www.koshishnepal.org KOSHISH July, 2019

Discussion is necessary on Mental Health Promotion Mental Health Situation, Opportunities and Challenges in the present context and Future Priorities

n interaction program was organized on “Mental Health Situation, Opportunities and Challenges in the A present context and future priorities” on 7th June 2019 chaired by Chief Guest Mr. Mahendra Prasad Shrestha, Chief of Health Coordination Division, Ministry of Health and very person has an expectation of wellbeing. Wellbeing is a Efeeling that mostly depends on mental health. Alternatively Population and with participation from representatives from saying, without mental health, complete wellbeing is not possible. Ministry of Health and Population, Department of Health However, we must ask ourselves how sensitive we are in such an Services, Epidemiology and Disease Control Division (EDCD), important issue? How much we discuss it? In recent years, public debate (discussion) has increased regarding National Woman Commission, National Human Rights mental health. Acceptance of mental health problem as a common Commission, World Health Organization and relevant Civil health problem has increased. Mental health problems such as Society Organizations. anxieties and depression have already become critical issues in both rich and poor countries all over the world. It is also an established Presentations were made by Dr. Bikash Devkota Chief of Policy, fact that mental health problems are not caused by individual Planning and Monitoring, Ministry of Health and Population weaknesses. Anyone may be affected by mental health problems, no matter if he or she is a politician, high-level employee, business on existing laws and policies relevant to mental health and Dr. person, artist or the general public. In all classes, mental health Bibek Kumar Lal, Director, EDCD who shared about plans for problems like alcohol and drugs abuse, depression, anxieties along the future in regard to mental health and Mr. Matrika Devkota, with suicide are escalating day by day. Our society shows a high concern for mental health on one side. Executive Director of KOSHISH who shared the right holders Yet, persons with mental health problems have been deprived perspective and his expectations from the government. of employment, community participation, voting, running own institution/organization, etc., even though the constitution of and UNCRPD have strong provisions non-discriminated discussion where the participants shared their expectations on any ground. Ironically no one really cares for the promotion of Following the presentations, the floor was opened for such an important issue of mental health. in regard to what the “Mental Health Promotion, Treatment Family and society should be supportive and caring for good and Rehabilitation Strategy” being developed by EDCD should mental health. The main causes of raising mental health problem incorporate as per the objective of the program. The feedback are discrimination, stigma, and negligence. We observe changes collected will thus be submitted to EDCD and it is expected to in behaviors, thought processes and activities in mental health problem. It is as real and factual as a physical health problem. support the governmental body to make the strategy document There may be trau ma, depression, anxiety, or any other problem more comprehensive and inclusive of opinions from relevant like wounds, injuries or various diseases in physical health. stakeholders.  We have heard, “I never ate sugar, but I have the chronic problem of diabetes”. Similarly, mental health is too. How it starts, we cannot before its start. There may have different mental health condition among the twin who is grown up in the same condition, health care, education environment. Another notable thing is that there is a variety of mental health issues like the difference in common cold, cancer weakness and diabetes. We use to hear, “I never ate sugar, but I have the chronic problem of diabetes”. As diabetes is not solely related to sugar, mental health problems can be not identified with a single cause. It is developed in the congruence of social, family and environmental factors. We should also note that there are varieties of mental health issues and they differ from each other as physical health problems differ from each other from common cold to cancer or diabetes. In the end, mental health condition is not an individual weakness. Good mental health is possible only if society, environment, and situation are favorable. Let us openly discuss Mental Health. Sanjay Raj Neupane General Secreatary 2 July, 2019

Workshop with Members of Parliament

workshop with Parliamentarian The members of parliament and of persons with psychosocial disability Committee for Law, Justice and representatives from NHRC made and mental health issues and to include A Human Rights was conducted commitments to prioritize the rights this issue in their work agendas.  on 31st May 2019. The main objective of the workshop was to highlight the current situation of persons with mental health issues and psychosocial disability and its relevant Nepalese legal provisions. The law makers wholeheartedly accepted the fact that it is their duty and responsibility to work for the protection and promotion of persons within vulnerable groups and made commitments to amend the discriminatory laws to ensure the dignity, protection, and promotion of persons with mental health and psychosocial disability. One of the MP’s said “My perception has changed 180 degrees on a dime after this seminar.” There were a total of 34 representatives from the National Human Rights Commission, Parliamentarian Committee for Law, Justice and Human Rights, Parliamentarian Committee for Health and Education, Women and Social Committee of the Parliament, and Parliamentarian Committee for Development and Committee. Honorable MP (Chairperson of the parliamentarian committee for Law, Justice, and Human Rights), Honorable member of National Human Rights Commission, and Senior Advocate Workshop with parliamentarian members from Law, Justice and Human Rights Committee, Govinda Sharma Poudel made key Health and Education Committee and Women and Social Committee. remarks on the Nepalese Legal framework and situation of medical doctors in relation to mental health and psychosocial disability. The Information Sharing and Collaboration Meeting with National Executive Director of KOSHISH shared his lived experience of dealing Inclusion Commission with issues of mental health and n Information Sharing and psychosocial disability. The honorable psychosocial disability. Senior Advisor Collaboration Meeting was members of the commission were of KOSHISH Advocate Shudarson organized with the National grateful towards KOSHISH, as it has been Subedi also contributed facts based A Inclusion Commission on 12th playing a key role in providing service to on his experience: that due to stigma June 2019. The National Inclusion those suffering with mental health and and lack of awareness, bureaucrats Commission is responsible for psychosocial disability, which should be involved in the law-drafting process the protection and promotion of the government’s role and responsibility. are not receptive towards the issue vulnerable groups including people The chairperson highlighted the fact that of mental health and psychosocial with disabilities. The meeting was the commission is in need of support disability. A presentation on legal organized to update the commission from KOSHISH in the formulation of plans provisions that are contradicting with about issues related to mental health and policies in regards to the issue.The the constitution of Nepal, UNCRPD, and and psychosocial disability in regard commission also made commitments the Rights of Persons with Disability to press the government to implement to the current situation in Nepal. Act 2074 was presented. This included existing plans and policies regarding the the best international practices and Honorable Chairperson of the National issue of mental health and psychosocial recommendations from the UNCRPD Inclusion Commission, Dr. Shanta Raj disability. The commission agreed to committee. Poem recitation and Subedi and Honorable Member Bishnu collaborate with KOSHISH to work awareness songs were performed by Maya Ojha made commitments to support together on the issue of mental health and rights holders. issues related to mental health and psychosocial disability.  www.koshishnepal.org 3

Interaction program with province 1 parliamentary members on mental health

n interaction program was organized on 14th June in A Biratnagar on “Mental Health situation in Province 1 and efforts, opportunities, challenges and future priorities for the local government”. Some key stakeholders in the program were Province Parliament members, Deputy Parliament Speaker, Chief Secretary of Province 1 and Director of NHRC Province 1. In the program, the Deputy Parliament Speaker mentioned that there has been a campaign on healthy life and to manage health better. There have also been provisions for nurses in each secondary schools and it was now upon them to make it effective and ensure that awareness in regard to mental health provincial laws related to mental health children in these schools receive not just even among the members. She also is important. physical health support but in mental mentioned that even though it is a The program has been able to establish health as well. She also mentioned that bit late to have these discussions as mental health issues as one of the sending persons with mental health they are preparing for endorsement major concern for Province 1 and the issues in rehabilitation centers outside of budget in the provinces, they will key stakeholders made commitments the province is not practicable and it is see how they can allocate budget for to raise this issue in the parliamentary important to rehabilitate them in their mental health from the overall health own communities. budget. She concluded by saying that budgets for mental health from the A parliament member also they will speak with the parliamentary discussions as well as figure out acknowledged that there is lack of speaker and try to convince him that 2076/77.  overall health budget in fiscal year

Regional level Interaction program on Mental Health in Dhankuta

regional level interaction program was organized on A 15th June in Dhankuta on “Current Mental Health Situation, Opportunities and Challenges”. There were a total of 47 participants in the program with participation from key stakeholders such as Head of District Coordination Committee Dhankuta, Mayor of Dhankuta Municipality, Chief

Province 1. WithDistrict mention Officer of and interaction Director on of mental NHRC

district, the stakeholders expressed healththat they being have first witnessed of its kindmany in cases this where persons with mental health There have been some positives as well promote mental health. issues have completely recovered. with persons with mental/ psychosocial Yet, availability of services remains disability receiving disability ID cards Finally, the chief guest for the farfetched as people have had to travel of category ‘A’ and ‘B’ from women, program, head of District Coordination long distances to receive treatment. Committee Dhankuta stressed on the Some of the highlights were also on the the district. In his concluding remark, need to develop technical expertise and need to collect data to be able to work childrenCDO of Dhanukta and senior called citizen upon officethe local of on these issues better and that these government to aware and sensitize the issues needs to be discussed further. general population of the district to health service.  fulfill the gap of unavailability of mental 4 July, 2019

Commitment to protect human rights of women with severe mental health issue due to gender based violence OSHISH organized a national consultation meeting on K “Gender Based Violence and mental health” on 13th May 2019. The objectives of the program were to shed light on the real situation of women who had severe mental health issues caused by gender based violence. The program also aimed to sensitize concerned stakeholders on gender based violence toward women with mental health issues and discuss the role of the state in protection of women with severe mental health issues. The Hon. Minster Tham Maya Thapa, Ministry of Women Children and still persist for women in Nepal. At the end of the program, citing the Senior Citizens, addressed the program data presented by KOSHISH, Hon. as the chief guest. The Hon. Minster Likewise, a representative from Minister Tham Maya Thapa stressed also accepted that despite mental Ministry of Health, Ms. Shrijana the need for further research. She also health being an important issue, our Gyawali, highlighted the efforts made mentioned that the government is government does not have enough by KOSHISH to mainstream the issue of sensitive and aware about the issues programs to cover the issue of mental mental health in overall health. She also of women and the issues have been health and violence against women. She expressed that the government needs considered while allocating the budget made commitment to include mental to work to make psychosocial services and developing programs. She shared health in the upcoming programs from accessible and affordable for all. Some about plans of government to take the ministry. The general secretary of the same ministry Ms. Rudra Sharma programs shared their experiences development for women who faced admitted that though various laws, beneficiariesregarding their of KOSHISH own mental mental health specificviolence, actionsas freedom regarding from the livelihood cycle of acts, policies, and programs exist, issues, KOSHISH’s support, and their violence is highly related to economic discrimination, violence, and inequality present situation. empowerment. 

Capacity Enhancement Program Accomplished

OSHISH organized the 'Capacity Enhancement Program' on K 22rd April, 2019 with the objective of enhancing the capacity of self-advocates and staff working for and psychosocial wellbeing/disability. Mr.advocacy Matrika in the fieldDevkota, of mental Executive health director of KOSHISH, shed light on the advocacy efforts made by organizations psychosocial disability and facilitated a inbrainstorming the field ofsession mental on the health problem, and opportunities, and threats. The program was facilitated by advocate Sudarshan Subedi (Immediate Past President of National Federation advocacy intervention, and ensuring Sharmila Parajuli and Trishna Thapa, of Disabled Nepal). He informed effective advocacy. A brief discussion advocates involved in advocacy programs of KOSHISH, also put forward participants on the strategy of on KOSHISH’s future advocacy strategy identifying advocacy issues, prioritizing their views on efforts made by KOSHISH document was conducted in the them, and analyzing the context of advocacy. He also discussed the program where all participants shared and psychosocial disability, as well as their respective views. inachievements the field of advocacy and threats. of mental  health identification of stakeholders, planning www.koshishnepal.org 5

Representation of Self-help Groups in "Speak Your Mind" Workshop

workshop was accomplished to know what is going in the present community. They also shared that if on 2nd and 3rd June in the the support of KOSHISH continued they A Godavari on taking forward They further said that they would like will arranging meeting, conference the mental health advocacy program world in the field of mental health. along with other related campaigns to support other people experiencing and drama for mental health and right in Nepal in the coming future. The mental health problems in their advocacy with local government.  members of 'speak your mind' campaign of 'United for Global Mental Health' had organized and facilitated the workshop in coordination with KOSHISH. The representatives of the different organization had attended the workshop. In total, 33 participants participated in the workshop from different organizations including KOSHISH, TPO, CMC, UMN, and WGDR. There was the presence of six self- help group's members (3 people from Bhaktapur, 1 from Lalitpur and 2 from Tanahun) who actively participated in the event. Al the participants, head of organization, staffs, executive members and SHG members had equal and energetic participation. The program had created the environment for all the participant Meeting of Self-help Group has been continuing to share their feeling without any hesitation. An interpreter was there he meeting of self-help group are very happy as their working ability to facilitate exchanges of ideas and operated by Koshish with the has increased and also they are getting feeling without language barriers. T support of Defar Denmark a chance to involve in family supports. The program which was conducted in Lalitpur and Bhaktapur are in Normally they spend their daily life in full participation of the individuals continuation. In total 30 meetings in doing agricultural works. Even the was completely focused on the issues group members who live nearby go to the duration of this quarter. Though agricultural works together. In this way, workingthat should in thebe prioritized field of mental for carrying health were held within five groups during out mental health campaign in the the staffs of Koshish represent the they are helping each other not only in the future. meetings, they have decreased their meetings but in practical life also. involvement respectively. In the program, participants had Along with the increase in their abilities, discussed the current situation of the perception of society towards them mental health in different groups. have similar kinds of problems but it was is also changing. Some members have At first despite the members of the group concluded that suicide, discriminatory started being members of other groups emotions with each other. But because in society. Though the local government Thelegal provisions, discussion lack had of identifiedenough mental and difficult for them to open up about all the health professionals, lack of awareness, of continuous meeting, conversation has not supported them directly the stigma, and discriminations are the and closeness they have started being local government has a positive attitude root causes of increasing mental health friendlier with each other. In the meeting, towards them. But for this reason, all the problems in Nepal. According to the self- the members of the group are involved in members of the group should appeal to help group leaders: familial disputes different entertainment activities, general and quarrels are the main factors the local government. which degrade their mental health and exercises, simple activities for stress With the motivation, support, and positive they have been receiving ignorance and management, yoga, and so on. Many of competition, the members of the self- offense from both community and state them even repeat those activities at home help group have started putting effort till date instead of support. also. on writing work also. They have started At the end of the program, group They feel that when they are practically writing poems and songs as well as they leaders of the self-help group said that excluded and rejected from the family have been aware of the rights of people such program provides the opportunity to explore their ideas. They also shared and society, at that time, they get support with disability. From this, it can be seen that after the program they were feeling and trust from the group members. that the self-help group has a bright energetic as they had the opportunity They also share that in recent days, they future.  6 July, 2019

Accomplishment of Participatory Rural Appraisal

fter the catastrophic organization. PRA, FGD, KII, Statistical All the activities conducted helps earthquake of April 25 2015, to identify the household of people A many activities were carried needs and importance of communities with disability, support system and out for the reconstruction yet many peoples.data tools All werethe communities' used to Identifies stake availability of mental health service such projects are still in development. holders, community's people's, This slow pace of development has health workers, FCHV, teachers and and facilities, attitudes and perception increased prevalence of severe mental Social worker were participated in of the communities' peoples towards health problems and suicide as both the session. peoples with psychosocial problems.  federal and local government in Nepal are always more focused on rebuilding of physical structural only ignoring health and especially mental health. KOSHISH National Mental Health Self- Help Origination coordinated with Panchakanya Rural Municipality

International (MI) to conduct Participatoryin financial supportRural Appraisal of Malteser in , Panchakanya Rural Municipality. Program was based on the participatory approached with different types of activities (social mapping, Resources mapping, Wealth ranking, Seasonal Calendar, and, daily clock) including all types groups and members. After catastrophic earthquakes 255 houses were built by the RSDC ndh'ª tyf uf]/vfsf ;a}sf nflu dfgl;s :jf:Yo Pkm=Pd= /]l8of]af6 k|zfl/t /]l8of] sfo{qmd

k|To]s dlxgfsf] bf];|f] / rf}yf] dËnaf/ ;fF³ &M)) b]lv &M#) ah];Dd d:of{ª\bL Pkm=Pd= (% d]ufxh{ / /]l8of] kfn'ª6f/ (( d]ufxh{af6 sf]lzz /fli6«o dfgl;s :jf:Yo :jfjnDag ;Ë7gsf] j]a;fO6 www.koshishnepal.org af6 klg nu Og u/L ;'Gg ;lsG5 . u'gf;f] tyf ;Nnfx ;'³fjsf nflu sf]lzz /fli6«o dfgl;s :jf:Yo :jfjnDag ;Ë7g, afu8f]n nlntk'/ )!%!()!)# www.koshishnepal.org 7 Sarala on the Way of Self-sustainability (Experience of Beneficiaries)

y name is Sarala Kaphle reach out to them. Even though the complaint was (changed name) and I am 46 After returning from Pokhara I started years old. I was born in the M visiting the psychiatric OPD in Damauli because of which I had no resources to Majhthana VDC of the and registered I had financial problems hospital every month. The hospital was was raised in the municipality running with the help of Koshish. The people that can’t help themselves” ward no 8 of the Tanahu district. I had fight my case. As it is said” God helps help that I was provided with from the it was true in my case because my a huge family of 12 which included my outpatient ward in the hospital had transportation fee was managed by a parents, 5 sisters, 4 brothers and me. helped me improve my mental health. government advocate and I was able My parents were involved in agriculture to win the case. My husband had to and I and my siblings would help them During this time my husband remarried provide 5000 in my name and 5000 in as much as possible. I went to a school and had started living separately with our daughters name monthly because that was in my village and studied till his newlywed wife. The suspicion that she was under 16. I was able to look the 10th class but I was not able to pass my neighbors had changed into reality. after the household, provide for my my SLC exams. When I was 21 I got daughter's needs and education and buy married to a family in Tanahu district. medicines from the same money that and wasn’t able to provide enough was being provided by my husband. I dowryMy family to wasn’tmy husband’s very financially family. stable As a started taking my medications properly result of which I had to face mental and regularly because of which I torture from my in-laws. Amidst such started showing improvements slowly. an environment at home, I still worked I started performing my everyday as a responsible daughter in law. chores properly and my children were also able to help me. During this time I gave birth to 2 children. After the birth of my children, My son is currently working in a our family separated. My husband was bachelor's degree. My daughter is also able to provide for our family of 4. Our postal office and is doing his 4th-year employed in a postal office so he was her 1st-year bachelor's degree. The started a problem. My husband had changesworking in mya cooperate health have office helped and doing me a alife sudden was happy change and of fulfilledbehavior but which then lot and I try to stay busy by involving myself in household chores and beating me and my children and religious works. stoppedincluded caring drinking about alcohol, the household. fighting, This continued for a very long time. From the help provided by Koshish, we were able to establish a self-help My neighbors suspected that he might group in Bhimad. The group consists of have an affair with other women. The people who have faced mental health comments from my neighbors and issues and discrimination from society. the lack of care and support from my People have different roles in the group husband resulted in me over thinking and I am working as the secretary of the situations. I started having problems group. We have been having meetings and showed abnormal behaviors which Sarala busy in maize and vegetable monthly where we discuss the current included willingness to stay alone away farming affairs, the events that were personally from my children and home and living in a temple. My hands and feet started faced by each individual during the This event had a huge impact on me. Had to become cold all the time. One year month and also conduct activities like passed by and my condition worsened I been in the previous mental situation yoga, relaxing exercise and also learn instead of getting better. People around I had I would have just cried and let my life skills. me that were affected because of my sorrows out. But now my situation is We have 11 members in the group. changed behaviors which included my no more the same I was mentally stable Many people have been able to involve children and my brothers and sisters in money-making activities because of got me treated from a hospital in the seed money provided by Koshish. so I had the confidence to demand my Pokhara. husband regarding multi-marriage in This has helped them improve their right and filed for complaint against my The doctor in the hospital made me aware of Koshish because of my weak Tanahu district with the help from my have also been one of the main focuses sister.the women and children's office of the offinancial the monthly state. meetings.These kinds  of activities financial state and suggested that I 8 July, 2019

Praises for the changes form doubtful ones

hree Prasad is a 35-year-old man who has successfully returned S to his permanent home in Byas (Tanahun). He has found a stable career selling vegetables from his farm. His wife is running a canteen in a nearby school. Both Shree and his wife are active members of the KOSHISH self help therapy group in their district. Together, they have a good source of income to provide for their family, their livelihood has become easier, and they are living happily with their two sons. Shree’s current happiness is a huge improvement from where he was just a short time ago. A few years ago, Shree went to Malaysia for work, where his mental health problems began. He health treatment. With round-the- experienced panic attacks to the point clock nursing care, therapeutic and where he could no longer work. As a recreational activities, and counseling, result, his company deported him to his mental health condition improved Nepal. Shree’s mental health worsened remarkably in just over a month at the and he became physically and KOSHISH transit center. Shree was able emotionally abusive to his wife. She also to reintegrate back with his family; his developed a mental health problem. In community was impressed with his a community visit program, Shree and recovery. KOSHISH gifted Shree’s family his wife were referred to KOSHISH’s with a water tank, pipes, and a water outpatient department mental health motor, which supports their vegetable services. Shree’s mental illness had farm. Their family was helped with led to alcoholism which prevented him investments to start the school canteen. from improving his mental health with KOSHISH continues to support Shree only outpatient treatment. and his wife’s wellbeing as they actively participate in a self-help group. Thankfully, the KOSHISH transit center in Lalitpur provided him a Shree says triumphantly: "After seeing my mental health problem, praise me positive community for recovery. for the change and show concern to me Shree received recovery-based mental used to doubt my capacity because of and my family".  me working in my field, the people who

School mental health program Accomplished

chool plays an important role family members on mental health and Maharsi Ved Vyas Secondary School, Vays- in the holistic development of psychosocial well being. KOSHISH is 2. A total 331 students (176 boys and 15 S children. All activities in school working in schools of the Tanahu district girls) participated in the programs. including the class environment, to promote mental health and psychosocial Following the programs, students stated teaching methods, behavior of teachers, wellbeing of children and adolescents in and discipline practices directly impact our Mainstreaming Mental Health and the overall development of children, Psychosocial Disability Project. They became more aware on mental health along with their mental health and andthat psychosocialthe program wellwas beingbeneficial and fordispelled them. KOSHISH conducted awareness programs myths and misconceptions regarding psychosocial wellbeing. on mental health and psychosocial well mental health. In response to previous It is a well established fact that school being in different schools of the Tanahu should help children to identify and polish district in the month of May, 2019. The school mental health programs, students their own abilities along with formal awareness programs discussed the reported that they became able to manage educational lessons. A formal education symptoms and types of mental health minor stressors by themselves. They also supports children’s development of and psychosocial problems, as well as shared with their family members about appropriate skills for a balanced, successful introduced stress management skills. mental health and psychosocial wellbeing. future. Additionally, children should be The programs were conducted in Sarada According to teachers, they have seen educated on mental health issues which Primary School of Bhimad Municipality, positive changes in students’ behavior will empower them to take care of their Sarbodaya School of Vays Municipality-5, and attitude after school mental health own mental health and educate their Min Madhyamik School, Tharpu and programs.  www.koshishnepal.org 9

Mental Health and psychosocial support related basic training completed

nder the inclusive community health project conducted U by KOSHISH, a three days basic training from June 17 to 19, has been completed. The 25 female health volunteers from the Palungtar Municipality were trained to detect mental health issues and its management and referral to the concerned authorities, for which this program was organized. During the three days of training, mental health, mental health issues, and its detection and management, main mental health issues and suicide prevention were discussed. After the training, the participants stated, that due to lack of adequate knowledge, the mental health issues are concealed, and are not discussed at volunteers like Khatija and Goma who have to be detected and brought to the all. They further said that the training do not have adequate knowledge about available mental health services. mental health, because of which persons informed them about mental health and The Chief Guest of the training program, are deprived of the basic mental health that they shall spread the knowledge so the chief of the Palungtar municipality services in the community. attained in the community. Engineer Deepak Babu Kandel stated Khatija Miyaan working as a female These female health workers comprise that the Palungtar municipality is health volunteer since the last 20 years, committed to promote mental health did not know that she has mental of contact, in the community health and to provide the basic mental health health issues. Goma Devkota working services.the grass-root The training level, to the build first up pointtheir services. He appreciated the role of as a female health volunteer for 7 years capacity in the mental health and the the female health volunteers in the was amazed to know that suicide can psychosocial well being by KOSHISH community and stated that they have a be prevented. is very useful in the community where There are many female health persons with mental health issues services.  significant role to play in mental health

KOSHISH RESCUES A WOMAN DESERTED AND HUMILIATED BY THE FAMILY

uring the program on the anger outbursts. Her family took her for through the Women and Children inclusive community mental minor treatment, which was ineffective health in the Gorkha and due to lack of regular medication. As time Municipality requested treatment for her. D Office after a few women of Lamjung districts, Kamala Thapa Magar passed, her condition became severe. Her She was rescued through the Inclusive of Beshisehar Municipality, ward No.2, family pursued traditional healing and Community Mental Health Program of was found by KOSHISH. She had mental locked her up. Her husband and family KOSHISH, which is being implemented health issues and due to desertion/ in Gorkha and Lumjung district with started to neglect her as her condition humiliation by her family, she had not the support of CBM. KOSHISH’s project had any treatment. team coordinated with the Besisahar duty as a loving wife, caring mother, and Kamala is a mother of a daughter and a son. worsened. For many years, she fulfilled her municipality for Kamala’s rescue and understanding in-law with great care, but Five years back, she experienced mental referral to Short-term Rehabilitation health and psychosocial problems for the when she need, her family most she was Services of KOSHISH. Currently, Kamala’s abandoned and forced to live in the streets. treatment is in progress and her condition from social settings and frequently had KOSHISH came to know about Kamala is improving rapidly.  first time. She began distancing herself 10 July, 2019

Consultation meeting regarding the promotion of mental/psychosocial health

OSHISH held a consultation meeting to discuss the current K situation of mental health problems, availability of services and the promotion of mental health / psychosocial wellbeing, the advice to the local stakeholders for the readiness in response, and the opinions compiled as also the discussions regarding possible potential collaboration, on 2075, Chaitra 25-27 and on Baisakh 15 in the seven municipalities, separately in Tanahau district for the concerned stakeholders. Program was held in municipality of Shukla Gandaki, Bhimadi, Byas, Bhano and Myagdi , Bandipur, Aabhukhaireni, in the presence of the concerned head, vice head, chief administrative the available services for mental health for the increasing mental health issues and psychosocial support in Tanhau but could not implement the same. He of the branch, representative of the District. said that only one organization could not solve this problem. There is a need officer,health organization, ward chairman women coordinator child , During the discussion the participants to have a partnership with the local health , education branch coordinator, said that the mental health program governmental authorities, which will representative of health organizations, focused on the students, training and enhance the trust of the people and their local male and female teachers, female psychological services for the persons communities. He suggested KOSHISH health volunteer and representatives working for the safe motherhood, present a proposal about the programs of the organization of disabled people training regarding the management of that can be run in cooperation with the of the related municipality, all were the transformed disorders, activities municipalities. present. to identify, make a referral, treatment, Similarly, Suraj Sigdel the National and socialization of the mental health Similarly, Sharada Khanal, deputy Director of the partner organization issues and a program to include these head of Bhimad municipality, told that CBM, program manager Milan Poudel activities as necessary. Similarly, the program has through his inner the suicide prevention and control self has opened his eyes. He said the also present. program, local level representatives adequate budget has to be allocated to and program officer Rita Gautam were and the concerned staff orientation the disability area. The municipalities Matrika Devkota, the Executive director program are required, the participants made the programs but due to the lack of KOSHISH, welcomed the participants said. of knowledge regarding the psycho- and highlighted the various aspects social disability, these programs of the program, and the program have been left out. He also suggested municipal district of Suklagandani who manager, Yuvraj Chand presented an that mental health and psychosocial was the chairperson of the program, overview of the current levels of the Chief Officer Kishwor Gurung head of the disability-related advice; suggestions said that the government has been able mental health-related issues as also consultation should be incorporated to detect the reasons and the remedies in the activities of mental health and psychosocial disability.

Byas Municipality, Mr. Dinesh Raj Pant Thetold that chief for administrative conducting the officer program of thefor the target group's disbursement of the funds to each ward is essential. There is a need to coordinate the programs of mental health with such wards, as also some other kinds of programs to ensure that there is one psychologist/ psychiatrist each in every ward. He further stated that since the mental issues are related to all issues, the programs of the municipality related to women and (cont. in page 11) www.koshishnepal.org 11

Livelihood Skill Development Program was held in Tanahun District

ivelihood Skill Development In the program, participants were during the time of his own mental Orientation program also encouraged to continue their health problems. L conducted by Koshish Mental traditional work relatively to the time Health Self Help Organization for the as well as they were informed that Furthermore, in the program, there people with disabilities and their family Koshish will play the coordination was interaction about the present members in Tanahun District under the role with the various relevant State profession of the participants and the Basic Impact Project for Mental Health institutions for providing the necessary hindrances that they face while doing and Psychosocial Disability are recently assistance. completed. The program was facilitated the work and the way of solving it by Basanta Bhatta, coordinator of the Also, in the program, Akkal Bahadur at the local level. The participants of project of Koshish in Tanahun district. Thokar, Treasurer of Koshish, shared the orientation program expressed that after being able to manage own In the program, Matrika Prasad that this program will help them to mental health problem, he chose Devkota, Executive director and move from self-sustaining agricultural founder chairman of the Koshish interacted and gave information about profession to commercial agricultural self-help group, the importance of self- time,literature he also field shared and washis ableexperiences to get profession.  help group and roles of self-help group success in that field. In the very same to the participants and members of self help-group who were present in the program. On the same occasion, he also informed participants about the legal and other rights provided by the Government to the people with psychosocial disability. He also enlightened information about the facilities and service that people with disability can get from the Government after obtaining a disability card as well as about the procedure of obtaining a disability card. In the next session of the program, there was interaction about how one can develop own professional skills and convert it into business for livelihood and how the skills can be improved and make more professional.

(cont. in page 11) assimilated, KOSHISH is planning multi- the concerned local municipalities year mental health and psychosocial proposal for a partnership along with gender-based violence can be shared promotion in Tanhau district. In this the approximate budget in the coming for the mental health services as well. regard, KOSHISH has presented in  He said that the programs should be contributing to the construction of the transparent and clean society through financial year as a matter of priority. which the mental health problems should also be resolved. The meeting organized for the compilation of the local stakeholders' suggestions and response and the probable partnership found the concerned stakeholders to be very keen to conduct a program on the mental health and psychosocial wellbeing. Based on the discussion, the conclusions, suggestions, and advice 12 July, 2019

Success Story Three Goats for Livelihood Manju Kshetri, Bhagwati Bastakoti Social Workers: Koshish ira Lamichhane a resident wounds in her body every time she goats which would help her live her life of Bhimsen Thapa rural visited us. After seeing your daughter more easily. While accepting the goats H municipality of the Gorkha whom you have never even put your district was reintegrated into her hands on in this condition was very home after full recovery of her mental hurtful.” health issues with the help of Koshish. she said,” this will definitely help me She started having mental health Koshish had provided Hira with three financially.”Having a lot of interest in studying she fully grown goats after she said: “If I issues because of domestic violence was a hardworking student and has was provided with goats I would earn she had to go through. Unaware of the psychological problems her completed her (10+2) studies. She money to provide for my medicines and has no plans of continuing her further remember Koshish for the help forever.” family restored to traditional healers (Dhami Jhakri's) for her problems but studies at the moment but would be her condition worsened. The family willing to work if she was provided condition of Hira Lamichanne’s mental members left her unattended because with a job. After knowing about her Afterstate reported a first-hand about observer her condition of the of which she was forced to return to her to Koshish, a rescue team was sent. parent's home. intentions the social workers from She performed abnormal activities like easily getting irritated and angry, After treatment, during the recovery talks were conducted on her it. As an answer to the request the ward breaking windows and doors and not chairpersonKoshish informed Lila theNath ward Lamichhane office about interacting with people. After the rescue, reintegration in her home but the she was brought to the residential home husband and his family were not said:” We are happy and excited by where she was immediately treated willing to do so. she was sad and said the improvements in Hira's health with a multidimensional approach. She with tears in her eyes“how shall I spend and believe that with good treatment the rest of my life with a family that is showed improvements after continuous mental health problems can be treated.” treatment. She was reintegrated into not able to understand my problem?” her home in a short period of 3 months He even added that he would provide help as much as possible and showed after proper recovery. from her husband and is living with her Inparents, present, sister she in hadlaw and filed her for niece divorce and gratitude towards the organization for She was the third daughter of Rudra nephews. Koshish has provided her 3 helping Hira. .  Bahadur and Bholamaya Lamichhane. She was named Hira which means “diamond” and she was considered a Hira because she was very friendly and cooperative with everyone which included her neighbors and friends and she was a hard worker and was hurry by her parents to a government physically fit. she was married in a beauty. Sheofficial grew who up with was a attracted lot of love by care her and pampering from her family. It was new environment. The family wasn’t difficultsupportive for of her the to fact quickly that she adjust was tonot a able to adapt to the new environment quickly because of which she had to be a victim of domestic violence. Hira’s parents with tears in their eyes Hira in a smile feeding grains to goats Hira on the occasion of family reunion after said “she would come with scars and receiving for livelihood the recovery from transit home of KOSHISH

Thank you for your generous support in transforming life of the most abandon and vulnerable people. We would like to invite you for long-term partnership.

Published by: KOSHISH Koshish, National Mental Health Self-Help Organization Newsletter PO Box: 9875, EPC: 2706, Bagdoll-4, Lalitpur, Nepal www.koshishnepal.org Tel: 977 1 5190103, 2221146, Email: [email protected]