Those who are affected by mental ailments, they do not have the understanding regarding their sicknesses



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The Project for rehabilitation and empowerment of mentally and physically retarded persons and defamed women and children , 2016-2023

As revealed by the Sri Lanka National Institute of Mental Health and from various Social research reports, 73% of the Sri Lankan population is subjected to stress at whatever the levels are. Out of this 18% are acute mental patients who should undergo treatments after hospitalization and the balance 29% should undergo clinical treatments. But many of them do not realize and accept that they are suffering from a mental ailment and even the occupants and the family members are not aware that they are suffering from a mental ailment. All of them are living with the rest of the society being subjected to various conflicts, pressurizing, ignoring and ridiculing of the rest of the society. This directly affects the progress of a developing country and reduces its advancement. Equally, by abusing women many crimes, abusing of children domestic violence which affects the personal liberty in the society.

There are key factors which influence the mentally affected persons not being coming forward for treatments, they are.


  1. Those who are affected by mental ailments, they do not have the understanding regarding their sicknesses. .

  2. The rest of the members of the family do not understand that this is a sickness.

  3. Though the affected person and his family members are aware of the sickness, they are not willingly to accept the same.

  4. . Though the mentally affected person and his family members are aware of the sickness, thinking that it would affect the family reputation, they do not readily come forward for treatments.

  5. Those who are mentally affected and those who are physically disabled being ignored, or being marginalized or being ridiculed or subjected to humiliation by the rest of the society.

  6. As most of the mentally affected persons are violent, the rest of the family members dislike to convince him or to get treatment due to fear. .

  7. By not taking treatments, due to economic factors,

  8. Lack of regional psychiatric clinics and rehabilitation centers.

The last thirty year civil war had a direct influence for the increase of these mental sickness and dishabilles this has been a tragedy especially more than in the areas, where there had been no war but in the war torn areas as well as in the marginal villages. Through this:

  1. Increase in domestic violence.

  2. The breakup of the family unit

  3. Increase in women abuse and also the increase in child abuse.

  4. Persecution of women and children

  5. Break up of education half way.

  6. Not paying attention to community health services.

  7. Unlimited Increase in number of disabled persons.

  8. Increase in number of acute mental patients loitering in streets.

For getting this position more acute, the contributory factors are the boundless economic poverty. Mental retarded, minimum of educational facilities available, and location being far away from the rest of the society.

In order to escape from this calamity, and for the purposes of joining this community too ,to get involved in the development activities of the country, long term permanent programs have to be launched quickly , with long term remedies, counseling rehabilitative and social and economic development methodologies .



THE AIM OF THE PROJECT

By means of training programs, to socialize as healthy and fruitful citizens , those who were subjected to mental sicknesses, the women and children who were abused , exploited and marginalized , who were subjected to abuse , sicknesses, and disabilities, by protective treatments and training guidelines .



THE PROJECT AREA :-

The Eastern and North Central Provinces

(Ampara , Batticaloa,Trincomalee , Anuradhapura and Polonnaruwa Districts)

THE PROJECT PERIOD

The original study period and operational period is five years.

The motivational and the follow up period is three years.

The full project period is eight years.



THE PROJECT COORDINATING PARTIES :-

  1. Ministry of local Government , all the District Secretaries, Divisional Secretaries , and Grama Niladharis

  2. The Ministry of Social Services, all the District Social Services Directors and welfare officials.

  3. The Ministry of Children's and women' Affairs, all the District Directors of Women and Children's Affairs and Welfare officers.

4. The Ministry of Health and Indigenous Medicine, all the District Medical Directors and Medical Officers of Community Health

5. The Ministry of Education, all the District Directors of Education, the principals , the trained teachers for special purposes, and school counseling teachers .

6. The Ministry of Industries and Professional Training, All the District Directors and entrepreneur training school principals

7. The Ministry of Defense and the Police Department, the relevant officials.

8. The Civil organizations of the area and main Social activists.

9. The religious leaders of the area.



THE METHODOLOGY OF PROJECT IMPLEMENTATION

  1. In the two provinces to undertake a preliminary feasibility study



  1. For the first stage of implementation, to select on priority criteria, three Divisional Secretariat Divisions and to implement in fifteen Divisional Secretariat Divisions.



  1. To start five District Project offices.



  1. Educating the supporting government and community institutions of this project.



  1. Establishing relevant coordinating committees of the governmental institutes.



  1. Implementing , community family units and educational programs for schools



  1. .Implementation of mental treatment mobile units.



  1. Helping for the development of health and water facilities.



  1. Implementation of broad methodologies to change the negative social attitudes regarding those who were affected by mental ailments, retarded and destitute persons.



  1. Building up voluntary community reform strengthening teams.



  1. The street loitering acute mental patients to be directed for residential treatments.

  2. Referring for treatments mentally affected identified persons in family units and in institutes.



  1. Starting short term District Rehabilitation centers.



  1. Implementation of necessary educational and professional training programs for the cured mental patients, retarded persons and the destitute persons.



  1. Those who complete the entrepreneurship programs to direct them to income generating activities or to employment institutes.



  1. To those who complete their entrepreneur training to introduce to the micro credit facilities and to other credit facilities.



  1. For those who complete the entrepreneur training, those who completed treatments, teams strengthened voluntarily, to create forum of voluntary teams building banking systems and building up social and cultural groups.



  1. To train voluntary monitoring follows up activists.



  1. Evaluation of activities for these persons who are being socialized to have a broad social promulgation at national levels.



  1. To conduct follow ups persuasion and supervision.



  1. At the end of the project period, the ownership of these resources shall be handed over to these rehabilitation units, under the supervision of the District Secretary.

After the first year of starting the project in parallel to the requirements of all the District Secretariat divisions, the project shall be operated.

THE PROJECT BENEFITS

  • Getting the due place in society for those who are affected by mental ailments, disabled and the destitute, by not becoming a burden to the society.



  • Minimizing of conflicts within the family unit and achieving a peaceful, and cooperative economic development.



  • Minimizing family violence, child abuse and women exploitation.



  • Providing protection, sanitation and nutrition to children and women, who are affected by mental disabilities, disabled and subjected to abuses and assaults.



  • Those who were subjected to mental sicknesses, disabled and destitute after being trained, making a contribution towards society's development.



  • Strengthening the society, by making a contribution to the national economy and thereby creating a healthy nation.

"The Community forums" who have got trained for the project shall take over the project in March 2023 and the Sri Lanka Hypnotists'Association will officially move out of the project.

THE ADMINISTRATIVE STRUCTURE OF THE PROJECT

  1. The Project custodian.



  1. The project Director

3. Medical officers treating mental diseases

(Western doctors, Ayurvedic Doctors, alternative community doctors, Community Health Doctors.)

4. Social Development specialist


5. Specialist Trained teacher for special situations
6. Specialist entrepreneur training special situations.
7. Chief Accounting officer
8 .Publication and Publicity officer
9. Computer operators
10. Project Coordinator


Sri Lanka Hypnotists' Association
01
04

01
01


01
01
01
05
01

FOR THE DISTRICT OF AMPARA (01)

District coordinating manager


Computer operator
Community Heath Development officer

Social Development officer

District Office Assistant
For workshops depending on the requirements the resource persons shall be deployed subject wise.

01
01


( One for each Divisional Secretariat Division)
( One for each Divisional Secretariat Division)
01



District coordinating manager


Computer operator
Community Heath Development officer

Social Development officer

District Office Assistant
For workshops depending on the requirements the resource persons shall be deployed subject wise

01
01


( One for each Divisional Secretariat Division)
(One for each Divisional Secretariat Division)

01


FOR THE DISTRICT OF BATTICALOA (02)

FOR THE DISTRICT OF TRINCOMALEE (03)

District coordinating manager


Computer operator
Community Heath Development officer

Social Development officer


District Office Assistant


For workshops depending on the requirements the resource persons shall be deployed subject wise

01
01


12

( One for each Divisional Secretariat Division)

12

( One for each Divisional Secretariat Division)


01


FOR THE DISTRICT OF ANURADHAPURA (04)

District coordinating manager


Computer operator
Community Heath Development officer

Social Development officer

District Office Assistant
For workshops depending on the requirements, the resource persons shall be deployed subject wise

01
01


( One for each Divisional Secretariat Division)
( One for each Divisional Secretariat Division)
01


FOR THE DISTRICT OF POLONNARUWA (05)

District coordinating manager


Computer operator
Community Heath Development officer

Social Development officer

District Office Assistant
For workshops depending on the requirements the resource persons shall be deployed subject wise

01
01


05

( One for each Divisional

Secretariat Division)
( One for each Divisional Secretariat Division)
01



IDETIFICATION, OF THE PATIENTS.

  1. Identification of the Psychosis patients

How to select psychosis patients ?

  1. collecting information from the psychiatric institute

  2. Director of National Institute of mental health.

  3. Consultant psychiatrist.

  4. Consultant in occupational medicine, a general practitioners



  1. Identification of the Neurosis patients. Ways of identifying the affected women and children :



  • At the Grama Niladhari Level,

  • At the Samurdhi Niladhri level ,

  • Through educative lectures and conferences,

  • By means of issuing notices and hand bills,

(In schools, in places of religious worship, and other common places where people gather,)

  • Making personal visits to houses and after discussions with the house mates.

(3)Identification of physically disabled persons.

(1) Reports obtained from government hospitals.

(2) Reports obtained from Divisional secretariats.

(3)In addition, by utilizing methodologies of identifying the aforesaid neurosis patients,



THE REASONS WHY THEY DO NOT TAKE MEDICINE IN THIS MANNER

  1. . Minor mental ailments, not knowing that they have a disease.

  2. .The fear that taking mental treatment is a reason to be ashamed and also those they would get marginalized in the society.

  3. .Due to economic problems

  4. .Lack of knowledge psychology and the inappropriate fear for it.

  5. .Due to no one coming forward to treat the patient.

(6).Due to the inconvenience of taking the patient to the hospital

(7) When in attempting to take treatments for women's ill treatments and assaults, the feeling that they would get similar treatments from those persons.

PRELIMINARY PREPARATIONS,

  • Selecting an appropriate common place,

Depending on the size of the District, and also on the number of Divisional secretariats, in the same district there may be several places.

  • Allocation of separate date for psychosis, a separate date for the neurosis patients also separate date for women and children and for the disabled patients, a separate date.

THE FIRST STAGE OF MEDICATION

  1. Categorization and identification of acute mental patients and compiling reports in respect of those patients,

(By the specialist psychologists, doctors and mental psychiatrists.)

  1. On behalf of their caretakers, conducting educational programs and explains our services.

( Schizophrenia, depression and other Psychosis ailments)

  1. Categorization and identification of minor mental patients. ( By Psychiatric doctors, doctors and .psycho scientists)

(4) With regard to minor mental patients to open up individual files for recording To educate such patients and the care takers and explaining regarding our services.

(Social phobia, Phobia, Stress disorders, OCD, Addiction, Sexual disorders(mentally) , Family problems, Women's problems, such children's problems ) ,



  1. Identification disabled patients (physically) and compiling a report pertaining to the sickness.



  1. Explaining our services required for the physically sick persons and how we can assist them, taking into consideration their views and that of the views of the care takers. Specialist doctors on physical ailments doctors and Physiotherapists.)

THE RESPONSE

PTSD

  1. Cognitive Therapy

Drug Treatment

Group Therapy,

Psycho dynamic

Psycho social rehabilitation

Hypnosis

Couple and family therapy

Creative Therapy for Adult

Creative Art Therapy for children



Treatment for Co morbid disorders

Getting addicted: Hypnosis Therapy

Counseling, Rehabilitation

Relaxation, Socialization

Behavior Therapy,

Drug Treatment

................................?

1st drug treatment

2nd Psycho Therapy

3rd Rehabilitation and Socialization

Depression

1st drug treatment

2nd Psycho Therapy and counseling


  • Anxiety

Drug Treatment Psycho Therapy

Counseling

Cognitive Therapy,

Socialization

All neurotic disorders



Neurotic Disorders

*Phobia - Meditation

- SRI

- Selective serotonin repudiate Inhibitors



- Anti Depressants

-Decongestions

- Relaxation

- Hypnos therapy

- Counseling


  • Obsessive Compulsive Disorder

  • Relaxation

  • Healthy eating and habits

  • avoid alcohol and nicotine

  • Get enough sleep

  • Meditation



  • Anxiety



  • Anti anxiety drugs



  • Relaxation

  • Counseling

  • RET

  • Psycho Therapy



  • Stammering



  • Speech and Language therapy,

  • Psychological therapy ,

  • Cognitive Therapy,

  • NLP

  • Counseling ,

  • Relaxation,

*Psycho sexual deformities.

*Family problems - Treatments

-Rehabilitation Therapy

- Drug Rehabilitation.

- Imputation rehabilitee program



THE PERIOD AFTER TREATMENT - ( The follow up period )

  1. Psychosis :

For the acute mental patients when removing out of the hospitals and also according to the views of the care takers ,to direct for further medication or for, rehabilitation.

When in that manner treatments are being made to make them socialize when after getting cured. And directing to a, professional level. . Otherwise to start a self employment to provide the necessary raw materials and the knowledge. and to prepare an environment to enhance the family income.



  1. For the Neurosis patients and the affected women

After treatments socialization on the wish of the family to provide them the guidelines required. For those who are not so to direct for a professional training or for a self employment and for that to provide the knowledge, advice and the raw materials. And secondly provide the necessary market for their products.

By inquiring as to whether this process is in operation, to solve the issues rising and to give encouragement to them.



  1. For the children :

For the destitute children after the treatments, to direct them to their studies again.

  • Finding out the causes to fall into such position and to prevent such problems to provide facilities to the family.

  • In such situations providing the necessary background for enhancing the sanitary, health, economic and social conditions.



  • To investigate the factors necessary for education and make a contribution (books, school bags, uniforms and shoes etc.)

  • To continuously to do monthly follow ups and looking after them.

4. Disabled elders and children ( physical deformities)

They after being given proper treatments, if long term treatments are necessary to continue giving such treatment



  • To provide them with the necessary supporting equipments.





  • To train them, depending on their capabilities for a professional level, training for self employments and to provide the necessary knowledge, guidance and raw materials for those.



  • To continuously supervise to ascertain whether this process is taking place and give encouragement to them.

5. For the family member of the sick .

To educate them how they should work with those patients and foe enhancing those to investigate and provide the necessary knowledge , guidance, and to introduce methodologies to enhance their economies and to provide the necessary factors for it. To provide the necessary psychological advice and the guidelines to overcome the depressions caused by being with those patients.



THE LINE OF ACTION WE TAKE TO ENHANCE SANITARY

AND HEALTH CONDITIONS

  • To provide the necessary raw materials and deploy service personnel to build up toilets or to repair the existing toilets.

  • If the toilet facilities they already have could not be used by the patients to provide the toilet facilities so that the patients can use them.

  • Provide the necessary advice, the raw materials and deploy service personnel to get other rooms, beds and household equipment's or to repair those.

  • To provide ancillaries necessary to those persons such as the supporting equipments.

(1) For those who cannot walk, after a proper study to provide such equipments as hand supports, artificial legs and other requirements.

(2) To provide hearing equipments o those who have hearing defects.

(3) If those who have vision defects to direct for the necessary treatments and to the modern equipments such as the white walking sticks,

(4) For those low income with defective eye sights to provide spectacles.

(5) For those patients who need eye surgery but who cannot afford to buy the lenses to provide such equipment sets.

(6) For the dump patients, to train their language (hand signaling), to their family members and to make them to attend to their work alone by them.

(7) If their houses do not have electricity connections, to give partial assistance to get the facility or to give the full electricity connection.

(8) If their houses are not provided with water facilities, to provide, wells, tube wells, water tanks and water purifying equipments.

(9) If their houses have shortcomings, for purposes of repairing those to supply the necessary metals, bricks, sand, cements, and roof sheets and deploy service personnel.

(10) For their access roads for the deformed persons where there are muddy areas, streams etc, to construct culverts and bridges.



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