KOSHISH is a nongovernmental organization working in Nepal, as a national self-help organization working in the field of mental health. The word "KOSHISH" means "making an effort”. KOSHISH follows a twin-track approach; advocacy and direct service delivery. Koshish is affilated with, Social Welfare Council under Ministry of Women, Children and Social Welface (Affiliation No. 25676) and registered in District Administration Office, Kathmandu (Registration No. 086/065) in 2008. Since 2008, advocacy for inclusion and dignity of people with mental health and psychosocial issues, as well as transforming lives of people living in vulnerable conditions, has been at the forefront of KOSHISH’s goals.
KOSHISH activities are focused on:
- Quality of life of people living with mental health and psychosocial issues is improved
- Reintegration of clients back into their communities
- Destigmatization of mental illnesses in Nepal
- Eliminate social, cultural, legal barriers regarding mental health and psychosocial disabilities issues
KOSHISH started as informal self-help group set up with self-experience modality with strong commitment, passion and interest. KOSHISH rescued the people living in severe mental health and psychosocial issue in streets through referral and cross referral of severe cases to “Samudaayik Manasik Swastha Sewa Kendra” in Danchi. The community based mental health program as a pilot was implemented in Mahadevbesi and Benighat of Dhading district. In 2010 in partnership with CBM, KOSHISH started Community Based Mental Health and Psychosocial Support (CBMHPSS) project in Dhading and Bhaktapur.
KOSHISH has evolved as a national self-help organization (Disable Peoples’ Organization) working in a twin-track approach. The milestones achieved are seen below:
- Self Help Organization: KOSHISH came into existence as NGO (DPO/Self Help Organization) in 2008 in spite of legal barrier that people having Mental Health and Psychosocial (MHPS) issues not being eligible to register the organization
- Inclusion of mental health and psychosocial disability:
- Inclusion in general health in Nepal Health Sector Support Program – II (NHSSP – II) 2010 - 2015.
- NHRC internalized the inclusion of Mental Health and Psychosocial disability in their strategy starting from 2013.
- Inclusion of mental health and psychosocial disability in election manifestos by major political parties of Nepal (Congress, UML and Maoist Centre) in local, federal and provincial election in (2016/17)
- Representation in NFD-N (2015): Mr. Matrika Devkota is representing as a central board member in the executive committee of the NFD-N since 2015
- Formulation of Multisectoral Action Plan (2014-2020): MAP (2013-2020) under non communicable diseases adopted by WHO, to be endorsed by Ministry of Health, KOSHISH’s advocacy brought back the document from the cabinet and make it more holistic and multi-disciplinary
- Establishment of Mental Health Focal Division & Focal Unit (2015): Mental Health Focal Division under Curative Service Division of Ministry of Health and Mental Health Focal Unit under Primary Health Care Revitalization Division (PHCRD) in 2015 under the policy of National Mental Health Policy – 1996
- Establishment of Mental Health Care Center: In government hospitals collaborating with NGOs and revised its budget allocation to MHPS issues although it’s not in function which needs a strong follow up and advocacy. And there is increase in the sum attributed for mental health sector continuously over the years
- National Health policy update: GoN formulated and brought in and implemented an updated National Health Policy – 2014 after 23 years including mental health as core component of health
- Allocation of budget for survey: for the comprehensive National Mental Health Survey in Nepal for the first time in 2016
- Adoption of Disability Right Act – 2017: Mainstreamed psychosocial disability as one of the major component, which includes separate provision for persons with MHPS disability regarding additional services and support. Furthermore, Clause 36 mentions that persons with MHPS disability will not be imprisoned in the name of treatment or protection regardless of what has been mentioned in prevailing laws
- Continuous Advocacy on inclusion: KOSHISH continuously raising voice for inclusion and mainstreaming in the area of health, disability, gender as cross-cutting issue
COMMUNITY BASED MENTAL HEALTH & PSYCHOSOCIAL SUPPORT
- Emergency Short Term Residential Center (2009): addressing abandoned and neglected people living severe MHPS issues and set an exemplary model where mental health problem are treatable and can be managed through proper care and support
- Change in working modality: from advocacy and specialized service incorporated in holistic model of community based MHPS support program with realization of importance of community involvement throughout the service delivery process
- Extension of CBMHPSS program (2014): as multi-year plan in 5 districts
- Integration of Mental Health Services: Primary Health Care System of government
- Capacity building of FCHVs: supported in identification, case referral, follow up and integration people with MHPS in their own community
- School Mental Health Initiatives (2015): assisted with tools and techniques to manage the psychosocial issues including Mass Conversion Disorder
- Extension of specialized care for male (2016): Establishment of Emergency Short Term Residential Center for males suffering from mental health and psychosocial issues after the earthquake
- Formation and mobilization of exclusive Self Help Group: of people with MHPS issue linking with livelihood support. This helps to break the social and stigma barrier among them
- Peer support group: members have been prepared as self-advocates and have formed delegation to Ministry of Health, PHCRD and Leprosy Control Division i.e. focal point for disability
Mental health and psycho-social well-being for all.
KOSHISH seeks to ensure dignified life for people with psychosocial problems through improving and implementing policies and legislation and expanding community-based mental health and psychosocial support.
Quality of life of people living with psychosocial problems is improved.
- Transparency: KOSHISH is an open book for all.
- Ethical: Maintaining confidentiality, privacy, and right treatment of the beneficiary.
- Informed: Sharing relevant message, data and statistics.
- Diversity: Encompass idea of acceptance and respect different ideas, opinions, background, expertise, culture and knowledge.
- Determined: We will not give up fighting against stigma associated with mental health
- Partnership: We believe in cooperation, together we can do more.
- Empathy: Not pity but respecting full dignity of person with mental health issue
- Integrity: We practice honesty, loyalty and sincerity