approach to community-based care.
Another important lesson involves the need to customise or operationalise the definition and implementation of "participation" for specific sectors, working in consultation with all stakeholders instead of employing a generic approach. This can help clarify its scope and enhance understanding, making a participatory approach more achievable.
Finally, BALM recognises the importance of ensuring fair compensation for individuals with lived experience in research activities. While many feel a moral duty to assist those facing similar challenges, it's essential to recognise their contributions as core researchers. This entails including their names in documents and equally valuing their representation, even if English isn't their primary language. Providing translation support and adequate compensation for their work transforms their involvement into a legitimate job opportunity. Placing this commitment at the heart of Banyan/BALM’s efforts is a priority.
BALM's participatory model empowers service users and peers with lived experiences, fostering inclusive research, scalable programmes, and stakeholder collaborations. This approach ensures that the efforts of both service providers and researchers align with the genuine needs and preferences of communities and users. By including individuals with lived experience in leadership roles, as well as training them as educators, trainers, researchers, advocates, and care providers, BALM and The Banyan recognises their invaluable perspective and expertise in delivering care and producing credible evidence for intervention and care. Moreover, BALM formally acknowledges and compensates communities as co-researchers, providing adequate support for their involvement in research activities.