"Practical Ideas for Rehabilitation"

(The following is taken from a longer paper entitled Empowering the Impaired by Ishita Sanyal, Director of a rehabilitation centre and clubhouse in Calcutta, India.)

Developments in the fields of science and technology have revolutionized Human Life at material level. But in actuality, this progress is only superficial: underneath modern men and women are living in conditions of great mental and emotional stress, even in developed and affluent countries. People from all over the world irrespective of culture and economic background suffer from mental illness and though a number of researches are carried out worldwide but till date it has not been possible to resolve the problem.

The most neglected invisible problem of the society in a developing country like India is the burden of mental problem, its effects and its outcome in the coming years. The World Health Organisation has warned that many countries will be unable to cope with a predicted boom in Mental Illness over the next decade. According to Dr. Gro Brundtland, the former head of WHO, “If we don’t deal with Mental Illness, there is a burden not only on Mentally Ill, on their families, their communities, there is an economic burden if we don’t take care of people who need our care and treatment.”
Few Facts

  In India over 125 million people suffer from Mental Illness.
  Prevalence rates have increased due to poverty, illiteracy, urbanization, industrialization, discrimination,
   better diagnostic methods, increased public awareness.
  After all drug treatment 33% of patients do not improve.
  Estimated population of chronic psychotic patients in India will be 50 millions by 2010.

But even then the government had no other option but to allocate funds on physical illness or disabilities like cancer, AIDS or any other problem than on Mental Illness. Lack of economic resources along with lack of professionals in the field has made the scenario even bleaker and worse. In India till date a person suffering from mental illness fails to receive any support either from Government or from any organisation. Disability Card, which is issued for all other disabilities except mental illness have remained a dream for us those who are living in West Bengal. Even the support of Disability Commissioner in this issue failed to provide any needed solution.

The mental problem is an invisible problem and so people cannot feel it or visualize the impact of the problem. Neither can they understand the impact it can create on the individual who is affected and his family members. The society is apprehending them as a burden and not putting efforts to utilize their potentialities or putting adequate efforts to change them again in to a productive member of the society.

The problem with illness like Schizophrenia is even more. They often remain a burden to the society. Some live their whole lives within the four walls of their dark room, remaining secluded and accepting a sedentary lifestyle where they spend the day and night without doing any effective work. They live their life on the mercy of other family members.

It is really difficult for the family members too, to make arrangement for a non-productive family member’s food, clothing, shelter and ever increasing cost of pharmaco-therapy. So these people, who are suffering through no fault of t heir own, are sent to homes or government hospitals, which are even worse than jails. Little attention is paid to their human rights, their feelings or their emotions –although a large part of their problem centres on feelings and emotions. Some start believing that they are not members of this world anymore – they are here by mistake or by chance not by choice. For some the agony is unbearable and they comit suicide. – some dare not as they are too weak physically and mentally to take a bold step like that.

To improve the quality of life of these persons rehabilitation centers are needed. These can provide them with vocational training to give them hope: to work on bringing back motivation, to remove their apathy and lack of drive and to make them capable to start earning.

It is seen that in urban populations the most important need for a person suffering from mental illness like schizophrenia is work and economic independence. So vocational training has the possibility of making them productive and is a method to reach more people.

Vocational training- People from both western & eastern world can overcome the burden of the disease if they can successfully employ themselves in creative productive works. Even in India, where a person gets too much support & does not need to earn money due to over protectiveness of parents, -the prognosis & functional level remains below others who are actively participating in rehabilitation process.

Selection of Vocational Training- Selection of Vocational training depends on the individual aptitude ability & interest of the candidate. Often the parents who accompany the patient have a preconceived idea about their child’s capabilities. They often try to guide us & discourage us about some Vocational training which they think cannot be suitable for their child. It has been seen so far that almost everyone has some creative abilities and if this can be successfully utilized it can help them in the long run to overcome their problems and help them towards becoming a productive member of society. They can utilize skills learned to help them reduce their anxiety and in some cases to earn their livelihood.

  A Few Simple Methods of Vocational training-
Collage works often help people to reduce their anger & aggression, water colours & works with plaster of paris helps them to overcome compulsive tendencies in them.

To unfold the hidden capabilities of these person we always encourage them to explore their capabilities starting from simple drawing, fabric works, glass painting, Block printing with vegetables, colourful earthen pots, colourful earthen wall hangings, jute works, jute decorative folders, bead work, bead ornaments, animals made of beads, mobile cover, embroidery etc.

Few Simple Techniques- At First we ask the clients to explore with colours & draw pictures. Within a few weeks, we can thus identify the person’s capabilities in drawing, painting & fabric works. Those who cannot draw or paint well or if they have trembling hands for which they do not have control over their brush are asked to cut the vegetables like potatoes, ladies finger whichever is available in their home in different shapes. They are then asked to clolour card/ file / clothes through the blocks developed by them or their friends from these vegetables. This is the simplest & attractive training programme where a client becomes active in a very short period of time. Other clients who are working for years together then give the final touch to the handicraft products developed by them.

Fabric works- Fabric works can also be started with block printing. As we lack funds we cannot afford to waste our clothes in the hands of person who are yet to gain control over their fabric works. For this reason starting with their own old ganjee or clothes help to practice them without any wastage. They too feel proud decorating their own clothes themselves. As they gain control we give them clothes to do it. We often give strips of clothes where they do the fabric works, and then it is stitched to the ganjee or shirt, which then looks attractive.

Glass Painting- This can be a very good handicraft product. To start with we often asked them to do simple geometric figures & then proceed to more complex drawing patterns.

Earthen pots, wall hangings- This too is started with line drawing, or geometrical figures, which is later, developed in to attractive drawings/paintings.
Handicrafts Works-This is started with Kantha stitch, stitching falls in a sari & then they learn other stitches & make table cloths, table mats, napkins, Handkerchief, tea cosy trey clothes, salwar suits, saris etc.

Marketing the products- Marketing the products is not very easy especially in India where handicraft items are readily available. The success of this sort of rehabilitation programme for persons with mental illness depends on the perseverance, the ability to motivate others, to make it a mental health movement. If the parents’ group makes it a practice to buy & only buy the products made by their children then it can be easy to get the initial market. This certainly doesn’t mean that they will buy only the products made by their own child- but think of all suffers as their children & buy the products made by them. If this can be made a movement like “swadeshi movement”developed by Gandhiji can be developed. And if the parents, their family members & friends have feelings for the cause & can start developing the habit of buying the products made by these persons with mental illness, then may be one day we will be able to economically rehabilitate every one of them; may be we would be able to change the world for them.

But we must be very rigid about the quality of the products, as no one should buy the products made by them out of sympathy.
Computer- Computer training is suitable not only for the Western world but also for eastern world .We are providing computer training for years together and all our clients are computer literate.

Computer often provides a tool for psycho education, social rehabilitation & economic rehabilitation too. The person who comes to our center at first lacks the self-confidence and self-identity. They are not sure about themselves. Writing their names on computer screens in different styles gives them the pleasure to learn more. The knowledge of the Internet helps them to get proper psycho education about their sufferings and possible solutions. This helps them to learn about their difficulties in a safe, criticism-free environment.

As they generally lose control over their lives – gaining control over a machine like computer helps them to gain confidence & desire to gain control over their lives. Computer training along with spoken English classes often helps them to get some jobs in nearby areas. They can even do computer typing in small computer institutes that have grown enormously in India or other developing countries.

The role of Parents in Vocational Training- Parents have a very important role to play in the rehabilitation of persons suffering from mental illness. It has been seen that supportive parents who are not overprotective can help their child to gain adequate confidence & functional level & on the other hand too much overprotective parents creates a hindrance towards the growth & development of their affected child.

Vocational training along with learning few basic life skills for their proper functioning like going to the bank, depositing electricity bills, marketing the day to day products, taking a few responsibilities at home, looking after their parents, helps to improve their functional level and make them self-dependent. We also have some fixed responsibilities for all the clients at the centr: eg some setting the mat on the floor; some distributing the tea, some selling the products during exhibition; elder clients helping the younger ones to learn the training programmes. As we have to run the center without any monetary support from government or any organisation we try to utilize the human resources of our clients. This not only reduces the running cost but also helps to regain the lost confidence of our clients.

Social rehabilitation – This is the most important need for the people suffering from these disorders. Whenever, any human being suffers from any disease or crisis it is human to want the support, the comfort of family members, friends and community. This culture still now prevails in India – though there is a breakdown of extended family, due to the impact of Western influence on Indian society – but till now there is a huge difference between the lifestyle of Indians and that of the western world. Till now people care for their family members; parents support their children till their death and siblings take care of their affected family member. Till now the Rehabilitation centers run by the self-support groups of India are more effective than those run by professionals. In this background where the bondage of love and understanding is important, social rehabilitation of the sufferers is important.

Due to stigma, due to hopelessness, due to fear of rejection – the sufferers often try to avoid interacting with the society. This creates a barrier. Self Support groups helps them to first get the social acceptance. “I am still loved & cared by so many group members” help them to get the needed support & guidance. It is really surprising to see how they help their fellow friends during the annual tours from our center.
A few important things for proper rehabilitation are developing the feeling of togetherness, the bondage, the love, the “family feeling” – that we all belong to the same family / community. This helps a lot to overcome their deep-rooted insecurities & anxieties.


-Ishita Sanyal 2006
Founder Secretary, Turning Point, a rehabilitation center.
Director Disha, a child guidance center.
Member of WFSAD (World Fellowship for Schizophrenia & allied disorder)
Indian Representative of ISPS (The International Society for Psychological Treatment of Schizophrenias & other Psychoses)
Director of NAMI, India, Eastern Region.
Presenters mailing Address-27 Jadavpur East Road, Kolkata-700032
West Bengal, India
E Mail address-ishitasanyal@hotmail.com
Phone Number-9830069106/24392316


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