Trust Shanthivanam
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Shanthivanam

In Management of Schizophrenia, treating with anti-psychotic drug alone is not sufficient. Treatments like psychosocial rehabilitation, improving the Communication & Social Skills, vocational training is very essential for comprehensive care of such Patients. In spite of the best efforts statistically almost 1/3rd of the patients with schizophrenia don’t respond to any of the above mentioned treatments and may sometimes show only partial improvement.

Some patients even when they are at home are quite troublesome to the family as well as to the community. They are aggressive, abusive, destructive quarrelsome or very negativistic, not communicating, stupors with very poor self care.

For these resistant patients antipsychotic drugs don’t give the expected improvement. With these patients at home, marriage of siblings and carrying out family functions become difficult or impossible. Family members are dejected, depressed and sometimes on the verge of breakdown.
If such illness develops at a young age, it tends to become chronic and this type usually forms the major emotional and financial burdens for their families. Some patients unable to get along with the society drift, disappear into the crowds far away from their homes losing their identity (Drift Hypothesis and selection Hypothesis). They are the “Wandering Lunatics” without any identity, shelter and living next to street animals.

Though the problem of homeless wandering mental stage is a global one, it reaches a pathetic state in India. There are approximately 1 Million homeless persons in which 4,00,000 are wandering mentally ill in India.

When we travel or walk on the roads, all of us see mentally ill people in a bad shape. Most of them are in totter, walk around aimlessly, gesturing and harming themselves.

Some even sing, others store the foul smelling garbage in their torn bags. It is a pathetic state to see even dogs vying for food with them in the garbage dumps. Mentally ill women with ragged clothes that do not cover them properly, their hair matted with grime are a very pathetic sight to see. Some even lie on the ground unmindful of the vagaries of weather.

They do not even know where they came from. Most of us pity them but do not stop to help them and soon forget about them. Some even make them a Laughing Stock. We have a misconception that they are aggressive and destructive. Family and society that is bound to protect, and care them are responsible for this pathetic condition. But can we ignore them? Shouldn’t someone take initiative to care for them?

Though we cannot adopt and care all the destitute, atleast to care a part of them as an initiative, TRUST opened SHANTHIVANAM to give humane, love and care with adequate treatment and rehabilitation and finally every effort to reintegrate them with their families.

Road Map of Shanthivanam

Initially in 2003, some homeless patients referred were cared in Secretary’s hospital setting. As the number of patients increased, we shifted to a rented building and with great difficulty we constructed and we moved to Shanthivanam on 02.09.2005.

Rescue Strategies

Once the information about a troubled homeless mentally ill reaches us – the rescue team comprising of social workers, helpers and nurses reach the site to identify whether the person is mentally ill or not. If so, FIR is filed and patient shifted to psychiatric hospital.

Self care, hygiene and nutrition are ensured. Co-morbid, physical illness are identified and treated. We had seen mainly anemia, skin disorders, bone injuries, TB, HIV, pregnancy, burns. As common accompaniment of the wandering mentally ill. Psychiatric disorders are treated. Once he / she is stabilized then he / she is transferred to Shanthivanam – Residential care.

The common diagnosis of these patients are majority Schizophrenia, Bipolar Disorder, Substance Induced Psychosis, severe depression, mental retardation.

National integrity could be seen in Shanthivanam as patients from all states, different religion, and languages are sheltered here.

Rehabilitation / Recreation Strategy

Our aim is not to feed them, give maximum to sedate but to transform their whole personality and to enable them to be independent with the self – dignity restored.

Rehabilitation involves

  • 1.To structure the day for the patients.
  • 2.Restore and balance activities uniformly.
  • 3.Channelize the interest and the potentials of the nature in a productive way.
  • 4.Cognitive rehabilitation.
  • 5.Therapeutic activities to improved task related skills, communication skills etc.,
  • 6.Play and Recreation.
  • 7.Yoga and prayers

We have at present

  • 1.Computer Training
  • 2.Tailoring and Embroidery
  • 3.Marketing Managements
  • 4.Home Industry Training – Phenyle, soap oil, candle, incense stick, etc..
  • 5.Go green activities – paper cover, carry bags
  • 6.Arts and Craft Unit – Art salt, Mural creation
  • 7.Painting Unit - Emboss Painting
  • 8.Rural Technology – Areca Leaf Plates, Organic Fertilizer, Kitchen Garden
  • 9.White Revolution - Cow rearing unit.

Recreation and Games

Daily residents are involved in various games and yoga. In all the functions organized by TRUST, our residents show their cultural talents which were appreciated by cine artists themselves.

Our residents have competed in various sports competition in district level and got various medals including gold medals which are again a feather on their cap.

Every quarter, residents are taken to 2 days tour to all part of Tamilnadu & Kerala. We thank the sponsor who helped us to organize these tours.

Reunion Strategy

Networking with other NGO’s, media, various government welfare departments is essential. Though networking we first find whether the address clue is valid. On confirmation our social workers visit that place, explain to family members about the nature of illness, educate the community, explain about the myths and misconceptions and bring the family to our centre to reintegrate the patient with them. We did have some bitter experiences during this with rejection by the family, community, sometimes violence. We had to seek the help of police to mediate with the family.

We also give the follow ups but our attempts are not always successful. Main difficulties faced is that the families frequently shift residence, lack of man power in our agency.

Ultimately the success of this programme is mainly due to our team work from Doctors to Caretakers.

If we find that reunion the patient will affect his progress, again face discrimination, or if the family members are too poor or old to care the patient, we bring them back to Shanthivanam itself. In spite of these efforts during follow ups we were taken backed many patients missing again due to poor psychosocial and medical negligence.

We acknowledge help rendered by Shradha Foundation, Mumbai an NGO, with similar ideology to reunite North Indian patients.

Ultimately the success of this programme is mainly due to the dedicated team from Doctors to Caretakers, sponsors who all along have shared our burden.

Now Government of Tamilnadu has realized the need of sheltering homeless mentally ill and has entrusted the responsibility of adopting atleast another 100 patients per year. This again will add huge burden to our maintenance. We appeal to every one of you to support this noble cause.