SELF-HELP GROUP OF FAMILIES WITH PEOPLE WITH MENTAL HEALTH

PROBLEMS (PWMHP) IN COMPREHENSIVE AND BALANCE

CARE MODEL

PRESENTATION OUTLINE

1. Conceptual frame work and MCNV intervention in community mental health program

2. Self-help group of families with PWMHP

1.Part 1: Conceptual frame work and MCNV intervention in community mental health program

Balance care model

MCNV intervention

1) Capacity building for health staffs from village, commune, district and provincial level 2) MH screening: Total people > 18ys involved in screening: 12.008 of whom we identified 755 people at risk ( with above 8/20 score) 251 checked by psychiatrists identified 99 need to treat by medication 25 new patients of epilepsy and schizophrenia 3) Set up 6 self-help group of families with PWMHP. This group belong to DPO

PART 2: Self-help group of families with PWMHP and results

Why do we need supporting family group?

• The burden for families living with a person with a mental illness is high both in practical caring, psychosocial and emotional well-being.

• Economical problems • Discrimination from community so the

PWMHP feel a complex about their situation• Higher risk of development of mental health

problems themselves• This burden is often underestimated

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Aim of self-help group of families with PWMHP

• To share experiences as well as feelings with other members.

• This helps the family members and caretakers learn more about the mental illnesses and care towards the PWMHP and family members.

• This activity also brings about chances for the families to get more social support.

Roles of stakeholders in self-help group of families with PWMHP

Provincial support group: psychiatrists, MD from SMS Function:-Develop the guideline of 8 meetings -Training for VHWs on how to use the guideline -Technical support in community and meeting -Reflection meeting with VHWs and other members to have lesson learn and adapt the guideline

VHW: - Facilitate the meeting,

encourage family members to share their experience

- Bridge between health staffs and family members

DPO: Identify the needs of members, sharing their experience and find out suitable solution on financial and social support

Family members: -Sharing their feeling, difficulty and experience -Find out suitable solution to solve their difficulty

Subject of meetingsMeeting Objective

1st meeting: Set up a support group

Set up a self-help group, get to know each other and identify expectations.

2nd meeting: Information about mental health disorders

- Connect families with PWMHP with psychiatrists and health workers.- Share essential information about mental illnesses (MI) and treatment by psychiatrists

3 rd meeting: Solving problems encountered when giving care to the PWMHP.

- Communication and behavior towards the clients. - Guidelines for dealing with the clients

4 th meeting: Empowerment for family members and PWMHP

To help the family with the PWMHP be empowered and feel more confident in life and therefore much eager for participating social activities and improve their quality of life as a result

Meeting Objective

5 th meeting: Problem solving

- Help the group members be capable of solving some daily problems.- Share positive experience in caring the PWMHP.

6 th: Prevention of relapse

Help the group members be capable of supporting the PWMHP with prevention of relapse

7 th: Social support Help the PWMHP and their family access to social support to meet their needs

8 th: Evaluation of 8 meeting

- Evaluate the cooperation between health workers and families in patient care and treatment. - Evaluate the achievement of the group members’ expectations after 8 meetings

Discussion and sharing in the meeting

Results

• Chance for them to share feeling, emotion, take care of MH people and learn from each other

• Increasing awareness on MH illness as symptom, cause, take care and relapse

• Recovering some serious MH cases• More confident of member and their family• Social support from other family

Ms Thi is 54ys, she has schizophrenia since 1989. She did not continue to take medicine in long time. She wandered about the community and destroyed every thing that she wanted. Her family put her in the hermetic room for a long time with out medicineAfter 2 meetings, her father went to CHC to receive advise and medicine. Family pay more attention in talking with her her situation better and better. Begin June , his family open the room for her to stay with them and now she can do some house works as pig feeding, cook.

Results

Mr Ngô Văn Kỉnh father of Thi schizophrenia women

At the end of the 2nd meeting, Mr.Kinh sincerely confided: “I wish there had been meetings like this two years ago. My daughter and my family would have been less miserable”.In the 5th meeting he said that: I tried to negotiate her to take medicine so that she has taken medication regularly. “It’s a valuable lesson that I have learnt from other group members”. Helping his daughter to take medication used to be a hard challenge to him and he seemed not be able to fulfill this.

In the 8th meeting he said with happiness voice: the most valuable experience he learnt from other members in not only knowledge, or the best way to care the PWMHP but also the attitude and the love of other family members as well as the support of the community toward the PWMHP and their family

Nam is 32ys, has schizophrenia 7ys ago. He receives treatment at CHC. He drinks and smokes a lot. In the family, some time he has conflict with his father. He didn’t confident to joint any social activities.

NMr Nam

With support from 2 men of the group, Nam

jointed in fourth meeting

In the thirst meeting, Nam’s mother tell her difficulty when take care Nam that he drink so much and ask every

one to help. The meeting decided who will help and What

Now he less drink, play more with his son and more participate in the community activities

At the end of the first meeting, Ms Nu from Vinh Son commune, Vinh Linh district who has suffered from schizophrenia since 1987 and has been recovering said while weeping : “I have a feeling that this is the first time I have felt to have someone sympathize and share with my feelings and wishes for years… I hope the group will help each other and together try to give better care to the PWMHP.

Mi Lem-a 47 year-old woman in Suoi Trai , Son Hoa, Phu Yen province – has suffered from schizophrenia since 1990s. Mi Lem has been treated with Aminazine at Suoi Trai Communal Health Center since 2000. After a period of time, her health status became stable. However, Mi Lem has recently refused taking medicine for the reason that she wasn’t ill. During the 2nd meeting in May 2014, the health worker of Suoi Trai CHC was consulted by the psychiatric doctor from MH Center, Phu Yen province, to replace Aminazine by Haloperidol. The new medication is improved Mi Lem situation. At present, Mi Lem has recovered much better; she can help her daughter cook rice or tend oxen.

Sharing from some members of family group

Ms Hieu, the wife of Mr Duong – a case of schizophrenia in Vinh Son, Vinh Linh, Quang Tri province: I have been joining Vinh Son Communal Organization of Disabled People (DPO) since the DPO was founded (2000). Compared to meeting organized by DPO, these 8 meetings for families with PWMHP are much more specialized and more professional. I wish there will be next meetings so that we can have more opportunity to exchange and share our thoughts, joys as well as sorrows and how to give the best care to the PWMHP with each other.

Mr Khoi, schizophrenia patient in Vinh Tu, Vinh Linh, Quang Tri

Ms Thao, schizophrenia patient in Vinh Tu, Vinh Linh,

Quang Tri

Lesson learn from self-help group of families with PWMHP

• Participation of families and PWMHP is good for themselves, clients and professionals to learn from each other

• It is good to get clients who recovered well in the meetings• Build confidence, and dealing with stigma• Get DPO involved in the meetings, so that they provide social and

financial supports for families with PWMHP• Families with PWMHP were so happy to talk to psychiatrists in the 2st

and 6th meeting• Important roles of VHWs to encourage participants to share their

experience • Need to collect and document stories of the families who solved their

problems to share with other families• Each meeting last in 2h •

Disadvantages from self-help group of families with PWMHP

• Barrie from language especially at ethnic minority people. So the VHWs can use their own languague

• Not convenience to have suitable meeting location due to far distance from members

• Some of family didn’t fully participate in 8 meeting because they are busy to take care PWMHP and their own work

• How to continuing and suitability of self-help group of families with PWMHP?

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