CNMH's Social Model approach to Mental Health Care
By Bidya Maharjan - Programme DevelopmentOfficer
Raju is a 32-year-old male who has suffered from mental distress for over 10 years and was medically diagnosed with schizophrenia and prescribed medication two years ago. However, he has not taken medication consistently, and as such, his condition has worsened. Raju lives with his mother and older brother. Raju’s 72-year-old mother is his sole carer and both Raju and his brother are entirely dependent on her for their basic everyday needs, including bathing and eating. Raju’s mother is also in charge of administering and monitoring his medication intake. Raju’s mother is greatly distressed by the situation, but continues to provide for her sons in her old age. As an aging caregiver, Raju’s mother is deeply concerned about her son’s will fare when she is no longer around. Referencing her age, Raju’s mother stated: “I have to do everything for my sons and I just want to die sometimes” .Providing an example of a time when she was hospitalized for three days then spent two further days at the home of a relative for further recovery, she tells that neither of her sons were able to cook for the entirety of the time she spent away from the household and as a result they relied on eating dried goods. She then stated: “If I die, I want them to die as well” or “I want them to die before me” indicating she is worried about their well-being when she is gone.
Raju’s mother holds deep beliefs that relatives of the family have cursed both Raju and the family home with black magic and that is why he is ‘pagal’ (mentally unstable). As a result, she sought the help of traditional healers in the past, to no avail. Approximately two year ago Chhahari was introduced to her through the community member and the family has been receiving both social and financial support ever since. The family is under immense financial distress and they live off of intermittent financial help from family members who no longer live in the household and from the senior citizen allowance that Raju’s mother collects monthly. When Raju was well he worked as a tour guide and as a waiter. However, the illness coupled with back pain from an injury he sustained when he jumped from a window of the family home after hearing a voice that told him to do so has hindered his ability to work. Moreover, this has left him socially isolated. Raju was quick to express his appreciation for our company during home visits on multiple occasions. Though living in a state of financial distress, the social support offered by CNMH is more vital to the family’s well-being. The entire family is incredibly stigmatized in the community and as a result the family suffers from social isolation. When Raju is asked about relationships outside of his home, he speaks exclusively of his relationship with Suraj (chhahari’s client), who he socializes with at CNMH. This provides an important example of the social network that has emerged as the result of CNMH’s Social Model approach to mental health care. The approach has facilitated positive relationships in the community that act as supportive relationships for clients who are socially excluded and isolated.
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