District Mental Health Programme – (Ramnad)

Spiritual Healers from Erwadi Dargah attending Mental Health Awareness program
Dr. CRS moderating the session on faith and medicine as partners in care
Stake holders of the Dawa & Duva program
Mental health awareness programs for school students
Street plays for Mental Health promotion

Ramanathapuram is the Holy abode of Temples, Churches and Dargas, popularly known as RAMNAD with population of 13 Lakhs. Unfortunately, when we talking about the Mental Health, the people of Ramnad are gloomed with their Ignorance, Beliefs, misconceptions, Stigma and they strongly believed that Mental Illness is occurring due to Sins, Possession by Evil Spirit and Witch Craft which lead him to depend on Religious Healers/Traditional Healers than consulting Mental Health Services. The commonest method of treating mentally ill was simply chained and isolated them from the society or put them in asylum. These kind of attitudes and ignorance has led for the mushroom growth of asylums in Ramnad District, most of the asylums are run by the recovered patient.

On August 6th, 2001,a cloud of gloom engulfed Erwadi at around 5 a.m, a fire breaks out at one of these private homes(asylum) claiming 28 lives of mentally disabled people who were chained in the name of Treatment and 19 other inmates are sustained with severe burn injuries and bone fractures. This incident shook the nation, more than any event, which brought to light the deplorable state of mental health care in the country and programmes. After this incident the state Government announced a series of measures to regulate the functioning of homes for the mentally ill. It has ordered the immediate closure of all homes functioning in thatched sheds, other homes should obtain a license within a month and no home can be set up without a license. A committee was setup to formulate a separate program which is known as Ramnad District Mental Health Programme. For that committee, District collector was the chairman and Nodal officer, Mental Health Programme was the secretary. M.S.Chellamuthu Trust and Research Foundation was appointed as a Technical Advisor to the above said programme.

Initially, they have started sensitizing the entire Ramnad District revenue officers and officials concerned with this programme about the basic psychiatry and their role in the programme. Because most of the officials were totally ignorant of psychological disorders and also lacked in motivation. The Ramnad District Mental Health Programme was implemented in four phase manner.

  • Survey & IEC activities (Information, Education and Communication activities)
  • Treatment Programme
  • Training Programme
  • Rehabilitation Programme

Survey

A door to door survey was conducted by NSS volunteers and health workers. There were given two days intensive training on mental health and also in identification of mental illness. After identifying the needy people, they were given education on the importance of attending the mental health camps that were to be organized and also the benefits that they are going to receive including the venue and date of camp to be declared.

Awareness Programme

Simultaneously, the awareness programmes have been conducted throughout the Ramnad district through Street Theatres, Pamphlets and Mental Health Festivals which in turn educate the participants about Mental Health and eradicate their stigma against mental illness. There was a spontaneous response from the public and also a steep increase in the referral to Government Hospital. so far 125 street plays has been conducted in and around Ramnad district.

Training

Training was given to the Medical personnel, non- medical and para- medical people on basic psychiatry which includes identification and initiation of basic treatment.

Mental Health Camps

It was organized in 12 places. The team members comprise of General physician Pediatrician, Nero Physician, Psychiatrist, Psychologist, Social worker, Vocational Therapist, DDRO, Thasildar, VAO under the leadership of the District Collector who attend all the camps which gave big moral boost to the officials and general public. The response was spontaneous and over whelming. Uniqueness of the camp was that it was the first of its kind in Tamilnadu.

Under one roof the patients were examined by various specialists and treatment programme including rehabilitation programme was formulated on the spot for each patient. Various benefits including Disability Certificate, Free Bus Pass, Free Psychiatric medicines, Free Food Grains, Free land Pattas, for the landless poor disabled and also vocational rehabilitation programme. Most of the people were of lower social economic status and they had Malnutrition, skin lesion and contractures due to chaining, bone deformity because of chronic immobilization and presence of florid psychiatric features because of lack of proper psychiatric treatment. Family members were having low motivation and had lot of stigma and most of the patients were suffering from chronic Schizophrenia, Mental Retardation and Epilepsy.

Rehabilitation

The District Mental Health Programme-Ramnad District is an unique and created history by its innovative, pioneer work in the rehabilitation of the handicap in general and the mentally disabled in particular .Rehabilitation of the disabled is to integrate them into the mainstream life which required concerted and coordinated efforts of all stake holders and the general public. Without which the efforts put in will go into vain and the disabled will find it very difficult to get himself accepted fully in the society and will face neglect, discrimination and exploitation. The District Administration-Ramnad and Govt.of Tamil Nadu have entrusted the Rehabilitation Programme to M.S.Chellamuthu Trust and Research Foundation, Madurai which is the single largest institute which primarily working for Mental Health.

The Trust has wide range of activities which includes treatment, psycho-social rehabilitation, vocational training and placement which helps the persons with mental disabilities to recover and reintegrate with the mainstream community. The competent and dedicated team of mental health professionals ensures quality mental health care services. As per Govt. Order–(4D)No.1,Department of Social welfare and Nutritious Meal Programme, Govt. of Tamil Nadu), the M.S.Chellamuthu Trust and Research Foundation was appointed as Technical Consultant to Ramanathapuram District Mental Health Programme.

Satellite Vocational Rehabilitation Training Centers

Our Trust in coordination with District Administration-Ramnad has established the First Satellite Vocational Rehabilitation Center in the Collectorate Complex. Our Trust has played a vital role in promoting vocational training as it is an integral part of any rehabilitation programme, which will enhance the quality of life of the persons by facilitating the process of reintegration and enhance their self-esteem, which will elicit positive responses from the community. The work and the work skills will change the perception of the people towards mental disability. Because of the impact created by Our Trust, the District Administration has entrusted the task of expanding the services of Satellite Vocational Rehabilitation Training Centers to Our Trust. Now there are 11 Vocational Rehabilitation Training Centers in the following places. Ramanathapuram district.

Activities of these centers are

These centers are managed by a Vocational Instructor, Physiotherapist and two assistants.
The following are the Vocational trades identified and training are being given:

In these centers, some economic activities and related trainings are being identified and work opportunities and income would be generated continuously for them. Those who will be placed in jobs would have regular follow up through these centers.

The recovered / trained persons are motivated to start their own enterprises with the financial assistance of District Administration which in turn help them to enhance their Quality of Life and their social dignity.

Significance of the Programme

The Benefits extended to the trainees

Peoples committee

Our Trust has emphasized the importance of Peoples Participation in the process of Treatment and Rehabilitation. The Peoples Committee is comprising of village leaders, prominent persons in the community, NGOs working in the respective area, parents of disabled beneficiaries, officials representing Government Department etc. this local committee consisting of 8 members is meeting once in 1 month to plan and review activities of the Vocational Rehabilitation Training Centers.

Working with Family

Working with family is very essential because they are the one who bear the burden posed by their disabled members. They require information, knowledge and skill to manage better their disabled members in their family environment. In the beginning of this programme, Our Trust has conducted periodic meeting for the family members to create awareness about the mental disabilities which in turn motivate them to take keen part in rehabilitation activities.

Self Help Groups

Our Trust has initiated the formation of Self Help Groups among disabled members and their family members is taking place throughout the district. Forming self-help groups at the district level among the disabled members is the first of its kind in India. Around 180 Self Help Groups are started and most of them have started opening the bank accounts. The first self help group based at Ramanathapuram VRTC got the bank loan to start paper cup manufacturing unit in the center itself.