MEDICARE
Scarf: Overcoming a stigma
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The Schizophrenia Research Foundation (SCARF) in Chennai has been fighting the myths surrounding mental illness for 20 years. SHALINI UMACHANDRAN talks to Dr. Thara of the challenges that face the institution.
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S. THANTHONI
Learning to live again.
IT'S an unobtrusive little building past the sprawling Annanagar West extension bus stop in Chennai. A tiny yellow board meekly declares that you are in the premises of the Schizophrenia Research Foundation (SCARF). Inside, patients mill around waiting to see the psychiatrists and therapists who will prescribe medication and treatment so that they can resume their lives or learn to live ...
Established in 1984 as an NGO by the eminent psychiatrist Dr. Sarada Menon, SCARF is celebrating 20 years of research and rehabilitation of persons affected by schizophrenia and mental problems. "The challenge was overcoming the stigma of schizophrenia. Even donors were afraid to be associated with mental disorders," says Dr. Thara, the present director.
Schizophrenia is not, as is commonly supposed, split personality or multiple personality disorder. It's the scientific term for what is commonly referred to as insanity. "The relative non-visibility of the condition is a problem. It's only when people start ignoring their personal hygiene or having major hallucinations that the family is willing to admit that something is wrong. And that's the acute stage," says Dr. Thara.
Societal perceptions are the biggest challenge facing the crusaders for early detection and treatment of mental illnesses. "We see only a fraction of the cases because of misconceptions and the stigma attached to going to a psychiatrist," explains Dr. Thara. The misconceptions include black magic, witchcraft, evil eye and being possessed by a spirit. Films often stereotype the mentally ill as aggressive or complete imbeciles sitting in corners and singing to themselves. That's why a film like "A Beautiful Mind" (the 2001 Academy Award winning film on mathematician John Forbes Nash's struggle with schizophrenia) is inspiring. "It showed that he could go on to live a normal life and even win the Nobel Prize despite being acutely schizophrenic. More importantly, it showed the importance of family support in rehabilitation." Despite the huge odds, SCARF claims to have provided free outpatient care to nearly 6,000 mentally ill, treated more than 1,000 rural patients through its community mental health projects and over 200 persons from urban slums. The community outreach programmes and outpatient care provide early intervention and prevention. These are patients who only require medication and monitoring to prevent lapses. SCARF is collaborating with the World Psychiatric Association to launch a global anti-stigma campaign on February 6. Rehabilitation of schizophrenics involves intervention at several levels. SCARF has two residential facilities at Thiruverkadu and Mahabalipuram to provide need-based care to men, women and elders. Workshops and activities include chalk making, screen printing, envelope making and file binding. SCARF also helps with placement of rehabilitated patients in other NGOs, production units and organisations. They run a programme to support the children of the mentally disabled — putting them through school and providing educational requirements.
Extensive research into the causes and effects of schizophrenia has led to collaborations with leading international organisations and in 1999, SCARF collaborated with the World Health Organisation (WHO) as a research centre for mental illness, a first for such an NGO is South East Asia. From January 29 to February 2, SCARF hosts an International Conference on Schizophrenia (IConS), which will bring together 350 delegates to discuss and debate the latest research findings and issues on mental health.
Dr. Thara ... challenging societal misconceptions.
SCARF also trains students from various disciplines and is affiliated to the MGR Medical University for post-doctoral research studies.
The decision to stay local, and not open more research or rehab centres elsewhere, was a conscious one, says Dr. Thara, because expanding would involve too many complications and the same level of service and research might not be maintained. "Instead, we encourage the people who train with us to set up their own NGOs — many are now working in the North East, in Kolkata, all over the country."
Though SCARF deals with mental health in general and schizophrenia in particular, they are working on positive mental health programmes as well, which focus on strengthening value systems, stress management and related fields. Manuals on mental health, the importance of family support systems, handling emotional and conduct problems in children and pamphlets and films to rid people of their fear of accepting and handling mental illnesses are just one part of SCARF's anti-stigma campaign. Her suggestion is that the government launch a massive campaign along the lines of the leprosy campaign to educate people. Though the Persons with Disability Act passed in 1996 includes mental illness as a disability, governments are yet to go beyond recognising physical handicap and mental retardation as disabilities.
Schizophrenia Research Foundation (SCARF) can be contacted at 044-26153971, 26151073. E-mail: scarf@vsnl.com
Website: www.scarfindia.org
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SCHIZOPHRENIA affects about one per cent of the population, and usually persons between 15 and 45.
Identification:
Withdrawal symptoms include loss of interest in family and friends; drop in academic or work performance and disturbed eating and sleeping patterns
Delusions may manifest as feelings of persecution, discrimination or belief in conspiracy theories
Hallucinations occur at the acute stage of the illness, the person hears voices and sees frightening figures
Disinterest in personal hygiene also occurs in the later stages, the person loses interest in personal appearance and surroundings
Inability to express emotion and does not appear to be in touch with reality
Treatment:
Medical treatment
Psychotherapy
Social rehabilitation includes occupational therapy, group therapy and family counselling
Recovery:
Studies show that a third of all persons diagnosed with schizophrenia recover completely, one third can live normal lives with continuous medication and treatment but there are cases that will improve but are too far-gone to recover completely.
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