Caregivers and Psycho Education
Psychoeducation is educating the Persons with Mental illness (PWMI) and their caregivers on mental illness/disorders. According to American Psychiatric Association Psycho Education is defined as education of the person with a psychiatric disorder in subject areas that serve the goals of treatment and rehabilitation. Psycho education includes cognitive, behavioral and supportive therapeutic elements. The PWMI and caregivers will feel more relaxed and in control of their condition if they have greater level of understanding of the mental illness. This will encourage them to actively participate in their self management and relapse prevention. The reduction of social stigma, rise in self-esteem, prevent relapse, compliance to treatment and become competent in handling emergency of PWMIs.
Psycho education is imparted by BNI team for reaching out to PWMI and caregivers in 4 states by training staff of partner organizations, groups of volunteers(ICDS workers, ASHA workers, recovered people with mental illness, caregivers ), members of Disabled People’s Organization (DPO), Panchayat members etc.,.
Psycho education is imparted in the following stages by the above groups :-
Identification stage
In this stage, the above groups carry out home visits of PWMIs and impart psycho education on the symptoms, types of disorders, treatment, guidance on PWMI and their ability to understand, possible situations/causes, role of family in supporting caregivers and PWMI, dispelling the myths, customary belief related to mental illness, managing PWMI’s with Severe Mental Disorder (SMD) and ensuring emotional support to the PWMI. Psycho Education expands to rehabilitative process that follows after the successful completion of medical treatment.
Treatment stage/ Treatment compliance
In this stage, the partner staff, the DPOs and Volunteer groups assist the PWMI and caregivers in providing psycho education by focusing on treatment, treatment schedule, basic knowledge about the type of medicines in treating mental illness, compliance, regular follow up and its frequency, side effects, consumption of Tobacco products while on treatment and consequences, relapse of mental illness and the importance of follow-up.
In case of PWMI with Severe Mental Disorders (SMD), the challenge is to overcome the indifferent attitude or resistance from PWMIs to subject themselves into treatment. Again, imparting Psycho education to caregivers, family members and community on Severe Mental Disorders (SMD), appropriate treatment and it’s local accessibility is crucial in handling SMDs. In case of multiple disorders (for instance: – epilepsy with mental illness/mental retardation with mental illness), the psycho education shall focus on the cause, symptoms, treatment of epilepsy which triggers or aggravates the mental illness.
Rehabilitation stage
In this stage, the treated PWMI who has recovered from mental illness is on the threshold of achieving normalcy. The professionals or trained DPO members or Voluntary groups shall impart psycho education to caregiver and PWMI on the importance of rehabilitation. The psycho education focuses on regaining skills/knowledge by PWMI to take care of daily routines, self care, assisting family members in household chores, engaging in productive activities at home, etc.. The psycho education on rehabilitation encompasses the re-acquisition of basic skills, advanced skills and special skills for preparing the PWMI to take up livelihood opportunities in future for the reintegration of PWMI.
Role of Caregivers
The caregiver of PWMIs are faced with inherent risks in handling violent, agitating, non-co-operative, unhygienic, unclean, undignified behavior of PWMI. Caregivers are also subjected to trauma, agony, pain, and forced to sacrifice their personal needs and comfort during their years of caring in their determination to restore normal health of PWMI. The caregivers are susceptible for mental disturbances as they may be depressed without any outlet to ventilate their suffering within the family and community. The PWMI are unlikely to recover from illness in the absence of caregiver in the family, as close monitoring is impossible, despite the best attempts by psychiatrists and the voluntary groups.
Conclusion
The caregiver in the family is the crucial support system for the PWMI and provides handholding support through the stages of identification, treatment, rehabilitation and livelihood. BNI has been imparting psycho education by mobilizing and organizing them into caregivers’ forum or groups. The formation of caregivers groups has resulted in a space to ventilate their suffering, presenting the needs of PWMIs and themselves, establishing strong linkages with volunteer groups/DPOs, for accessing the entitlements of the PWMIs, drawing attention on the need for better mental health Infrastructure and services and also laying out an agenda for all round development of the caregivers at the national level.
In short, Psycho education empowers PWMIs, caregivers and the community to understand the illness, its impact on PWMI, the course of treatment, relapse, recovery, rehabilitation, reintegration, access to social entitlements & mobilize groups to advocate for better infrastructure and services at the macro level and establish linkage and networking with all social groups to promote mental health for all in the country.