NIMH Occupational Therapy Department:

A ray of hope for mental patients to regain life skills

By Ranil WIJAYAPALA

An aura of sanity prevailed in the huge hall, though it was a place commonly known as a place for mental illness. But at a glance it looked like a place for creative people as paintings, craft and patchwork and many other art works were visible in small rooms within the hall as if it was an exhibition hall.

All those in the hall were engaged in work like any other worker in a workshop or factory. They were mental patients who were undergoing psychiatric treatment at the Angoda Mental hospital, which is under the National Institute of Mental Health (NIMH).

They all have a story to tell as they have experienced so many sad moments in their lives thus ending up as mental patients and being kept at the Angoda hospital for a long time. They are eagerly waiting to return to their normal lives to play the role they played previously as responsible members of society.

Like Vidyani, a former freelance writer and journalist, and Kamini, a senior lawyer by profession who are eagerly waiting to return to society to engage in their former professions after getting rid of their mental illnesses. Many other patients sought the help of occupational therapists to rebuild their shattered lives due to mental illness.

Anne Martin

Asoka Sanjeewa on Occupational Therapist

Kamini

The Occupational Therapy Department of the Angoda mental hospital has become a healing ground for many as it provides a wide range of opportunities for patients to refresh their minds and prepares them to return to society. They may have spent months and years at the hospital as patients, either without any place to go to or due to taking treatment for a long period, but they can engage in activities according to their interests and come out of the agony.

For Vidyani, who has spent more than one and a half years at the hospital, the OT Department has become her favourite place in the hospital. She is so enthusiastic about and wakes up as early as four in the morning to avoid the rush for the toilets and reaches the OT department to engage in bead making. Vidyani teamed up with Kamini, Deepthi and a number of other patients who were reluctant to identify themselves and were not in a position to express their views with us, were making beads out of paper pulp to make necklaces and become partners of - Mindful Jewellery _ a new jewellery line created by the OT Department of NIMH.

Necklaces made out of beads

The idea first originated when a teacher from the Central School of Art in London introduced the creation of paper pulp beads to the NIMH OT Department.

When Deepthi and the others are making paper beads, Vidyani paints them in different colours to make different coloured paper beads. Kamini drills all these beads with a small machine to knit them together into a nice necklace.

"I am enjoying the work and we are selling these to Barefoot Gallery and earn some money to spend for our needs," Vidyani says in a happy mood.

She thinks one day she can reunite with her son now living abroad and send him some money for his education and also to begin her work as a freelance writer. Like Vidyani, Kamini also wants to get back to her old profession to practise as a lawyer and reunite with her sister who is now living abroad.

"I enjoy this work and it helps me a lot to spend time at the hospital as a happy person till I commence my career as an immigration lawyer,"Kamini also added.

Anne Martin, a volunteer from the Volunteer Services Overseas based in the UK working at the NIMH OT Department said that there is a big demand for necklaces they make at the OT Department as Barefoot is ready to purchase whatever stocks that are made. "We cannot run this as a business to compete with others, what we need is to produce quality work with the involvement of mental patients at the OT Department and make use of the money they earn out of this product to buy materials needed and for the little requirements of the patients," she added.

She prefers if such a facility is made available outside the hospital, enabling all patients who cannot earn a living after the loss of their previous skills due to mental illnesses.

The bead making is not the only skill the OT Department provides for the patients at the wards.

"Patients also make bed covers, patchwork, jewellery boxes and lot of other handicraft items with the support of the staff at the OT Department. They can engage in sewing, and other activities according to their interests and skills under the guidance of the hospital staff and a few experts who visit the Department from time to time to teach them new things," she added.

Giving a broader picture about the Occupational Therapy department of the NIMH, Asoka Sanjeewa, an Occupational Therapist working at the Angoda Mental Hospital said both mental hospitals in Angoda and Mulleriyawa have Occupational Therapy Department for special activities for patients.

"For the rehabilitation of patients undergoing psychiatric treatment we have facilities in the ward itself. Specially in the intermediate wards where patients stay more than one month after initial treatment at acute wards we have direct based activities run by nurses and occupational therapists as the hospital administration facilitates them to start these activities. For special activities we have the Occupational Therapy Department," he added. "We start rehabilitation from the ward itself. They can start such work according to their abilities, interests and they can get special help from the OT department," he added. "We have seven occupational therapists in Angoda. And two Occupational Therapists in Mulleriyawa. The Chief Occupational Therapist is working at the paying or the villa wards," he added. "In the OT Department we get inpatients and outpatients also. If somebody is discharged from the hospital for a limited period they can ask for support from the OT to visit us on a daily basis or weekly basis and continue their programs," he added. What they do at the OT Department is to find out the needs of the patient, what they want to do and what they want to be occupied with.

"At the initial assessment we find their roles and their previous functional level. With these features we develop an activity schedule and support him to get back his previous life skills, role and sometimes professional skills based on vocational activities. We try to engage him in scheduled activities which is purposeful to him to achieve previous skills, roles and responsibilities," he added.

In that sense this program helps people to occupy themselves including looking after themselves, controlling themselves and contributing to the socio-economic means of their family. "Basically we target three areas self care, leisure and productivity. Self care is looking after themselves, leisure is to spend their time with their leisure activities, and productivity means socio-economic means to earning money and productively engage in vocational activities becoming a productive person in their families," he added.

"If we are don't earn we are not valuable to the family. Money is the key. That is why we started some selected activities which can earn bring in money. Otherwise just participating in activities is not that meaningful," Asoka added.

Occupational therapy is useful for self care, wealth, leisure, independent function, enhance development and prevent disability. "We talk about disable condition when considering the physical aspect but in a psychiatric condition people are at a disadvantage because there is a stigma attached to mental condition," he added.

"Sometimes people have skills and talent but at some stage they cannot perform their skills by facilitating them to use those skills through participation in activities. That is why when we prepare an occupational therapy program based on a particular patient or a client it should be relevant to that person," Asoka added.

Sometimes it is difficult to develop or upgrade skills to previous levels. "To do that we have to arrange the working environment. Whatever difficulties are there in their families, the working environment has to be considered. This is adaptation.

We have to prepare them to face those difficulties in their families and also the workplace. Then we can think of changing the environment according to the problems," he added. To achieve this we have to organise vacation based activities and leisure-based activities as well as run special groups to facilitate their interests.

"With the initial assessments we identify their interests and activities which are useful to them. Considering these factors we prepare timetables. For example a patient like Vidyani who is a professional writer is engaged with the creative writing group," he added."Occupational Therapists believe that people with mental health problems by engaging in meaningful activities and occupations improve their quality of life, thereby benefiting both their physical and mental well-being," he added.

Our aim is to address the stigma in society through their creation. We are printing annual calendar using the artwork of patients. October 10 is World Mental health day and we had an art exhibition at the National Art gallery last year and this year too we are preparing to have an exhibition aimed at addressing the social stigma," he added.

"If we can have a separate unit inside the hospital or outside enabling patients to visit and engage in activity to earn their living that will be a welcome move. If the private sector assists this would then be a reality and will be a boon to mentally ill people who can not return to their profession. We also invite professionals and artists to share their experience with these patients with mental problems to give them a light of hope for their life," Asoka added.