Abstract

One hundred and fifty million Indians, or 1 out of every 10 individuals, are living with some form of mental ill health, and 40–90% remain out of necessary care. Within this scenario, the intersection of homelessness with mental illness represents a particularly complex problem fraught with multifactorial issues. Women with mental illness living on the streets in India are ensnared into a disenfranchised, invisible, fringe existence that is more often than not predicated by a background of gender-based disadvantage, extreme poverty and critical life incidents. Gendered pathways into homelessness among those living with mental illness present the need to consider distinct health and social care system responses and practices. Few responses with an emphasis on social care have emerged in the Indian context, predominantly led by civil society actors, to tackle the crux of this complex nexus between mental illness and homelessness. This paper describes the experience of The Banyan, India, in developing a continuum of care for homeless people with mental illness. More specifically, the Emergency Care and Recovery Centre which offers crisis intervention to reintegration services for homeless women with mental illness is examined. It frames within the narrative of this experience, implications for mental health policy and practice for an extremely marginalized population. In particular, prospects for issues of long-term care and intersectoral service integration between health and social welfare for the homeless population are considered in the light of recent developments in progressive disability and mental health legislation in India that offer unprecedented opportunities to catalyse such niche innovations into a countrywide mental health system.

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