02028nas a2200217   4500000000100000008004100001653001800042653002600060653002400086100001700110700001600127700001600143700001700159700001300176245013400189856007200323300000700395490000700402520138700409022001401796       2019                            d10aMental Health10aMental health systems10aService development1 aNarasimhan L1 aGopikumar V1 aJayakumar V1 aBunders JG F1 aRegeer B00aResponsive mental health systems to address the poverty, homelessness and mental illness nexus: The Banyan experience from India.  uhttps://ijmhs.biomedcentral.com/track/pdf/10.1186/s13033-019-0313-8  a540 v133 a<p><strong>Background: </strong>Mental health has gained prominence as a global public health priority. However, a substantial treatment gap persists in many low- and middle-income countries. Within this scenario, the nexus between homelessness, poverty and mental illness represents a particularly complex issue. This article presents the experience of The Banyan, a 25&nbsp;years old non-profit organisation providing mental health care to people living in poverty in Tamil Nadu, India.</p>

<p><strong>Case presentation: </strong>The case study describes the evolution of The Banyan using a timeline narrative. By applying an action learning framework, the organisation's evolution through four lifecycles, strategy and the key elements underlying mental health system responses are identified and presented. 'User centred' and 'service integration' emerge as the main dimensions of The Banyan's responsive health system. Relating to these two attributes, a typology of services is derived, indicating the responsiveness of mental health systems in addressing complex problems. The role of the organisational culture and the expressed values during the transition is considered.</p>

<p><strong>Conclusions: </strong>The case study serves as an example of how responsive mental health systems may be constructed with both a user centred and a service integration focus.</p>
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