Help Ashadeep Rehabilitate Homeless women with mental illness .

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Help us to reunite a homeless woman with mental illness back to her family with dignity….!!!

Homelessness amongst persons with mental illness is a common sight in developing societies like ours where psychiatrist/population ratio is one for every million and poverty looms large over majority of the overall population. Vulnerability within this populace is two-fold in case of homeless women with mental illness whose number have always been increasing. In 2005, Ashadeep initiated project ‘Navachetana’ for rehabilitation of Homeless women with Mental Illness. The prime objective of this project – ‘Navachetana’ is to provide care, treatment and rehabilitation measures to these women and to eventually re-integrate them with their families. Psychiatric, and other medical treatment as may be necessary for admitted women and care; Psychological and other social rehabilitation services are provided at the ‘Navachetana’ residential facilities by a team of qualified personnel including psychiatrists, psychologists, counselors, social workers, and trained health care staff.

For the last 10 years, Ashadeep has been rescuing and providing rehabilitation services to an average of 65-70 such women each year. A total of 610 homeless women with mental illness have been provided intervention since Ashadeep started working with this marginalized group and 565 of them have been reintegrated with their families spread across North Eastern states,Bihar, Uttar Pradesh, Madhya Pradesh, West Bengal, Andhra Pradesh, Karnataka, Gujarat, Rajasthan to Bangladesh and Nepal.

Ashadeep was initiated in the year 1996 , with the vision of achieving a life of better quality for persons with mental disorders and their families by initiating and strengthening mental health interventions in the Northeastern states of India. Ashadeep has always consistently strived to reach out to persons with mental disorder in all context and has been a major service provider in mental health interventions for one and all in the community.

Families are often at a loss of words when they are reunited with their loved ones whom they had lost due to the illness. Each family and each reintegration has a unique story to tell!

Our success story.......

Certain sights linger in our memories long after they have been witnessed. For many of us in Assam it was the graphic visual of that of a woman breast feeding a puppy which was unmindfully and repeatedly being telecasted on our TV screens. The woman on the screen seemed to be unperturbed by the swarm of people gathered around her. It was being reported that she had recently given birth to a girl child who was taken away by local people of the area where she had been wandering for many a months. A few days after this incident was captured by the media and the ensuing hue and cry on talk shows had subsided the woman was brought to Ashadeep by the Police (of Rowta Police Station).

At the time of admission she was displaying symptoms like self muttering, self smiling, uncooperative, and hallucinatory behavior. After she was bought to Navachetana, she was given the anti-rabies injection and attended by a Gynecologist as she was having post delivery related issues. She was diagnosed as having Schizophrenia by the Psychiatrist. Soon thereafter her treatment begun and she was provided with psychosocial inputs. She was called as Munni by fellow residents and staff members.

After recovering substantially and spending nearly about 18 months at Ashadeep, Munni started recollecting names of few of the landmarks near her residence. Her home was traced to an interior village in Udalguri District (BTAD). On reaching her village it was found that that her mother had passed away a couple of months ago and she was survived by two elder brothers and a sister-in-law. She developed symptoms of mental illness when she was around 16 years old. She was under treatment and medication under the consultation of the LGBRIMH at Tezpur. During this period she eloped with a man from her village who had approached her family for her hand in marriage. Post marriage she discontinued her medication which led to a relapse of the illness. Few months later her brother found her sitting near the Tangla Market where he learnt that she was pregnant and has been wandering there on the streets. He brought her to home where she gave birth to a healthy boy child. Her husband contacted her family and took her back to his home along with the boy child. Her situation deteriorated in the absence of any treatment and few weeks later she wandered away from home and started living on the streets. It had been 8 years of wandering in the streets before she found her way to Navachetana and was able to regain her former healthy self. Presently she is leading a normal life with her brothers and continues to receive treatment at Ashadeep’s OPD every month.

Your Support Will……..

Ensure that these people do not remain edifices in the footpaths of the roads which you daily pass by. Otherwise neglected and looked at with disgust for no fault of their own, homeless persons with mental illness will get an opportunity to pursue a life of dignity and secure their basic rights of good health and well being. They will continue to receive interventions by a team of qualified personnel including psychiatrists, psychologists, counselors, social workers, and trained residential health care staff at Ashadeep. With the ultimate goal of reuniting them back to their family.

Therefore, the break up of the required budget is given below:

Expenditure for 50 inmates at Navachetna-Rehabilitation Home for Homeless Mentally Ill Women for one- year.

Head	Per month per woman	Yearly for 50 women
Food Expenses	1400	8,40,000
Medicine expenses(Anti-Psychotic drugs)	450	2,70,000
Medicine expenses(general)	100	60,000
Daily needs: Toileteries( sanitary napkin,soap, Shampoo and detergent), (daily wear clothes ,undergarments, bedsheet, towel)	250	1,50,000

	Total amount	13,20,000/-

Salary for health support staff for 5 workers @9000/- = 5,40,000

TOTAL AMOUNT 18,60,000

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7th October 2016

REHABILITATION OF HOMELESS WOMEN WITH MENTAL ILLNESS

Two homes are being maintained under this activity –

Navachetana (Transit Care) for women with 30 beds located at Rehabari, Guwahati.
Navachetana (Rehab) for women with 30 beds located at Bamunigaon, 60 Kms from Guwahati.

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

Sl. No.	State	Women
1	Assam	43
2	Bihar	2
3	Maharashtra	2
4	West Bangal	3
5	Bangladesh	1
TOTAL		51

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.