The Wish Tree: Bearing witness to vision of inclusive psycho-social development – Sugandh Dixit

On 12 October 2020, World Mental Health Day, the WHO encapsulated decades of crises in mental health services that the pandemic has now brought to the forefront. It called for greater investment in, and prioritization of these services, and quality access of mental health for all. For Bapu Trust for Research on Mind and Discourse team, it was a moment of reflection on the work we do and the future that we hope to build towards inclusion of persons with psycho-social disabilities in communities.

We critically reflected on the following questions:

What does it mean to invest in mental health?

How do we invest in mental health, and what does this investment mean for the communities we serve?

The visions, the values, and the aspirations for our future were commemorated by crafting a Wish Tree that was mounted on the wall of our service team office in Pune.

Each member of the team contributed to the tree with a leaf which had a unique wish on it. These wishes emerged from a place of heart and were not bounded by the limits of what existed or what was possible; expressing a mosaic of affirmations for what inclusive development and rights-based psycho-social services should look like — “accommodation was not provided out of sympathy but as a respect for diversity, a right” and “accessibility without request becomes reality for all persons with Disability” the wishes read.

As each of us imprinted our wishes on the leaves, we were confronted by memories — challenges we faced in our struggle for inclusion, and against stigma, discrimination, and violations of our clients in our work at the 25 bastis of Pune. Someone shared an all-too-common tale — that of a client wandering aimlessly, staring into nothing, and resultantly getting viciously bullied and violently accosted by neighborhood children and community members. The team’s repeated interventions through community and individual meetings, sensitization of the police that felt exhausting and heedless at the time, eventually resulted in community support and acceptance. As memories of that experience came flashing, we wrote on the wish tree:  “प्रत्येक व्यक्तीचे सहज समावेशन.” ^[1] And “प्रत्येक व्यक्तींच्या विचारांचा भावनांचा सन्मान केला जाईल.”^[2]  “I wish community owned and led initiatives is what the future is all about.”

The wish tree also bears witness to custodial brutality and coercion by family members and gatekeepers of the mental health system, which has unfortunately become normative. These questions and critical intrusions are becoming even more pervasive during the pandemic. For example, recently, barriers to our movement led to forced institutionalization of three clients by their family members. This coercion in the name of ethics of care compromises human rights and undermines social justice by taking away rights to decision making. While many reach our program, numerous other remain invisible stories of people who fall through the cracks in the system. To acknowledge these nameless others, on the wish tree we wrote: “ प्रत्येक व्यक्तीला स्वतःसाठी निर्णय घेण्याचा आणि आवडीचे निवडण्याचा निवड असो” ^[3] and “ I wish they include me in the decisions they said they are taking for me.”

The wish tree stands in the center of our office, but it is not alone. In the true spirit of a community mental health model, we surrounded it by weeds, flowers, and bushes. It symbolizes groundedness, nurturance, and sustenance. It represents the ecosystem that is community mental health, working in opposition to the western individualized model that locates pathology, wellness and resilience within the individual. The individual, much like the tree, cannot thrive alone, and is sustained by the community that exists at the periphery: the neighborhood support, circle of care, the political actions, advocacy, and public systems that need to be regularly weeded and challenged. As we stood witness to the wish tree and read the words, “Where care comes to one’s home and is all around” and “Each person will have some to support them when they are going through adversity […],” we remembered our 15-year-old client. She was diagnosed with tuberculosis, and endured stigma and discrimination while trying to access the public tap water due to fears of infection by the neighbors. Our continuous mobilization and awareness meetings in the neighborhood led to acceptance and peer support. However, the young girl succumbed to TB at the age of 17. While her neighbors expressed shock at the loss of a child, and grieved her memories, we carried the scars of a young girl who was failed by a public health system. These scars completed the wish tree as someone wrote “Everyone will have all opportunities for work, housing, livelihoods, health care, and circles of care that no one will feel alone, sad or hopeless.”

^[1]  Easy inclusion of each and every individual.

^[2] Each and every person’s ways of expression should be respected and heard.

^[3]  Every individual has the right to make decisions that embody their choice.

Sugandh Dixit

Educational Qualification: PhD Clinical Psychology, Duquense University.

Program Leader, Seher Community Mental Health and Inclusion Program.

As a mental health professional, my work lies in understanding the intersection of individual struggle and structural oppression, gender and body, and eco-psychology.