Patients’ and Carers’ column

The treatment I received from here helped me to realise & regain my strengths, here the treatment is focussed on rehabilitation, with which now I have rejoined my work which boosts my self-esteem..and now I can confidently say ‘I am also a productive member in this society..thanks to MGICMH’ ..A.N.

 I have found people who understand my illness and provide moral support to overcome it. My daily life is regularised after coming here. Before coming here I used to postpone/ escape from the tasks but now I am able to deal the things confidently rather than escaping from it. Psycho education, Family counselling helped me in improving interpersonal relationship with my parents and to improve my quality of life….K.S.N

When I came here with my aunt for consultation they had carried out a detailed assessment of her health, which motivated me to consult about my problem. I feel better after consultation, it’s a safe and secure place to ventilate our problems. My negative thoughts which were irritating for many years have slowly decreased. Now I am able to challenge my negative thoughts and my self esteem has increased. I hope this institution will grow and help a lot of people and the hospitality will be the same through out its life time….LJ

Carers’ column

My brother is suffering with bipolar disorder for many years. We went to 4 hospitals which are providing services for mental health problems. But the way we were received here was different from those, I feel the doctors here not only concentrated on the symptoms and drug treatment, but they included us (the family members) in the treatment planning. I hope those sessions will definitely help us for managing him at home better than before. In budding stage it self it is providing excellent service…I wish all the best for the team & MGICMH….V.R.

We admitted my mother in law who is suffering with OCD for more than 20 years. The nursing care was very good. The atmosphere was peaceful. Conducting group activities were much useful in our case. Change was noticed in her thinking. I hope this will definitely improve our Quality Of Life. Here the services are not limited to centre based, we felt very happy and relaxed when they extended their service & support with home visits, regularly enquiring regarding her health over phone and providing support whenever necessary, I wish success for the team…Mrs .S

We are fully satisfied for the hospitality and treatment given by the respective doctors of MGICMH and there is a lot of improvement in the behaviour as well as health side of our daughter…………..MrSVRKP & Mrs AP

Success vs complex stories

 

It is hard to define and achieve outcomes in the field of rehabilitation of psychiatric patients, in particular, in the context of NGO model which does have no support from the government whatsoever and has to depend mainly on payments made by families of patients and by occasional donations from good hearted public. Despite these mighty challenges, we feel that the achievements we made should not be totally overlooked by the society and the world. We have started evaluation of our service in a crude manner yet we feel still it is worth. Accordingly we gather feedback from all the inpatients and their families. We present the following cases (names changed) for the perusal of wider public.

 

Rajesh is a 21 year old single young man who lives with his parents who work as daily labourers. He has a brother and two sisters. He has moderate learning disability and also suffers from treatment resistant schizophrenia. His father misuses alcohol and blames his drinking on his social circumstances. Rajesh was also dependent on chewing tobacco product called MC and used to snatch these packets from small shops. He used to talk to himself and was verbally and physically aggressive towards his family members. For this reason he was chained to his bed with both hands and legs tied with a metal chain for 3 years prior to his admission to MGICMH. Rajesh’s father used to stay at home with a view to look after Rajesh which affected the family income. Rajesh was admitted to MGICMH for 6 weeks and received intensive treatment with Clozapine. His Ghutka habit was also addressed during the inpatient treatment. At the time of discharge, he was relieved from a prisoner state to a free person. He now carries out small scale activities and attends day treatment unit on a daily basis which provides a respite for the family. As a part of family intervention, Rajesh’s father’s dependence on alcohol was also addressed. Rajesh’s father also now attends for his work and family is now functioning at its maximum capacity. Rajesh was charged only Rs 150 a day for inpatient treatment which included accommodation, daily services for psychiatry, rehabilitation psychology, mental health nursing, occupational therapy and family therapy. The story is not over and it continues…….Rajesh and his family need an ongoing support on a long-term basis.

 

Kamala is a 25 year old unmarried woman who lives together with her parents and her brother’s family. Prior to relapse of her symptoms, Kamala used to work as a helper in a shop. She was admitted to MGICMH after she suffered from symptoms of Schizophrenia. Her family was very distressed because Kamala used to argue with everyone in the house and to accuse them of snatching the house from her in-laws. She used to hold paranoid delusions and to talk to herself. Prior to her admission to MGICMH she was admitted to psychiatric units 4 or 5 times and also received Electro Convulsive Therapy (ECT) number of times with a brief spell of improvement. Kamala was diagnosed to suffer from Treatment Resistant Schizophrenia and was treated with Clozapine at MGICMH. She was admitted for 1 month during which her symptoms resolved to a maximum extent. Subsequent to discharge she was invited to attend for day activities for few days before she started to work again as a helper in the shop she used to work before. Although she is not totally free of her symptoms due to intolerance of high doses of antipsychotics, she is able to go to work on a regular basis and is able to get on with her family members. Kamala was also charged Rs 150 per day for the inpatient treatment she received due to her family’s low income status. Again Kamala’s story is not over……….She and her family need a continued support from MGICMH on a long-term basis.

 

Both Rajesh and Kamala need monitoring of their blood counts as per protocol for the treatment with Clozapine on a weekly basis initially for 18 weeks followed by fortnightly monitoring for a year.

 

Kareemulla is a 33 year old vegetable vendor who lives with his wife and two young daughters. He approached MGICMH with a problem of alcohol dependence. He used to spend Rs 800 per day to buy alcohol by taking loans. He had to sell his house and his business was affected very badly. He also had to spend about 1 lakh rupees for the treatment of problems with his stomach, Liver and Pancreas in a private hospital. Despite 2 admissions to gastroenterology unit, he continued to drink till he was admitted to MGICMH. He stayed in MGICMH for 15 days as inpatient for detoxification followed by daily attendance for the group for alcoholics held at MGICMH for 15 days. Despite all these efforts, he drank alcohol one day which upset his young wife who brought him back to MGICMH for help. Fortunately he stopped drinking alcohol immediately and continues to attend the group on a weekly basis. Kareemulla was charged slightly higher than patients below poverty line due to his better financial position in general.

 

Satish is a 27 year married but separated young man who lives with his parents and a brother in a small village in Guntur district. The family owns half acre of farm land and leases out 4 acres of land to grow paddy. Satish’s wife has been living with her parents in a different town together with her daughter for the last 2 years. Since then Satish has been living with his parents. His symptoms started gradually as he started to believe that his own family had conspired against him and his wife and were the reason for his wife’s departure. He became more and more isolated and withdrew himself from his work responsibilities at the farm land.  Gradually he stopped eating and drinking as well. In Sept 2010, he was brought to MGICMH, Guntur for assessment and treatment. Satish has been diagnosed to suffer from Paranoid Schizophrenia with paranoid delusions against his family members. He needed 45 days of inpatient care which helped him to gain weight up to 43 KGs from 30 KGs at the time of admission. He refused to take medication following discharge. Despite a home visit to his village (50 kms away from Guntur), he remained adamant that he did not need medication. Due to this reason he relapsed and needed a second admission in May 2011 again for refusing to eat and drink. He was started on depot antipsychotic during this admission. It transpired that due to severe loss of weight, his in-laws were suspicious that he may be suffering from AIDS. Social interventions like liaising with his in-laws and educating them with information about Satish’s illness were done with partial success. Satish has been discharged to his parental home again with a follow up plan on outpatient basis.

 

The above cases illustrate the complex issues involved in supporting patients like Rajesh and Kamala whose families can never afford to provide the kind of treatment and support they received at MGICMH. We also noticed many families do not feel it is worth spending money for the treatment of mental illness. On the other hand none of the psychiatric services by the government are able to provide service as required by patients like Rajesh and Kamala where there was a need for assertive approach and additional efforts to educate the families.

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