REHABILITATION OF HOMELESS WOMEN WITH MENTAL ILLNESS

Two homes are being maintained under this activity –

The prime objective of this activity is to provide care, treatment and rehabilitation measures to these persons and to eventually re-integrate them with their families. Psychiatric and other medical treatment and care; Psychological and other social rehabilitation services are provided at the residential facilities by a team of qualified personnel including psychiatrists, psychologists, counselors, social workers, and trained health care staff. A unique feature of these homes is the fact that scientific tools and approaches such as Growth Chart, Mental Status Examination, Positive and Negative Symptoms Scale, Indian Disability Examination and Assessment Scale and Global Assessment Functioning are used in a homely environment instead of a hospital like set up. Once the persons are reintegrated with their families, follow-up support in terms of treatment, counseling, and free medicine supply are provided to them on regular intervals. During 2015-16, 103 women (48 new admission and 9 re-admission) has been provided with these services of which 51 women have been reintegrated in various parts of India including Maharastra, West Bengal, Bihar, Bangladesh and Assam.

The sources of rescue and admission are generally categorized as under :

Rescued by Ashadeep

Brought by police

Referred from other organization

Referred from Ashadeep’s Free Psychiatric OPD

Referred from ongoing Community Mental Health Programme (CMHP) sites of Ashadeep.

53% women out of those rescued during 2015-16 have been re-integrated in the same year. The following Table shows the states where re-integrations have taken place. One woman had been re-integrated in Bangladesh.

Places of Re-integration in 2015-16

CASE STUDY

Missing for a decade, memoir of a life: Bindiya

Rescue: Bidniya was rescued by the staff members of Ashadeep on 08/07/2014 after information was received from the public about a woman loitering on the streets of Birubari area and behaving in socially unacceptable manner. The team reached the said location and brought her to Navachetana’s Transit Care at Rehabari, Guwahati. When asked to get down from the car, she did, but hurriedly ran towards the exit gate and tried to run away. However the nurses and other staff members were able to catch hold of her and brought her back.

Intervention:  Bindiya was ill kempt, muttering to self and carrying a pile of garbage that she wasn’t willing to part with. She was immediately given a bath, and provided with clothing and food. The Symptom Identification Scale and Mental Status Examination provided the picture of symptoms present at the time of rescue and admission. To get a more objective depiction of the same, PANSS, IDEAS and GAF were also administered. She was diagnosed with Chronic Schizophrenia and her pharmacotherapy started thereby. In the initial days, Bindiya had blunted affect, was irritable and attempts to carry out psychotherapeutic sessions failed as she would not cooperate and present a guarded attitude, or at other times, simply walk out from the room. She remained emotionally and socially withdrawn from others and communicating with her was often challenging as she would refuse to listen to anyone. For many days she refrained from maintaining personal hygiene and lacked toilet habits. The staff had to constantly prod her to carry out activities of daily living and over time they started providing her structured training for the same. Psychosocial rehabilitation in terms of cognitive retraining and token economy was started to help sustenance of goal directed behavior and her engagement in at least a basic few activities. 

Over time as her medications and therapeutic intervention continued, her active symptoms of psychopathology were minimized, and she was shifted to Navachetna (Rehab), at P.L.Campus, Bamunigaon on 27/12/2015. She was involved in household chores that required sharing responsibilities with other in-mates so that it facilitated socialization with others. She was also taught jute work that helped in refining her fine motor skills. In the course of her stay, it was noted that her sense of work responsibility was very high and she would never leave a job unfinished. The person, who once refused to cooperate with anyone, now participated in taking care of other in-mates as well. 

Discharge: Bindiya’s remote memory was largely intact and she had reported her home to be located in Jirrah village of Bankura district, West Bengal. Once the discharge recommendation was received from the Psychiatrist, her psychosocial status was assessed that revealed appreciable growth point scores and adequate functional levels. Her disability index had subdued to minimal and so did the positive and negative symptoms of schizophrenia. A plan for her reintegration with family was initiated and accordingly she was discharged on 21/02/2016.

When the reintegration team reached Bindiya’s place, the entire community gathered to welcome her. She was home after 10 long years! Her husband and children were at a loss of words to express their emotions. Over the years they had come to believe that she must have died while wandering on the streets. She was suffering from psychiatric illness for almost 30 years and though they sought treatment, they couldn’t afford to continue the medications due to financial challenges. She had given up on any hopes of homecoming, and over the years on streets, she accepted it as her life’s dictation.

And yet a spring did await her, and now that it has arrived, the winter shall only be a memoir.

REHABILITATION OF HOMELESS PERSONS WITH MENTAL ILLNESS

3 homes are being maintained under this activity –

The prime objective of this activity is to provide care, treatment and rehabilitation measures to these persons and to eventually re-integrate them with their families. Psychiatric and other medical treatment and care; Psychological and other social rehabilitation services are provided at the residential facilities by a team of qualified personnel including psychiatrists, psychologists, counselors, social workers, and trained health care staff. A unique feature of these homes is the fact that scientific tools and approaches such as Growth Chart, Mental Status Examination, Positive and Negative Symptoms Scale, Indian Disability Examination and Assessment Scale and Global Assessment Functioning are used in a homely environment instead of a hospital like set up. Once the persons are reintegrated with their families, follow-up support in terms of treatment, counseling, and free medicine supply are provided to them on regular intervals. During 2015-16, 103 women (48 new admission and 9 re-admission) and 69 men (37 new admission) have been provided with these services of which 51 women and 26 men have been reintegrated in various parts of India including Arunachal Pradesh, West Bengal, Bihar, Madhya Pradesh, Karnataka, Orissa, Jharkhand, Gujarat, Andhra Pradesh and Karnataka.

The sources of rescue and admission are generally categorized as under :

Rescued by Ashadeep

Brought by police

Referred from other organization

Referred from Ashadeep’s Free Psychiatric OPD

Referred from ongoing Community Mental Health Programme (CMHP) sites of Ashadeep.

53% women and 69% men out of those rescued during 2015-16 have been re-integrated in the same year. The following Table shows the states where re-integrations have taken place. One woman had been re-integrated in Bangladesh.

Places of Re-integration in 2015-16

CASE STUDY

Missing for a decade, memoir of a life: Bindiya

Rescue: Bidniya was rescued by the staff members of Ashadeep on 08/07/2014 after information was received from the public about a woman loitering on the streets of Birubari area and behaving in socially unacceptable manner. The team reached the said location and brought her to Navachetana’s Transit Care at Rehabari, Guwahati. When asked to get down from the car, she did, but hurriedly ran towards the exit gate and tried to run away. However the nurses and other staff members were able to catch hold of her and brought her back.

Intervention:  Bindiya was ill kempt, muttering to self and carrying a pile of garbage that she wasn’t willing to part with. She was immediately given a bath, and provided with clothing and food. The Symptom Identification Scale and Mental Status Examination provided the picture of symptoms present at the time of rescue and admission. To get a more objective depiction of the same, PANSS, IDEAS and GAF were also administered. She was diagnosed with Chronic Schizophrenia and her pharmacotherapy started thereby. In the initial days, Bindiya had blunted affect, was irritable and attempts to carry out psychotherapeutic sessions failed as she would not cooperate and present a guarded attitude, or at other times, simply walk out from the room. She remained emotionally and socially withdrawn from others and communicating with her was often challenging as she would refuse to listen to anyone. For many days she refrained from maintaining personal hygiene and lacked toilet habits. The staff had to constantly prod her to carry out activities of daily living and over time they started providing her structured training for the same. Psychosocial rehabilitation in terms of cognitive retraining and token economy was started to help sustenance of goal directed behavior and her engagement in at least a basic few activities. 

Over time as her medications and therapeutic intervention continued, her active symptoms of psychopathology were minimized, and she was shifted to Navachetna (Rehab), at P.L.Campus, Bamunigaon on 27/12/2015. She was involved in household chores that required sharing responsibilities with other in-mates so that it facilitated socialization with others. She was also taught jute work that helped in refining her fine motor skills. In the course of her stay, it was noted that her sense of work responsibility was very high and she would never leave a job unfinished. The person, who once refused to cooperate with anyone, now participated in taking care of other in-mates as well. 

Discharge: Bindiya’s remote memory was largely intact and she had reported her home to be located in Jirrah village of Bankura district, West Bengal. Once the discharge recommendation was received from the Psychiatrist, her psychosocial status was assessed that revealed appreciable growth point scores and adequate functional levels. Her disability index had subdued to minimal and so did the positive and negative symptoms of schizophrenia. A plan for her reintegration with family was initiated and accordingly she was discharged on 21/02/2016.

When the reintegration team reached Bindiya’s place, the entire community gathered to welcome her. She was home after 10 long years! Her husband and children were at a loss of words to express their emotions. Over the years they had come to believe that she must have died while wandering on the streets. She was suffering from psychiatric illness for almost 30 years and though they sought treatment, they couldn’t afford to continue the medications due to financial challenges. She had given up on any hopes of homecoming, and over the years on streets, she accepted it as her life’s dictation.

And yet a spring did await her, and now that it has arrived, the winter shall only be a memoir.