Mental Health Specialized Care Program

Program Background "A 'short term' residential emergency relieve center' strives to provide holistic treatment that includes psychotropic drugs, counseling, recreational activities and range of therapies for people with mental health problems. The ultimate objective is to rehabilitate the clients into their family and community" People with severe mental distress in Nepal are chained, tied and locked up at homes or are abandoned in the streets. Such persons can be commonly sighted wandering in the streets. It remains as a silent epidemic and a neglected health issue in Nepal. The history and establishment of KOSHISH and its Short Term Emergency Residential Center began with one person's passion and interest to work for the cause of people suffering from Mental Health problems. This untold struggle and perseverance is the reason why KOSHISH today is the one and only pioneer organization working in Mental Health sector. In the initial years, before the establishment of KOSHISH, the hardship of the man's effort was visible in successful individual life changes lives of different people suffering from Mental illness. Under the Mental Health Specialized Care program, KOSHISH operates 2 transit centers, separately for male and female, where people with mental health problems are admitted for recovery. While the female center was opened in 2011 with the capacity of 40 beds, KOSHISH was able to open the male center only from the beginning of 2016 with the capacity of 30 beds. The transit center provides holistic care, combining medical expertise with human affection, to aid the timely recovery of the beneficiaries before they are reintegrated into their own families and communities. While both the centers are located in Lalitpur district, they receive persons with mental health problems from all across the country. KOSHISH facilitates the process of rehabilitation by identifying the family, and providing psychosocial education to the family members as well as the community. The Transit Home ensures that the women and girls reintegrated into their families live a life with dignity and respect. KOSHISH's services has benefitted many who previously were deprived of treatment or resorted to traditional healers. This program has immensely become successful to set the example that mental health and psychosocial problems are treatable and can be managed through proper care and support challenging to deeply rooted social stigma and misconception. Vision: To improve the quality of life of persons with mental illness through treatment and their reintegration into the family and community that will provide an opportunity to live a dignified life. Objective: Provide multidisciplinary treatment (clinical, psychological and social support) in a residential care to abandoned persons, especially women of reproductive age (WRA) with mental health problems and reintegrate back for their community living. Progam intervention: I. Rescued and Received Person with mental health problems are rescued or received from streets or from locked up conditions at home. Awareness is created through psychoeducation given in the field, through social workers, mass media or through the distribution of IEC materials. Similarly many were received based on referrals received from government organizations, non-governmental organizations, families and individuals II. Residential Support Specialized care, including psychiatric treatment, psychosocial counseling, nursing care, medication as well as food and accommodation were provided to the beneficiaries of residential care. The persons were also involved in various recreational and therapeutic activities as a way of therapy as well as relaxation. III. Reintegration Following recovery, upon the authorization of the psychiatrist, the persons were reintegrated back into their families and communities. In cases where the families were not identified, they were rehabilitated into other organizations that provide long-term care to destitute men and women. IV. Psycho-education and Follow-ups Following reintegration in the community, psycho-education programs were conducted for family and community members for sensitization of the issue and to minimize the commonly held misconceptions about mental health. In addition to it, follow-ups on reintegrated beneficiaries were made to understand how they were coping in familial setting, their current situation in their home and their family's response towards them. V. Therapeutic involvement Therapeutic involvement is an important activity that takes place at the Transit Center. Activities like beads making, card making, Nepali handicraft box and dairies making, yoga, dance therapy, growing small kitchen vegetables etc. are carried out by the beneficiaries with the support of KOSHISH staff. We have understood that our beneficiaries are people with mental health problems which means that they have difficulties to perform normal task. To bring them to their normal self through our Transit home care and support is a challenge in itself and engaging them into therapeutic activities and linking them to their economic empowerment has been a BIG challenge ahead of us. In this regard, therapeutic activities aim to engage our beneficiaries into taking up small manageable project that will help - Distract their mind - Concentration building exercise - Also fun to work at due to use of different beautiful colors - Work in group that helps train them into team work since we reintegrate our beneficiaries into communities - Some focus will be on their economic empowerment - Skill development and Gross/fine motor skills - Reduction in pain, social anxiety, depression - Prevent social isolation