Rebuilding lives

Vipin, an 18-year-old student, had to take a one-year gap in his academic career after completing his first PUC (class 11) due to mental illness. As he was keen to pursue his education, a psychiatric social worker introduced him to a supported education programme (SEP) to aid his academic reintegration. This support included improving his study skills and motivation, working with his family to enhance their support for his efforts, coordinating with his college to re-enrol him in the PUC second year, and providing reasonable accommodation. After one year in the SEP, he successfully passed his second PUC exam and was preparing for his NEET exams.

Ram, diagnosed with autism, faced challenges in securing employment due to a lack of social skills and societal prejudices. He joined the vocational rehabilitation programme (UDYOG) at NIMHANS, where a psychiatric social worker conducted an assessment of his vocational potential, provided vocational counselling, networked with prospective employers, offered job-related training and placement, and gave continued support for six months. Through vocational training in the hospitality sector, Ram gained skills and found stable employment, dispelling misconceptions about individuals with neurodevelopmental disorders in his community.

Menaka, a 40-year-old woman, was abandoned by her family due to mental illness and had been staying in a mental health hospital for many years. The psychiatric social work team traced her daughter with the help of local police and facilitated their reintegration. Today, Menaka efficiently takes care of her daughter, her house, and her mental health.

Arjun, who was diagnosed with a neurodevelopmental disability, participated in a five-day art workshop at NIMHANS last year. He was one of the 54 participants whose two canvas paintings were sold in the art exhibition, earning him around Rs 20,000. Today, he has his own webpage where he sells his paintings.

Suresh, from Turuvekere, a village in Karnataka, was diagnosed with a mental illness. His family lacked the funds for follow-ups or medications. The social worker made home visits and facilitated the acquisition of a Unique Disability Identity Card, which subsequently enabled him to receive a disability pension to help buy his medications.

The above clients (names changed) benefited from various models of psychosocial rehabilitation such as supported employment, supported education, social care, and empowerment through the facilitation of welfare benefits. These interventions aided their recovery and reintegration into the community. The goals of psychosocial rehabilitation are to help people with mental health disabilities develop skills to live, learn, and earn in the community, fostering inclusivity and independence. According to the World Health Organisation, it implies both improving individuals’ competency and inducing relevant environmental change.

In addition to these individual examples, a family of four, where three members (the mother and two sons) were diagnosed with mental illness and were from a poor background, was helped using the Family-Centric Rehabilitation model. A plan was prepared considering the family as a unit, which, in this case, made a significant difference to the successful outcome of their rehabilitation. The family was able to maintain their mental health recovery through medication adherence and regular follow-ups. The vocational placement facilitated for the two sons made a significant difference in the lifestyle of the family: they were able to procure groceries with their own money, providing a sense of autonomy and community status. Facilitation of social welfare and security measures such as disability pensions, bus concessions, and food and civil supply cards helped in taking care of the family’s daily basic and health care needs.

The above-mentioned models of psychosocial rehabilitation have been scientifically tested with research evidence and found to be feasible in their implementation. Clients recovering from mental illness need to be aware of such services and should reach out to centres that provide psychosocial rehabilitation services if they need help reintegrating back into society.

Psychosocial rehabilitation not only helps in recovery from mental health issues but also develops independence, self-confidence, and integration. It helps reduce stigma towards persons with mental illness and helps in creating an inclusive environment, which in turn plays a pivotal role in enhancing the quality of life for the persons with mental health and their families. However, for it to be successful, there needs to be synergy between all stakeholders in the community, such as users, care givers, non-governmental organisations, and the government. Society engagement, such as opportunities for work placement, entrepreneurship, training, etc., are important components of the success formula. Individuals and organisations in society can pitch in by volunteering their time and/or money to facilitate such rehabilitation.

(The writer is an additional professor at the Dept. of Psychiatric Social Work and Consultant Psychiatric Rehabilitation Services, NIMHANS.
This is the fifth of a DH-NIMHANS series on mental health)