IntroductionBasicNeeds is an international developmentorganisation, which works to bring about lastingchange in the lives of people affected by mentalillness and epilepsy. The organisation has built aninnovative approach that tackles peoples’ poverty,as well as their illness. By ensuring that their basicneeds are met and their basic rights are respected. Established in 1999 by Chris Underhill withfunding from Andrews Charitable Trust and theJoel Joffe Charitable Trust, BasicNeeds haspioneered a way of working, which places peoplewith mental disorders at the heart of all that it does.
Interventions areas of BasicNeedsBN working in 5 continents of the world Europe Africa Asia Latin America Australia
Model of BasicNeeds in Pakistan The model is formed of 5 separate but interlinked modules; these are: Capacity building Community mental health Sustainable livelihoods Research Management and administration
Cross cutting themes Working in partnership Animation Gender development Participatory techniques Flexibility
Getting started Feasibility Identifying partners Programme planning Identifying donors and securing funding Assembling the team
Forums for capacity building Filed consultation Other consultations Self- help group
Field consultation A field consultation is typically the starting point of building capacity and one of the founding programme activities. This activity brings together people with mental disorders, their carers and families, and partner organisations. Other consultations The field consultation is the first of many consultations that continue to be held throughout the lifetime of the programme.
Self- help group Self-help groups play multiple-roles and are established for a range of purposes. For example, carers and people with mental disorders may come together to form, or join, a group to encourage better integration
Tools for capacity building Animation Research Awareness- raising and sensitization Games and songs Trainings
Animation Animation is that stimulus to the mental, physical, and emotional life of people in a given area. which moves them to undertake a wider range of experiences through which they find a higher degree of self-realisation, self-expression, and awareness of belonging to a community. Research Individuals’ capacities are also built through the process of generating data and research. Life stories are a primary data source used for analysis in research.
Awareness-raising and sensitisation Awareness-raising and sensitisation campaigns are used widely to challenge pre conceptions, change attitudes and share information about mental disorders. A variety of methods are used in awareness including street, theatre personal counselling sensitisation workshops consultations media campaigns
Games and songs Awareness-raising Games and songs, also known as energisers. are introduced in many group activities within a programme. They are a means of helping a group of people, possibly strangers, to get to know each other and bond.
Trainings The range and breadth of training that is carried out within a programme is considerable. Therefore, whilst acknowledging that training is a key component of capacity building
How does it happen? Build partnership Community mental health services Identification Follow up support
Build partnership Correct diagnosis and treatment is an important step towards recovery for a person with a mental disorder. Often people with mental disorders, are also living in poverty will not have had access to the mental health services that they require. Community mental health services In some cases, clinics may be held at existing health facilities, such as hospitals or health centres and are wholly provided
Identification Once regular community mental health services are established, it is important that people with mental disorders attend them. However, a person with a mental disorder may be less visible in their community, perhaps physically hidden or not welcomed at community events because of their illness and the stigma that so often surrounds it.
Follow up visits Community psychiatric nurses continue to support community volunteers to monitor the people under treatment, provide support to carers and appropriately advise and report on the progress of each of the people
Assessment of livelihood opportunities Home visits Making link with development organizations Income generating and productive activities Self help group New business Access to resources Returning to education Therapy and income generation entering into productive work New skills
Home visits Home visits facilitate a culture of work and self- sufficiency amongst people recovering from mental disorders and their families by providing encouragement and support, guidance and mentoring and information on opportunities. Making link with development organizations In pursuing a sustainable livelihood, a person recovering from a mental disorder may opt to return to a previous occupation or decide to pursue other options that require additional skills or capital.
Income generating and productive activities There is a real diversity of employment and productive work that result from this module. Individual level, people recovering from mental disorders have returned to their previous occupations Developed new skills, started businesses and entered into new professions and livelihoods.
Self help group The self-help groups have been specialising in goat and chicken nurture, gardening of vegetables, farming of rice, maize, pineapples, beans and sesame productions. New business Establish new business
Access to resources Returning to education Come back to education Therapy and income generation entering into productive work New skills
Research methods Participatory action research Outcome studies Policy studies Baseline study Primary data Life stories Individual files Clinical files Process documents uses of evidence Influencing policy and advocacy Evidencing efficacy and challenges Knowledge base
Participatory action research Participatory action research forms a significant part of BasicNeeds’ research work and is integral to a programme. The process involves cycles of data collection, analysis, feedback and reinterpretation with the outputs used to assess need and the effectiveness of interventions
Outcome studies Outcome studies build on the data generated through participatory action research use it to evaluate the efficacy of the model outcomes. The purpose of this type of evaluative research is to evidence how effective the interventions of the model are in bringing about real change in the lives of people with mental disorders
Policy studies Policy studies involve specific, one-off pieces of research that focus on a particular set of issues that significantly affect intervention quality or model outcomes. Often the reason for commissioning a study will have resulted from issues highlighted through participatory action research and the outcome studies.
Baseline study A baseline study is a review of the situation of the programme area specifically looking at the lives of people with mental disorders and all of those factors in the external environment that affect them. Primary data Primary data collection is an on-going process, which involves complete documentation of the lives of people with mental disorders, their carers and families, via a number of formats. Life stories Life stories are a way in which the lives and experiences of people with mental disorders can be recorded, as told by them.
Individual files Every person with a mental disorder who is involved in the programme will have an individual file. Such files are a factual account of the individual, including information on their background and history; their medical information including type of mental illness, symptoms and treatment their family situation.
Clinical files As with individual files, clinical files are kept for every person with a mental disorder participating in the programme Process documents uses of evidence All field consultations and focus groups involving people within the programme are recorded via process documents.
Influencing policy and advocacy The research methods described above generate a body of evidence that is used for many purposes. Evidencing efficacy and challenges The knowledge gained from the research discussed above contributes to demonstrating the efficacy of and the challenges faced when implementing the model for mental health and development. Knowledge base The evidence generated through this module, contributes to a significant knowledge base that serves two main purposes
Fundraising Managing and building partnership Partner meetings Monitoring Financial management Reporting cycle Programme evaluation
Fundraising Without funding, putting the model for mental health and development into practice would not be possible Managing and building partnership All of the programmes that are currently running are dependent on partnership work for their success. Partnerships are formed with a range of organisations Partner meetings Partner meetings provide a platform for all organisations involved in the programme to share information and experiences and learn from each other.
Monitoring All the activities carried out and details of the people who benefit from them are tracked within the programme. Activity tracking sheets, statistical tracking sheets process tracking sheets are used by BasicNeeds and its partners to collate this information. Financial management Setting accurate budgets and monitoring income and expenditure occurs throughout a programme.
Reporting cycle Partner organisations collate the monitoring data on monthly basis and then submit quarterly reports to BasicNeeds describing what has occurred in the programme over the last three months. Programme evaluation Evaluations are undertaken at two points in the lifetime of a programme – one halfway through and one at the end of a programme’s funding cycle (normally every three or four years). Typically, the mid-way evaluation is carried out internally and an external evaluator completes the final evaluation.
Community mental health training Research training Documentation training Animation training Delivering sustainable livelihoods training Management and administration training
Community mental health training Building on the capacity of existing primary health care or community infrastructure, the training equips participants with the skills to undertake and deliver more effective mental health care. Research training The research approach adopted by BasicNeeds uses participatory processes that place the stakeholders at the heart of generating and analysing the data. Within the model, people such as health workers, community workers or partner organisations may be involved in carrying out research.
Documentation training A strong feature of a programme, is that everything that takes place is thoroughly documented including life stories, process documents individual and clinical files Activity and statistical tracking sheets the various reports (quarterly, annual and partner).
Animation training Animation transcends individual modules and is vital to delivering change, increasing capacity and empowerment. Delivering sustainable livelihoods training The sustainable livelihood module is often delivered in partnership with development and other organisations or institutions and helps individuals to access opportunities and resources to make a living.
Management and administration training The management and administration training provides partner organisations with relevant project management skills required to implement the aspects of the programme they are responsible for. Topics such as, preparing logical frameworks, budgeting, finances reporting are offered to partners where there is an identified need.
Training for people with mentaldisorders, their carers and families Managing illness training Employment or productive work training Advocacy training
Managing illness training To sustain effective treatment, people with mental disorders, carers and family members need to know how best to manage their illness. Employment or productive work training Sustainable livelihoods training enables people recovering from a mental disorder, carers and family members to pursue a path that will lead to employment or productive work. The training is highly specific and can range from horticulture skills to bicycle maintenance, from mechanics to business planning.
Advocacy training Advocacy training aims to equip people with mental disorders, their carers and families with the skills and abilities to demand the services they are entitled to and the confidence to speak up for their rights.
RolesCommunity workers Coordinating and running the activities such as field consultations and community meetings Helping a person with a mental disorder to pursue a course of treatment Assisting in the establishment and operation of self-help groups and cooperatives. Supporting and encouraging a new business venture Identifying a person with a mental disorder and referring for treatment Helping at mental health camps and outreach clinics Providing follow-up support, managing side-effects and relapses Recording and documenting life stories and maintaining individual files Providing the link between the person with a mental disorder and BasicNeeds/partner organisations
Mental health professionals Mental health professionals play a very important role in diagnosing, treating assisting people with mental disorders in their recovery. Including people like psychiatrists, clinical psychologists, clinical social workers psychiatric nurses, their primary involvement in the programme is within the community mental health module where they carry out a number of functions and duties.
Animators The animator has “a special responsibility to stimulate people, to think critically, to identify problems, and to find new solutions
Traditional healers The significance of traditional healers in many poor peoples’ lives and the part they play in diagnosing and treating mental disorders must be given due emphasis. Within the programmes, relationships have been built with healers and in some cases a strong collaboration has developed between the two parties. Partners
Partners Effective partnerships help BasicNeeds run effective programmes. Partners increase the reach of the model, complement and add value to the work and support its sustainability. Depending on which aspects of the programme require partners any of the following organisational groups could be approached: Community-based organisations Development organisations Community-based rehabilitation organisations Primary and mental health care providers Micro-credit organisations Training and educational institutions Self-help groups Government departments
The model’s impact A better quality of life for poor people with mental disorders