Ethiopia is a country of 78million people that has onlyone psychiatric hospital with200 beds, a large outpatientpopulation and only elevenpsychiatrists. However, thissmall mental health fraterni-ty is trying to do somethingabout this. They haveundertaken a number of ini-tiatives under the leadershipof Dr. Atalay Alem.

The first initiative was tohost in April 2006 the“Mental Health in Africa:Time for Action” congress ofthe African PsychiatricAssociation. The conferencewas a landmark in Africanmental health, being the first of its kind for many years. Itbrought together around 300 delegates from all psychiatric disci-plines from sub-Saharan Africa. Among those taking part wereprofessionals from Ethiopia, Mali, Chad, Sierra Leone, Sudan,Kenya, Uganda, Tanzania, Malawi and South Africa.

Thomas Walunguba, chairman of the Uganda SchizophreniaFellowship, and I were proud to attend. The meeting generatedan aura of optimism, friendship and cooperation. It was notablethat prominent psychiatrists from outside Africa shared a leadingrole, lending their support and expertise to the proceedings.

The second initiative, reported at the congress, was research onmental illness being conducted in Ethiopia. Areas of studyincluded: Violence against Women; Pathways to Care; and

Economic Impact ofSchizophrenia and Mortalityin Schizophrenia. For the lat-ter it was reported that theincidence of infectious diseaseamong people with schizo-phrenia is high and this is alsoa factor in premature death.

The Pathways to Care study(authors Prof. Alan Flisher, Dr.Atalay Alem and Dr. YonasBahre-Tebeb) found that whenhelp was first sought, “ if thevisit was not with the psychi-atric service, native or religioushealers played a much biggerrole as the first port of call thandoctors or any other modernhealth care providers. Seeking

care from traditional healers is a reflection of the prevailing beliefamong Ethiopians that mental illnesses are caused by supernaturalor other outside forces. It also reflects the fact that traditional heal-ing services are more accessible, acceptable and affordable thanmodern treatment. Hence, people consider psychiatric treatmentonly after they exhaust all other possible alternatives ”.

The third initiative is the partnership program between theUniversity of Addis Ababa and the University of Toronto,spearheaded by Dr. Clare Pain in Toronto and Dr. AtalayAlem in Addis Ababa. Three times a year two staff psychia-trists and a resident psychiatrist from Toronto go to Addis totrain young doctors in psychiatry. The first group of sevenpsychiatrists will graduate this year.

Wor ld Fe l l owsh ip fo r S ch i zoph ren ia and A l l i ed D i so rde rs Th i rd Qua r t e r 2006

WFSAD Newsletter

Initiatives in Ethiopia ...................................................... 2Glimpses from the Asia Pacific Forum ............................ 4Practical Ideas for Rehabilitation..................................... 8

Personal Story ................................................................. 9Regional News ............................................................... 10Members’ Update ........................................................... 11

Dr. Atalay Alem in the Amanuel Psychiatric Hosipital in Addis Ababa Photo: John Morstad / Globe & Mail

(continued on page 2)

Initiatives in EthiopaBy Diane Froggatt

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 20062

Cover Story:

Focusing on Realistic Actions

Among the international delegates at thecongress, Professor Norman Sartorius, for-mer president of the World PsychiatricAssociation, spoke of the need to focus onrealistic horizons – things that the psychi-atric professions do well and things whichcan be reasonably achieved. Long termgoals, he said, are of no value to anyonewhen governments change frequently. Hesuggested that the allied professionalsshould meet together everywhere in Africaand that we should invest in a new genera-tion of psychiatrists. [Ed note: the nextmeeting of this association is scheduled forMarch 2007 in Nairobi.]

Rachel Jenkins, Director, WHOCollaborating Centre, Institute of Psychiatry,London, spoke of the need for locally tai-lored solutions. Strategic planning shouldincorporate the idea that mental healthshould be embedded in government and dis-trict health plans. There should be effectivelinks between primary and specialist care,good practice guidelines, liaison and mentalhealth promotion in the community includ-

ing schools, NGOs, police, prisons, thesocial sector and child protection. A dialogueshould ensue with traditional healers.

Emeritus Professor Sir David Goldberg,UK Institute of Psychiatry, emphasized theneed to adapt training to the needs of thosedoing the work. He spoke about and illus-trated training courses that he has beeninvolved with in India, Pakistan and

This newsletter is an internationalbulletin published by the WorldFellowship for Schizophrenia andAllied Disorders (WFSAD). Ourgoal is to provide information tothe world self-help movement forschizophrenia and allied disordersthat includes national local organi-zations, individuals coping with ill-ness and friends and professionals.

President

Dale Johnson

President-Elect

Martha Piatigorsky

Vice-President

Radha Shankar

Executive Director

Patricia Telesnicki

Treasurer

Stephen McCourt

Secretary/Development

Officer

Diane Froggatt

Past President/Chairman of

Asian Region

Jim Crowe

Editor

Mary Hancock

World Fellowship forSchizophrenia and Allied disorders

124 Merton Street, Suite 507 Toronto, ON M4S 2Z2 Canada

Phone: 416 961-2855Fax: 416 961-1948Email:info@world-schizophrenia.orgWebsite:www.world-schizophrenia.org

Thomas Walunguba (left), Chairman of the UgandaSchizophrenia Fellowship, with one of the Ugandanpsychiatrists at the Leadership Training for YoungPsychiatrists in Addis Ababa, Ethiopia in April, 2006.

Standing: Young psychiatrists at the Leadership Training workshops in Addis Ababa 26-28 April, 2006. Seated inthe front row from right to left are several Faculty: Charlotte Hanlon, Thomas Walunguba, Diane Froggatt, FrankNjenga, Dr. Norman Sartorius, Sir David Goldberg, Gunner Kullgren, and Dr. Atalay Alem.

Initiatives in Ethiopia (continued)

(continued from cover)

3

Zanzibar. These courses were for medical officers, multi-purposecare workers, public health officers and native and religious heal-ers. Of particular interest was the use of cartoon flash cards toillustrate patients and conditions and to help people understandwhat they might expect from the health clinic. This was ahands-on presentation that showed what could be done with thewill to do it.

On stigma, Lynne Jones of the International Medical Corps of theDepartment of Developmental Psychiatry at Cambridge Universityspoke of trying to overcome hostile attitudes to the mentally ill. Shedescribed the workshop that she gives – a vivid presentation includ-ing photographs to provoke discussion and change attitudes. [Ed.Note: Lynne has graciously agreed to provide the workshop toWFSAD so that we can benefit from her knowledge and expertise.]

Throughout the congress the role of families – their need to besupported and to be listened to – was emphasized by nearly everyspeaker. In the opening session Mr. Eyesuswerk Zafu, Chairman ofthe Mental Health Society of Ethiopia, the Ethiopian family organ-ization, spoke of his organization’s role in advocating for the provi-sion of mental health services. The Society created a link betweenall the stakeholders, managed support groups, urged appropriatetreatments and medications and supported the psychiatric hospital.He drew attention to the value of having the First Lady attend theopening ceremonies of the congress and thanked her for coming.

Later we met with Mr. Zafu’s wife, Mrs. Yezabnesh Zafu, who,like so many family members, has taken on the volunteer role ofgeneral manager of the Mental Health Society. We also metother family members and exchanged information and experi-ences, and were honoured to attend a dinner at the Zafu’s home.

We learned that mental health promotion and psychiatric servic-es have not been priorities in Ethiopia. Cultural beliefs that putschizophrenia in the realm of a curse or the work of spirits gounchallenged. It is difficult to find a way to attract families tosupport meetings given that schizophrenia is not recognized as amental illness. Advertisements must address these beliefs so thatfamilies recognize the behaviours they have been observing, notto say suffering, in a distressed family member.

In Ethiopia, as in many other places, families experience economichardship when a family member suffers in this way. Families whocome to meetings ask if the society can find work for their dis-tressed member, a request that in most cases cannot be filled suc-cessfully. Families hardly realize what they are experiencing nor theroad they must travel in order to assist their loved one. We havesince been in touch by email and hope to be able to arrangeexchange visits between Kenya, Uganda and Ethiopia in the future.

Diane and Thomas had the pleasure of meeting with Dr. AbdullaAbdulrahman, Chief of Psychiatry at the University ofKhartoum. Over coffee in the lounge he reported a meeting of

voluntary organizations that discussed future mental health plan-ning and policy in the Sudan. This work had been encouraged byDr. R. Srinivasa Murthy of the Division of Mental Health of theWorld Health Organization. Prior to finalizing mental healthpolicy several focus groups have taken place to involve the stake-holders. These groups were health administrators, psychiatrists,the media, carers of the mentally retarded, nurses, medical assis-tants, psychologists, traditional healers, family members of thementally ill, social workers and other voluntary organizations. Wewere pleased to receive reports of the focus groups of voluntaryassociations, social workers and family members. These docu-ments will be useful to us as we network with the Sudanese peo-ple to establish family organizations. The possibility of exchangesbetween Khartoum and the Uganda Schizophrenia Fellowshipwas enthusiastically discussed for the near future.

Leadership Training for African Psychiatrists

Following the congressThomas and Diane took partin an innovative venture:Leadership Training forAfrican Psychiatrists, devel-oped by Professor NormanSartorius and EmeritusProfessor Sir DavidGoldberg. This was a three-day course for 35 selectedyoung African psychiatrists.WFSAD’s role was to voicethe family perspective as wellas to describe the qualitiesand skills necessary to devel-op family advocacy, bearingin mind the limited resourcesand different cultures.

The enthusiasm of thetrainees was infectious, andthe exchanges between all the

participants were stimulating and exciting. Topics ranged fromhow to approach mental health in a medium-sized town, to con-vincing authorities/governments of the need for mental healthservices, to working to involve primary care physicians.

All the sessions were very professional and of high interest to thetrainees. I very much hope that Prof. Norman Sartorius offersanother of these sessions in Latin America where WFSAD isbeginning to make progress.

WFSAD participation in these important meetings was supportedby a grant from the Skoll Foundation.

Dr. Amel El Tigani, a youngpsychiatrist from the Sudandemonstrating her poster at theLeadership Training workshops.

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 20064

Special Feature:

The Asia Pacific Forum was held in Kuala Lumpur and was onceagain very successful. The discussions reflected the progress that hastaken place since we started some six years ago. (This was the fourthforum as there was a gap caused by SARS.)

Those six years have passed so quickly, especially since the idea for theforum first saw light of day at the WPA meeting in Yokohama when Imet Eli Lilly representatives for Asia. The commitment that beganback then continues to the present day and from the enthusiasm gener-ated we hope the Asia Pacific Forum will continue on into the foresee-able future. We hope too that the networking that has happened owingto the forum can be transmitted to the WFSAD Toronto conference“Lighting the Path” which will take place in September next year.

The Banyan in Chennai is a model of excellent work with the dis-advantaged and poor mentally ill and I was glad to be able toinvite them to give a presentation that would be an inspiration todelegates at the Asia Pacific Forum. Everyone involved gave detailedand interesting presentations and a lot of new ideas were exchanged.

There is now a definite move towards consolidating the journey wehave undertaken. This was shown in discussions around making themembers of the Asia Pacific Forum an official group. In the steeringcommittee meeting, I moved that the Asian Pacific Forum comeunder the umbrella of WFSAD.

I spoke briefly of similar initiatives that are under way in LatinAmerica with the positive moves of the WFSAD Alianza Latina. Itwill soon be necessary to formulate new bylaws to reflect the recentgrowth and possible regionalization of WFSAD.

I have been privileged to witness happenings in Asia for almost 20years and have come to know our people in Asia extremely well andthe people me. We have built a trusting relationship which strength-ens every time we meet.

- Jim Crowe, Chairman of Asian Region, Past President of WFSAD(To contact Jim please write to WFSAD at info@world-schizophrenia.org)

Highlights from Advocacy Skills Workshop

The following is a sampling from the large number of interestingpresentations at the Asia Pacific Advocacy Skills Workshop.

China

The Shanghai Association of Persons with Psychiatric Disbilityand their Families and Friends were represented by its presidentJue Wang. She reported that the association has governmentsupport and guidance and is part of a complete mental healthcare network of which the association played an active role.Family and friends were making a positive contribution andassociation staff were professional and enthusiastic.

There is keen government support for progress towards their tar-get of providing “rehabilitation services to every disabled personwho has the need by 2015”. The mentally ill will be taking part inthe Special Olympic Games to be held in China in 2007, prior tothe Olympic Games in 2008. In 2010 Shanghai is holding theInternational Exhibition convention which will give a furtheropportunity for public awareness of mental illness problems.

Some of the challenges are:

1) the large population of mentally ill in China;

2) an insufficient work force, especially under the pressure ofthe large population of people with mental illness;

3) mental health professionals and staff are not well trained orwell educated and most work part-time;

4) it is difficult and rare to have contact with colleagues inother parts of the world who work in the same disciplines.

For the future, the association intends to clarify its objectivesand to be “people oriented”. There will be efforts to reduce dis-crimination, to find improved methods of rehabilitation andemployment, and to network with similar organizations. Theirslides included a detailed Work Plan with a schedule.

Singapore

The Action Group Mental Illness (AGMI) organization fromSingapore characterized their group in terms of a business plan:Strengths, Opportunities, Weaknesses. They described theirgroup as a good dedicated core team made up of all the stake-holders and service providers. They have a good relationship witha responsive media. They focus on advocacy issues rather thanconcentrate on service provision.

In the near future they plan to review insurance policies forthe mentally ill; to discuss involuntary treatment with theMinistry of Health; to conduct anti-stigma activities – e.g.,through a walk scheduled for 31 August - and to have repre-sentation in the Silver Ribbon Singapore. There was need forbetter and more contact with members and therefore they

A special event during the forum.

Glimpses from the Asia Pacific ForumFourth Asia Pacific Advocacy Skills Workshop – March 22-23, 2006, Kuala Lumpur, Malaysia – Organized by WFSAD and Eli Lilly

5

plan to provide a newsletter anda dialogue session (though theyhave no full-time secretary).They are also planning to updatetheir website.

Thailand

Taweesin Visanuyothin, M.D,Psychiatrist and Project Managerof the National Mental HealthCampaign, spoke about the“Destigma” campaign.Beginning with statistics onmental illness in Thailand, hecontinued with details of thecampaign. It is to be conductedin phases. Phase 1 will be to pro-vide knowledge; phase 2 will beon awareness; phase 3 will workon improving attitudes; and thefinal phase will generate actions such as walks, rallies, confer-ences, and so on. Each phase was described in detail and illus-trated with photographs and graphs. The campaign will coverall areas of society and encourage the media to becomeinvolved. There will be a conference on mental health law.Events will take place throughout the country. Useful toolswould include success stories from people in recovery and tes-timonies from celebrities.

The Philippines

Like some of the other countries the Philippines presented amental health plan for the next four years. The displacement ofover 4,000 patients because of the closing of the NationalMental Health Centre presents a great challenge. Political insta-bility is also a problem. Financial support is lacking and dis-crimination is a strong barrier to improving mental health.Nevertheless there is general support from the government andfrom the psychiatric association. A national mental health planis very necessary. Mental health services need to be integratedinto the general health services. Training of mental health per-sonnel is vital to develop better levels of service. This year it isexpected that a national alliance of Filipino families of the men-tally ill will be inaugurated.

Mental Health Legislation in Korea

By National Assemblyman Choon Jin KimMember of National Assembly Health and Welfare Committee

While serving on the National Assembly's Health and WelfareCommittee for the past two years, one of the areas I focusedon was policies for the mentally ill. Korea currently has related

legislation in the form of the Welfare of Disabled Persons Actand Mental Health Act.

The Welfare of Disabled Persons Act outlines a variety ofsocial welfare benefits for disabled persons such as providingallowances and facilities. Benefits vary for different levels andcategories of disabilities. However, many mental diseasepatients are hesitant to seek out such benefits due to the socialstigma surrounding the mentally ill. In addition, by beingclassified as mentally ill, they would be restricted from usingwelfare facilities for other disabled persons.

Meanwhile, the Mental Health Act deals mainly with healthand medical treatment for such patients. It includes a systemto regularly review hospitalization of patients at mental institu-tions, a measure designed to prevent human rights violations.Realistically however, such systems are not living up to theiroriginal purpose.

In fact, on September 28th of 2005, the National Human RightsCommission of Korea announced that the current Mental HealthAct was not preventing violations of patients’ basic rights. Itpointed to loopholes regarding the prevention and treatment ofmental illness. The Commission therefore recommended the lawbe revised to better protect their human rights.

Following the recommendation, the National Assembly has beenpicking up the pace of legislative activities related to mental disease.

First of all, the government presented a revised Mental HealthAct, the main point of which was to transfer duties of themunicipal and provincial governors to the chiefs of cities, coun-ties and districts. The revision was submitted on October 31stand is in line with the government’s policy of decentralization.

Top left: Outpatient family support group of the Philippines General Hospital. Top Right: Dan Brindle, left, andJim Crowe, second from right, were honoured at the forum by the Korean delegation with a presentation of ancientearrings worn by Korean emperors. Choon Jin Kim, Congressman of the National Assembly of the Republic ofKorea, is second from left and Wong Dal Song, President Korean Family Association for Mental Health is far right.Top Right: A special event during the forum.

(continued on page 6)

On the same day, lawmaker Lee Sung-ku of the NationalAssembly’s Health and Welfare Committee filed a motion on arevised Mental Health Act which included recommendations bythe National Human Rights Commission.

In various national certificates including those for hairdressers,mentally disabled persons who are not qualified to take theexams are expressed in a very vague term. This has promptedlawmaker Ahn Myoung-ock, also of the National AssemblyHealth and Welfare Committee, to submit ten related revisedlaws so that mentally disabled who are not allowed to take theexams would be clearly defined as mentally ill patients who arenot able to perform the related work. If the proposal isapproved, it is expected to pave the way for patients of mentaldisease to lead more independent lives.

In addition, the government is preparing revisions to theMental Health Act, focusing on recommendations by theNational Human Rights Commission and I am also personallyreadying a revised Mental Health Act.

The focal point of my Mental Health Act revision is to improverelated legislation to allow those suffering from mental illness tolive together with their families, rather than isolating them tomental hospitals or treatment facilities.

For this, I divided the current halfway houses (or intermediatecare facilities) by segment and profession much like welfare facil-ities for the disabled. Another provision includes awarding vari-ous benefits to family members who care for patients who werehospitalized in mental institutions for a certain length of time.

However, one thing that cannot be forced by law is to changesociety’s perception of mental disease. Without such change, anyrevisions in laws or policies may only be a formality.

This is where we can all play an important role. The meetingsfrom today have provided valuable insight into this issue. Inparting, I ask everyone here to join me in doing all they can towork towards this end.

The Banyan Model – Building on SuccessThe “Banyan” is an organization that cares for those who arementally ill and destitute in Chennai (Madras) India. A Banyanrepresentative took part in the Asia Pacific Advocacy SkillsWorkshop as an example of a successful model. The followingis only a small part of the presentation.

We are talking about health not pathology

“The Banyan Model” is based on a paradigm of health ratherthan on a model of pathology. We work with “people”, with“clients” - not “patients”. A “resident” and “client” is a personwho is alive and living in this world first, and a part of this per-son’s experience and history is mental illness.

Care begins with a positive peer environment

Our most successful and loved therapeutic intervention is thecreation of a positive peer culture within the Banyan. Thewomen … motivate one another, are creative together, andlearn how to increase their overall level of role performance andinterpersonal skills.

All people have the right to medical, psychiatric, psychologicaland legal care in a dignified environment

We are committed to providing for the women we serve andfeel satisfied with our progress and movement towards continu-al organizational refinement and expansion of services.

We all have the right to live with freedom and dignity in com-

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 20066

Special Feature:

Forum delegates from Thailand. Delegates from Korea to Asia Pacific Forum.

Glimpses from the Asia Pacific Forum (continued)Fourth Asia Pacific Advocacy Skills Workshop – March 22-23, 2006, Kuala Lumpur, Malaysia – Organized by WFSAD and Eli Lilly

munities not institutions

Symptom reduction is the result of the rehabilitation process.Rehabilitation refers to the process of each woman reclaimingher own body, mind, spirituality and interpersonal relation-ships. Therefore all treatment modalities at the Banyan have agoal of rehabilitation and personal empowerment, appropriateto each woman.

Each client is a unique person with a unique identity and experience

Mental illness manifests in degrees of intensity and symptoms.Our curiosity in all these manifestations allows us to know eachresident’s unique experience and to meet them where they are.

Restore health first, so that people are enabled to make choices

There are arguments that no person should be involuntarilycommitted to any health care facility for treatment. At theBanyan, we feel that this is true under ideal circumstances.However, our clients are in a state of siege and crisis. Our goal isto facilitate our residents’ journey from crisis to stabilization sothat they may be able to make choices for their own lives.

Solutions lie in addressing systems not individuals.

We reject the notion that mental illness is solely the problemwithin, or of, an individual person. Mental illness is also aproduct of a larger interaction in society, and between the indi-vidual and the various systems that they inhabit.

We cannot work alone – we work toward a spectrum of peo-ple to own the cause

We at the Banyan cannot work alone with homeless women inChennai or in India; nor can we work solely in the non-govern-mental sector. We believe in working in partnership with multi-ple stakeholders from the state to civil society actors.

The onus of response is on all of us

At the Banyan, we believe that the state and society have a dutyto provide dignified services to homeless people with mental ill-ness. In addition, as citizens we are required to combat the situ-ations, relationships and interactions that create homelessnessand mental illness.

Two paths to the difficult reality

We have concluded that there are two paths leading to this dif-ficult reality. First, mental illness precedes homelessness. Thereality of living with mental illness creates a situation where awoman is more vulnerable to homelessness. Second, homeless-ness precedes mental illness.

Providing localized care is crucial to address the issue

One of the key areas of intervention is going to be strengtheningof the existing public mental health care system. The aim is tomake care available right at the doorstep, from the urban to thedistrict and rural levels, bringing care to the remotest of areas.

Respond, research and then advocate

The Banyan’s organizational long-term vision is to flourish inthe areas of research and development, rehabilitation, network-ing with other NGOs and lobbying for a positive change inmental health practices throughout India.

7

Poornima Mathew, Rehabilitation and Network Coordinator, giving apresentation on the Banyan.

Jue Wang, President Shanghai Association of Persons with PsychiatricDisability and their Families and Friends and Vice President ShanghaiDisabled Person's Federation presents Jim Crowe, past president WFSAD,with a presentation case of historic Chinese hand-painted ceramic faces.

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 20068

Rehabilitation

To improve the quality of life for people with schizophrenia andlike diseases, rehabilitation centers are needed. These can providethese people with vocational training to give them hope; to workon bringing back motivation; to remove their apathy and lack ofdrive; and to make them capable to start earning. Work and somedegree of economic independence is important for both patientand family. People from both the Western and Eastern world canovercome the burden of disease if they can successfully employthemselves in creative productive work.

Selection of vocational training

Selection of vocational training depends on individual apti-tude, ability and interest. Often the family who accompaniesthe patient has a preconceived idea about his/her capabilities.They often try to guide us and discourage vocational trainingthat they think would not be suitable. Almost everyone hassome creative abilities and if this can be successfully utilized itcan help patients in the long run to overcome their problemsand help them towards becoming productive members of soci-ety. They can utilize skills learned to help them reduce theiranxiety and in some cases to earn their livelihood.

A few simple methods of vocational training

Collage works often help patients to reduce their anger andaggression. Water colours and works with Plaster of Paris helpthem overcome compulsive tendencies.

To unfold peoples’ hidden capabilities we always encouragethem to explore their capabilities starting from simple drawing,fabric work, glass painting, block printing with vegetables,colourful earthen pots and wall hangings, jute decorative fold-ers, bead work, bead ornaments, and animals made of beadsand embroidery.

At first we ask the clients to explore with colours and drawpictures. Within a few weeks, we can thus identify the person’scapabilities in drawing, painting and fabric works. Those whocannot draw or paint well or who have trembling hands so thatthey do not have control over their brush, are asked to workcutting the vegetables (such as potatoes) that they bring fromhome into different shapes.

They are then asked to print plain materials or clothes withtheir printing blocks (cut vegetables). Starting with their ownold clothes helps them to practice. This gives them pride intheir work. This is a simple and attractive training programwhere a client becomes active in a very short period of time.Other clients who have been working for years together thengive the final touches to the handicraft products developed bythem. In addition clothes may also be decorated by sewing onstrips of cloth in patterns (appliqué work).

Glass painting is a very good handicraft product. To start they dosimple geometric figures and then proceed to more complexdrawing patterns.

Painting earthen pots and wall hangings is also pleasing. Thistoo starts with line drawing, and later geometrical figuresdeveloped into attractive designs.

Sewing includes making table cloths, table mats, napkins,handkerchiefs, tea cosies and more.

Marketing

Marketing the products is not very easy especially in India wherehandicraft items are readily available. Success depends on mak-ing the work into a mental health movement, for which oneneeds perseverance and the ability to motivate others. If the par-ents’ group makes it a practice to buy only the products madeby their children, then it can be easy to get the initial market.We must be very disciplined about the quality of the products,as no one should buy products out of sympathy.

Computer

A computer often provides a tool for psychoeducation, socialrehabilitation and economic rehabilitation too. The person whocomes to Turning Point at first lacks self-confidence and self-respect. They are not sure about themselves. Writing theirnames on computer screens in different styles gives them pleas-ure and the desire to learn more. Knowledge of the Internethelps them to get proper psychoeducation about their sufferingsand possible solutions. This helps them to learn about their dif-ficulties in a safe, criticism-free environment. Gaining controlover a machine like a computer helps them to gain confidenceand motivation to gain control over their lives. Computer train-ing along with spoken English classes often helps them to getjobs in nearby areas. They can even do computer typing insmall computer institutes that have grown up in India.

The role of parents in vocational training

Parents have a very important role to play in the rehabilitationof persons suffering from mental illness. It has been seen thatsupportive parents who are not overprotective can help theirchild gain adequate confidence and functional level. On theother hand too much overprotection creates a hindrancetowards the growth and development of their affected relative.

Vocational training along with learning a few basic life skills fortheir ordinary functioning like going to the bank, depositingelectricity bills, buying day-to-day products, taking a fewresponsibilities at home, and looking after their parents, helps toimprove their functional level and make them self-dependent.We also have cooking classes. The primary focus is of course tomake them independent so that they can cook their own food.

Practical Ideas for RehabilitationExcerpted from a paper by Ishita Sanyal, Director, Rehabilitation Centre and Clubhouse “Turning Point” in Kolkata, India

(continued on page 9)

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I trained as a nurse, worked as a mental health nurse in the1960s and am now a senior lecturer at Christchurch College,where I teach clinical effectiveness to mental health nurses.

My son has schizophrenia and lives in a community home nearto us.

He first became ill when he was 19. I was 48. It is only in thepast two years that he has come out of the fog.

He spent about nine years as a revolving door patient. His lov-ing and caring nature has only recently returned. I put thisdown to the period after he started taking clozapine, a medicineused when most others have been tried.

Although he is now well, he has had several heart attacks whiletaking clozapine. All people who take the medication are moni-tored while they are taking it.

He now feels happy - and that's the first time I've heard him saythat since he was a teenager.

He has started going to church regularly since his occupationaltherapist took him to a Lent group.

I hope that he has been through the worst. He has been treatedin every type of ward and tried all kinds of medication.

As a result of the illness, I've had to deal with the feelings of lossand bereavement and denial.

I was grieving though he's still alive - and I howled like a wolfthe day I realised he would never fully recover. We didn't imag-ine that he would have any kind of life.

Some professionals - including some of the nurses I teach -assumed that I knew what was wrong with him; after all, he hadbeen getting ill for a year before he was admitted to hospital.

He had a very fragile brain, a difficult birth and was slow to talk. Iknow now these may have been contributing factors to his illness.

One of the best things we did was to join the NationalSchizophrenia Fellowship - as Rethink was then called. I nowhave two filing cabinets full of information!

Too often, the clinical approach lacks compassion and doesn'trecognise that for some people with schizophrenia, religion is animportant way of expressing their spirituality.

From an educational point of view, more mental health nursesare needed nationally, but the Department of Health has notmade any particular plan.

The carer's role can be quite powerful - several of my colleagueshave written articles about mental health based on my experi-ences and perspectives.

One of my son's school friends has stayed in touch - it's impor-tant to recognise how powerful one good friend can be.

The media doesn't address the social, physical and mentalaspects of people with schizophrenia.

Siblings of people with schizophrenia are often neglected. Myother son, who is an actor, has only recently come to terms withhis own anger.

Recently, I've learnt to let go, and while I have always believedin God, my faith has been strengthened recently and I'm think-ing of starting to attend church again.

My son has been a wonderful teacher. In some ways, I think ofhim as a soulmate. Nobody should ever give up hope – it hasgiven me the courage to fight on.

(Mary’s story is from Rethink website at www.rethink.org; nameshave been changed to protect anonymity)

Personal Story

A Mother’s Story

In addition, we also have some fixed responsibilities for all ourclients: e.g., setting mats on the floor; distributing tea; sellingproducts during exhibition; and older clients helping theyounger ones to learn the training programs.

Social rehabilitation

Due to stigma, hopelessness, and fear of rejection the sufferersoften try to avoid interacting with society. This creates a barrier.Self support groups help them to first get the social acceptance.“I am still loved and cared by so many group members”. Thishelps them to get the needed support and guidance. It is reallysurprising to see how they help their fellows and friends duringthe annual tours from our centre. An important thing for proper

rehabilitation is to develop the feeling of togetherness, the bond-ing, love, and “family feeling” – that we all belong to the samefamily/community. This helps a lot to overcome their deep-root-ed insecurities and anxieties.

Dreams for the future

One idea we have is to establish a coffee shop in the future asthey are becoming rather popular here in India. But getting thefunds to open a shop is difficult. I also have a dream to make anentertainment park - a park that will have everything that repre-sents typical Indian village life - where all the work will be doneby our children at Turning Point. That would give me an oppor-tunity to rehabilitate a huge number of persons at a time.

(continued from page 8)

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 200610

Regional News

Papal Indulgence Raises Awareness Advocating for Early Treatment andFamily Support

In February of this year Dr. Austin Mardon, an activist, writerand consumer from Alberta, Canada, had an audience withArchbishop Collins of the Catholic Archdiocese of Edmonton toexpress his and WFSAD’s thanks for the Papal Indulgence grant-ed by Pope Benedict XVI for the service of the mentally ill. Wehope that this thoughtful move will help raise awareness of thesad plight of many people suffering mental illness around theworld. Dr. Mardon praised the Pope for taking this courageousmove which could potentially save lives of Catholics with schizo-phrenia in many parts of the globe. Some years ago Dr. Mardonwas granted an audience with the previous Pope. He is now seek-ing an audience with the new Pope to thank him personally.

Dr. Austin Mardon, left, with Archbishop Collins of the CatholicArchdiocese of Edmonton.

Q. What’s the outcome for a young person that doesn’t get theright care?

A. Well, the outcome can be death. I mean ten to 15 per cent ofyoung people with a serious mental illness will die in the earlyyears after diagnosis from suicide and other causes, so this is apotentially lethal situation. The scenario, in terms of wastedlives, is much more pervasive, I suppose. We can get 90 percent of our young people symptom-free with treatment, evenwith severe psychosis, but only 50 per cent of them are goingto get back to meaningful vocational activity.

Q. So they’ll be unemployed for most of the time?

A. They will be unemployed, on benefits, because of a lack of real-ly proactive community-orientated care, and this doesn’t haveto happen. There’s enough knowledge and expertise aroundnow to really transform the landscape for young people withemerging psychiatric disorders, but there’s not enough politicalwill devoted to tackling this public health problem.

Q. Now, we’ve talked about how traumatic an episode is on ateenager. How traumatic is it on their families?

A. Well just to give you an example of that, when I’ve been oncall over the weekends say for our inpatients unit, I couldspend the whole of a Saturday just sitting in the inpatientsunit talking with families and just dealing with that level ofdistress. They are absolutely distraught when they first realiseand get involved in the whole process of trying to, first of all,get into treatment there, their son or daughter, and then help-ing them recover. And the shock, the crisis aspects are reallyvery, very strong indeed - as they are with any illness situation- but often it comes out of the blue and they’re not preparedfor it. I think it is another big message to the community real-ly, that psychiatric disorders are common. They’re very likelyto affect someone in your family or yourself, and when youturn around for help it will be very difficult to obtain, in aquality and professional way in Australia, in the present day.So the families are very unsupported and it’s a major sort ofchallenge to help them deal with the crisis.

The following is part of an interview from the AustralianBroadcasting Corporation program Four Corners betweenhost Janine Cohen and Professor Pat McGorry, Director ofthe Orygen Youth Health, in Melbourne, Australia inMarch of last year.

The Mentally Ill Are Called ManyThings... – By Doreen Lynn Varga

Amongst Others: Bizarre, Disturbed, “Not Right”, Disabled,Retarded, Eccentric, Odd, Fanatical, Peculiar, Strange, Rare,Defective Units, FREAKS OF NATURE

I call them: Original, Creative, Intuitive, Sensitive, Perceptive,Individuals, HUMAN BEINGS, Sufferers…and Survivors

Leigh Fox, from the University of British Columbia, Canada (middle), andThomas Walunguba (holding hammer), Chairman of the UgandaSchizophrenia Fellowship, with Matovu Alex and his father and brotherduring the tree planting in Uganda organized by Leigh and Thomas.

Members of the Uganda Schizophrenia Fellowship serving refreshments attheir annual picnic.

Member’s Update

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Uganda: Tree Planting and Picnic Goa, India: New Ambulance andUpcoming WorkshopCarers Hope of Goa, India – including Anne Pinto, carer, andNamdev Gawas – met recently with government representativesto solicit a much-needed ambulance. Health Minister ShriDayanand Narvekar has now given the ambulance to the Carersto meet their emergency situations. The ambulance, which willbe used for all of Goa, is being run by the Institute of Psychiatricand Human Behaviour.

Also, get in touch with Namdev Gawas at ngawas@sify.com tolearn more about an upcoming seminar on “Mental Health – NoMore in the Shadows”. The seminar is being organized by thePublic Relations Cell as well as the National Social Service Unitof the Government College of Arts and Commerce in Virnoda,Pernem, Goa (where Namdev is a professor). The resource peopleat the seminar will include psychiatrists Dr. Peter Castelino andDr. Ajoy Esteibeiro, as well as some carers and recovered patients.The tentative date is September 16. Please contact Namdev tolearn the firm date and further details about the seminar.

Support Group Established inMartiniqueIn May 2006 Yolène deVassoigne gathered with a group of parentsin Martinique to establish a support group for families and con-sumers suffering from mental illness. The group is growing – it has15 members so far – and is working on the group’s statutes so thatit can be legally declared. In addition to providing support for eachother, the group plans to defend their rights, as well as educate andinform members and the general public about mental illness. If youwant more information, please contact Yolène at: lucievoza@wanadoo

ACMI: Lobbying for Laws and Rightsof Persons with Mental IllnessAction for Mental Health (ACMI) – with the active support ofthe National Law School University of India – organized anational level workshop on "Law and Rights of Persons withMental Illness" on May 5 and 6, in Bangalore, India. A largenumber of participants representing care-givers, consumers andmental health professionals attended the workshop. Dr. NirmalaSrinivasan of ACMI reports that the outcome of the workshop iscontinued planning for a combination of political, legal and aca-demic strategies to push for amendments to legislation that safe-guards the interests and rights of persons with mental illness.

World Fellowship for Schizophrenia and Allied Disorders Third Quarter 200612

WFSAD is not supported by any level of government and relies on your generosity.

ExpressionsA healthy mind …

To have clear thoughts, the ability to solve

the problems of daily life; to enjoy good

relationships with friends, family and

work colleagues; to be spiritually at ease

and be able to bring happiness to others.

Vikram Patel MRCPsych Ph D Reader in International Mental Health, London School of Hygiene and Tropical Medicine

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