Creating opportunities for people living with mental illness in Sri Lanka

VSO has supported the development of the mental health sector over the last 15 years, helping to create more clinics and rehabilitation centres as well as establishing training programmes to raise standards of mental healthcare. An estimated 2.5 million Sri Lankans have been reached by the efforts of VSO volunteers during this time. Chandani's experience illustrates how VSO's intervention has helped transform one woman's potentially bleak future into a much brighter one.

Thirty-five-year-old Chandani was born and raised in poverty as the daughter of manual labourers in a village near Kandy. "I remember using a plastic bag to carry my school books throughout my childhood," she recalls. Economic woes have been in Chandani's life for as long as she can remember, but she was able to get by.

It was immediately after the birth of her second child that Chandani's mental illness developed, and after being taken in by her parents and experimenting with traditional healers; she was admitted into hospital as an emergency in-patient and diagnosed with bipolar affective disorder.

Chandani remembers this difficult period in her life, "I was outcast from society and criticised in the community – people were calling me a mad woman... it was very difficult." Her husband was forced to return from his duty with the armed forces during the civil war to care for her.

Her condition was controlled, and Consultant Psychiatrist Dr. Wickremasinghe played a key role in treating Chandani. VSO volunteers worked alongside him at an organisation called the Nivahana Society of Kandy to help integrate Chandani and others back into society.

The Nivahana Society of Kandy is a VSO partner that develops primary, secondary and tertiary mental health services in partnership with the Sri Lankan Ministry of Health. Around 15 VSO volunteers have been placed at Nivahana over the years, raising standards of occupational therapy, providing specialist training and introducing mental health community rehabilitation to primary care workers.

VSO volunteer Mark Chamberlain was as an advocacy adviser during Chandani's process of rehabilitation back into her community. He was involved in creating a Kandy-based consumer action forum (Hitha Mithru Sangamaya) in 2008 that enabled Nivahana to establish links and networks with other similar emerging organisations in the country.

Soon after returning to her community, Chandani started to earn a small living by making and selling 'string hoppers' (Sri Lankan staple food made with rice flour). It didn't earn her sufficient money, but kept her mind focussed and her condition stable. She soon became a founding member of a small grassroots support group that emerged out of the support received by the Nivahana Society of Kandy.

Thanks to the links established by VSO volunteers and Nivahana, the grassroots group organised a workshop with a company engaged in small enterprise development. The session focussed on the importance of selecting an income-generating venture with a therapeutic value. Impressed by Chandani's efforts and her plans to expand her small business activity, Chandani was able to secure a small loan that gave her access to a string hopper machine a few months later.

The machine has enabled her to increase her production from 150 string hoppers to 1500 per day. All the loan interest has been paid off through the money she has earned, and her success has dramatically improved awareness of mental health illness in her community.

"I am very happy, I have no financial problems and the stigma has reduced... I feel that people are even jealous of me now that I am doing so well!" remarks Chandani, who today is a shining example of how a person with a mental illness has transformed her life.

Sri Lanka has suffered a long civil war, internal displacement and a tsunami in the last decade, yet the national health system was previously unable to manage the psychological consequences of such traumas as well as common mental health problems.

VSO's partnership with Sri Lanka's Ministry of Health over the last 15 years has led to the development of around 40 rehabilitation centres and mental health clinics. Nearly 50,000 mental health professionals have participated in training and workshops carried out by VSO volunteers to improve the quality of mental health care in Sri Lanka. Sharing skills with 10 partner organisations, the work of 65 skilled VSO volunteers is estimated to have influenced more than 2.5 million Sri Lankans, supporting the transformation of the country's mental health service.

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