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DISABLING MENTAL ILLNESS
Concept notePartnership for a movement to achieve highest levels of `wellness’ and coping skills for persons with mental health/illness and their families.
Key work focus areas in mental health/illnessi. Improve knowledge of what affected families and individuals go through and want – across economic classes. ii. Conduct education programmes for the concerned persons and their families. iii. Strengthen/improve current outreach programmes and services in a geographical unit in Delhi as a pilot (part of the above point gets addressed here in the initial assessment) iv. Relook at care and rehabilitation initiatives. Promote a group of professionals including psychiatrists interested in this approach. v. Relook and use existing services/approaches spelt out in urban mental health program, primary health care program, the public health policy, the disability policy, the mental health act and the PWD Act to influence changes if needed (links with points iii and iv).
No doubt there are positive developments in the much neglected mental illness area in recent years, yet, there are amazing gaps existing in understanding the issues from the perspectives of those affected and their families. The gap in this understanding is reflected in the policies, strategies and approach to work be it rural or urban areas, cutting across all economic classes. These are most often developed on an understanding developed from individual case profiles and anecdotal evidences. The current strategies have a strong medical approach. While this is crucial, the families are keen that a non-medical resolution also be worked upon to integrate those affected and their families in a manner that brings them dignity, improved quality of life and long-term security. There is a need to innovate and create opportunities to achieve the highest levels of wellness and dignity. It will be much more than helping individuals just stay well. In most instances the current approach is to silence them through medication so that the families and those around can get on with their lives and in extreme cases abandoned on the roads or in institutions. Our aim is to create opportunities to try out new ways to redefine care and rehabilitation strategies and initiatives. This will be done through a pilot programme comprising of a center with outreach services in close partnership with those affected and other primary stakeholders (medical fraternity that includes psychiatrists, general physician, nutritionist, alternative health therapists, sports physicians and tie ups with local services where the family lives; social development and rehabilitation professionals; prospective employers, HR networks and mentors). This center will evolve into a resource and referral center in time. The centre will innovate and create opportunities to build on the strengths of the individual/family. It will focus on developing education programs for the patients and their family members on illness management (including diagnosis); increase the functional capacity as much as possible of those concerned to reclaim their lives and support them to develop methods towards integration into healthy and productive living. For the patient and the related family the pilot centre will encourage the formation of an informed, proactive self-help group. Later - this group will support and initiate other community based family groups in different parts of the city. These will promote the role of the patients and the families as partners in care and rehabilitation by promoting family education on the illness and its dynamics, its day-to-day and long-term management and related coping strategies for support and care leading to better quality of life.
Objective 1Conduct situation assessment across economic classes and what is currently available to themImprove understanding of families and concerned individuals experiences, what rights are being violated and by whom and what support and care inputs are needed. § Bhatti mines, Lal Kuan, Govind puri (latter 2 with ASTHA) § RML hospital, IBHAS § Family groups linked with day care centres/NGOs Tasks would involve a series of consultations to improve our understanding/knowledge base:
Objective 2Explore and pilot outreach mental health services in Bhatti mines, Chattarpur PHC and IBHASNeed to put together a multidisciplinary team to lead the work in coordination and partnership with the Chattarpur hospital and IBHAS Objective 3Improve quality of life of the person and the family a) Managing the illness/symptoms § Improve knowledge base of the illness and its manifestations and management § Management of side effects of drugs and overuse of drugs § What to ask the doctor? § Mainstreaming: implications, preparation, joint partnership between those involved § Livelihood mainstreaming: skill and knowledge development (build on what is available); employment avenues and competing in the market with reasonable accommodation and what this means in practice; procedures and support mechanisms needed b) Day care centers, Half way home and Hospitals Entry, exit and transition strategies: generic and individualized Leading a productive life (part of exit and transition strategies)
Objective 4Resourcing and networkingScanning (government, private, charitable)
Objective 5Sensitization workshops for various government depts./ministries, NGOs, family groups Develop material: small capsules Though a plan of action will emerge from discussions with patients and their families, Sathi All for Partnerships volunteers to facilitate this group to seek support from experienced individuals and institutions in the planning and execution of the programmes.
Partnership for a movement to achieve highest levels of `wellness’ and coping skills for persons with mental health/illness and their families
The Intention in time……..
For persons affected with mental health ailments§ To promote active involvement of patients and their families in charting a course for medical, supportive and rehabilitation moves. § To connect medical inputs with other therapeutic and supportive inputs ie – yoga, pranayam, meditation, massages, hydrotherapy, sports, nutrition, arts/dance etc etc. § To support capacity building initiatives including relationship building, time and resource management, looking at self and life to help take charge. § To create/snowball befriending circles – bring in elements of fun and togetherness. § To promote mainstreaming as part of healthy living. § To initiate out-reach programmes for support within families/homes. § To promote an informed, proactive self-help support group.
For the related Family§ To promote family education – whole family - on the illness and its dynamics, its day-to-day and long-term management and related coping strategies (emotions/feelings (patient and different members in the family), time, family members, relatives and friends, family finance…) for support and care leading to better quality of life. § Education on drugs and side effects management and documentation of progress. § To promote the role of families as partners in care and rehabilitation. § To build a database of available resources in the city and elsewhere. § To form an informed, proactive self-help group. Later support it’s mushrooming in different parts of the city.
For the cause and affected group of people§ To lobby and advocate for better practices in the medical fraternity (type of drugs, dosage, timing, side effect management, documentation etc). § To reconstruct `rehabilitation initiatives’ – its content and approach. § To explore the role and links with nutrition. § To network, explore and link with other sectors such as HIV/AIDS, violence, abuse, trafficking, disasters, conflict/riots, acid throwing, severe disabilities, terminal illness, dementia etc as part of a larger anti stigma campaign and service improvement. § To move towards a systematic gain in knowledge of various issues through documentation and research. § To network, build alliances with people and institutions in the larger society (Government, NGOs, Hospitals/health centers, NGOs/Donors, Private sector, Media, HRD Network)
SATHI COUNSELING SERVICE
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