Psychbigyaan Podcast : Interview With Jenny Joyce

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In this podcast we interviewed Jenny Joyce, newly graduated and soon to be qualified occupational therapist from London who was in Nepal for applying her knowledge in mental health service in Amrita Foundation. We interviewed her on the occasion of World Occupation Therapy Day, 2017 to enlight us with the concept of OT and its significance in mental health in the context of Nepal. Here is the link to the interview:

The power of activity: Nepali mental health patients find purpose in occupational therapy.

– Jenny Joyce, Kripa Sigdel and Sujan Shrestha

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In the sunlit courtyard of a mental health residential facility in Boudha, Katmandu, men and women sit drawing and painting hand-crafted paper balloons, decorating the entrance to the 100-bed Amrita Foundation Nepal building.Patients here are on a journey of recovery from various mental illnesses.“When I’m drawing, I’m not inside my own mind anymore” says one of the men who regularly suffers hallucinations.

Nepal is still emerging from the devastation of an earthquake in 2015 that killed at least 8,000 people and left over 700,000 homes destroyed.Adding to a litany of challenges that already face the country  – crushing poverty, a decade of insurgency and continuing political instability – incidents of mental health problems appear to be on the rise since the earthquake. There are reported cases of increased suicide rates in the districts worst hit by the earthquake like Sindhupalchowk. While no official data exists on the prevalence of mental health illnesses estimates suggest around 20 to 30 percent of people in Nepal suffer some form of mental health problem.

Significant strides have been made in decreasing infant and maternal mortality rates and improving access to health services. Sadly the same cannot be said for the realm of mental health. It is perhaps the most neglected health issue in Nepal, demonstrated by the government expenditure of less than 1% of the health budget on mental health and the existence of only one government-funded mental hospital.It is alarming that Nepal was ranked 7th in the world for its suicide rate, according to the World Health Organisation in 2014.

Occupational Therapy

Amrita Foundation Nepal in Boudha is a privately-run mental health facility where patients suffering from illnesses including bipolar disorder and schizophrenia attend therapy sessions including some run by occupational therapists from the United Kingdom. Occupational therapy, sometimes called “OT”, aims to improve physical and mental health through engaging individuals in activity.Routines of everyday life like cooking and washing as well as leisure pursuits such as sport and music are activities that “occupy” our lives and help give it purpose.

Occupational therapists believe that a person who cannot participate in these activities because of a mental or physical ailment cannot achieve their potential and can find themselves left behind by society. Enabling people to regain and maintain crucial life skills is vital to a successful recovery from ruptures in life like family break-ups and natural disasters.

OT is a well established health profession across many countries globally. In Nepal, however, it is still in its early stages and OT practitioners are a rarity amongst the health and social care facilities around the country. The Association of Nepal’s Occupational Therapists set up in 2008 is working to promote the profession and raise awareness. Their efforts connect international occupational therapists working in Nepal with Nepalis who have sought OT qualifications abroad and returned to practice at home.Until now no educational programmes for training occupational therapists have been established in Nepal.

Wakeup Call

The earthquake in 2015 served as a wakeup call for both the government and the public to acknowledge the importance of mental health. A deluge of programs launched by NGO s and INGOs are seeking to address the growing needs of earthquake survivors suffering emotional and mental turmoil. It is essential to exploit this newfound awareness to bring about a more sustainable approach to mental health in Nepal. Positive changes are happening. The government for the first time has allocated a portion of the budget to implement mental health programs in different districts, work that is mainly being carried out by NGOs. In addition a new mental health policy has been drafted which is expected to address the gap in mental health delivery in the country.

One of the biggest challenges faced by Nepal is ensuring that all aspects of mental health care are integrated rather than only pursuing medical or biological treatment. Occupational therapy fits in this holistic perspective of mental health which can play a major role in helping the recovery and adjustment of mentally ill people.

On Friday, patients at Amrita Foundation Nepal will gather in the garden and build a tree sculpture to mark World Occupational Therapy Day 2017 which celebrates the profession internationally. Recently one of the patients at Amrita explained how living with depression and having nothing to do meant that “days are long but months and years slip by fast”.

To ensure patients like him do not pass through life feeling this way and to enhance the quality of life for mental health patients alike, it is crucial to provide opportunities for people to be occupied.

( Jenny is a occupational therapist from London )

The article was featured in Republica on 27th October, 2017. To see the online edition of the article in Republica click OT DAY 

Mental Health at Workplace

-Sujan Shrestha and Kripa Sigdel

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In today’s busy world human life has been reduced to mere mechanistic ritual of making a livelihood. Every adult’s life is subsumed by the conundrums of their work which after some times have the greater likelihood of being monotonous. Being in the constant pressure of workload, deadlines, pleasing the boss, yearning for extra buck and recognition among colleagues can be deterrent for our mental health. In this context, to make us all aware of the work related stress and its impact in our mental health World Health Organization (WHO) has decided to celebrate this year’s world mental health day, October 10,  with the theme ‘ mental health in workplace’

Any work is better than no work?

Undoubtedly, it’s good for our overall wellbeing for us to be employed rather than staying idle. But, at the same time, negative working environment can be the potential stressor in life threatening our mental health. The recent study conducted by Chandola and Zhang (2017) in the UK revealed a quiet insightful finding. The study was done between the population who were re-employed in poor quality jobs and those who were unemployed. They found out that the population who were unemployed had lesser biomarkers of stress than those who were reemployed in bad working condition. This research has elicited the crucial understanding that any sort of job may not necessarily be better than no job. We need to focus on qualitative aspect of job rather than a job itself.

Cost of mental health problems

Negative working condition is very stressful for employees. This stress results from many sources. Some of the chief sources are: workload, inflexible work schedules, poorly managed shift works, intrapersonal conflict, low participation in decision making, job insecurity, poor pay, low social relationship, conflict with supervisors and managers, bullying and harassment etc. All these factors can lead to mental health problems such as burnout, anxiety, depression , substance abuse and some may even resort to suicide. All these have downward effect on the productivity of the job.  As per WHO, depression and anxiety have been attributed for costing global economy US$ 1 trillion each year in lost productivity.

One of the glaring evidence in Nepali context has been the news of suicide of those who went for foreign employment in Middle east countries, Korea and Japan. The report, “When the Safety of Nepal Migrant Workers Fails” published by International Labor Organization (ILO) in 2016, attributes suicide as being responsible for  about 10 % of all the deaths in foreign employment. The report compiled the number of deaths from the year 2008 -2015. Out of many reasons we can speculate negative working condition, work related stress and job dissatisfaction having contributory causal role to the suicide .

People with mental health problems have been suffering doubly. On top of their detrimental condition they have to bear the brunt of social stigma. They are seen as unfit for work. First of all we shouldn’t conceive ‘mental health problem’  constituting complete derangement of mental state and being out of reality only as demonstrated by the derogratory terms such  as ‘bahula’  and ‘pagal’. Infact majority of the people have mental health problems not exhibiting the symptoms of psychosis and they appear to be functioning well professionally. Due to the fear of stigma many people keep mum about their conditions in the workplace which will ultimately worsen their conditions

Protecting rights

Nepal is a signatory of The UN Convention on the Rights of Persons with Disabilities (CRPD). Article 27 of The UN CRPD provides a legally-binding global framework for promoting the rights of people with disabilities (including psychosocial disabilities). Similarly The Constitution of Nepal, 2015 enshrines the fundamental rights of all Nepali citizens regardless of disabilities. But still there are provisions in the law which debar the people with mental health problems from taking official responsibilities assuming the mental and cognitive incapacitation. The legal provision is vague in stating the mental state that constitutes mental and cognitive incapacitation but has sweeping generalization that puts all the mental health conditions in one basket. The government should amend the flawed laws which cast out the persons with psycho-social disability from workplace.

Majority of workplaces in Nepal do not have an insurance scheme for the health of their workers let alone for mental health. The attitude of co-workers and manager are not favourable to the employees who are facing mental health difficulties. There’s a need for understanding of such problems which can happen to anybody at anytime and not make it as a taboo. An environment of safety and security should be created for the employees who are facing mental health problems.

Nepal has recently introduced The Sexual Harassment at Workplace Prevention Act, 2015 which aims at preventing sexual harassment in the workplace, protecting the victims and punishing the culprit with the fine upto Rs. 50000 and six month imprisonment. Such laws should be introduced to prevent other forms of workplace harassment such as bullying. The organization should have non-discriminatory policies for their employees and have punitive provisions for the harassment and bullying and protection for vulnerable employee.

What needs to be done?

An organization can start with hiring a industrial psychologist or counsellor who can provide regular counselling services for the employee. Any employees can be benefitted by such facilities regardless of their mental condition and can be effective shield against any mental health problems. The management should be sensitive enough to understand the problem and accordingly design the job flexibly for employee with mental health problems and have supportive and confidential communication.

In terms of working condition we might be surprised to know that workers value more intrinsic motivations such as good relationship with supervisor, praise, respect, recognition than extrinsic motivation such as pay rise, bonus, good physical setting etc. This has been proven by famous study known as ‘Hawthorne Studies’ which compared the workers in different working conditions and  found productivity to be increased when the supervisor – worker relationship was good  than when physical conditions such as lighting, pay , breaks were increased. Therefore, good management and worker relation can improve the productivity and at the same time make positive working condition.

Employees should be aware of their own self care for one’s own physical and mental health. Regular physical exercise, plentiful rest, sleep and hydration are simple yet very effective for good mental health. Employees self care can be complimented by the organization by making good and flexible job designs and motivating the staff. One simple exercise of periodic group supervision in which members perform some rituals such as mindfulness exercises, share their highs and ups in work and personal life can have therapeutic effect.

While we are busy in making a living let’s take break sometimes to live a life!

(The article was published on October 10, 2017 in Republica. Here is the link of the article in the paper – mentalhealth in workplace )

Unlocking Mind Through Poetry – August Series

We celebrated the second anniversary of Psychbigyaan Network Nepal with Poetry and Video session. The program was featured by national daily,  Republica , the details of which is given below :

Unlocking the Mind through Poetry’ was organized by Psychbigyaan Network Nepal-PNN on
Sunday at Godavari Alumni Association Hall, Thamel. The event was organized to mark the
second anniversary of PNN, which has been hosting awareness programs through podcasts,
intellectual discussions on psychological and mental health and ‘Psychological Help’ and ‘Mental
Health Campaigns’.

The program saw the participation of 1 2 youths, who performed touching verses on mental
health, suicide depression, anxiety and a few other stigmatized mental health situations.
In the sidelines of the event, program coordinator Kripa Sigdel said the main purpose of the
program was to bring up the issues that affect mental health and wellbeing through poetry.

“Psychology is just not about mental illness, it’s about enhancing our wellbeing as a whole. Let’s
talk about it. Let’s get connected to make the world a mentally healthy place,” she said.
She added that ‘Unlocking the Mind through Poetry’ was a relatively new concept. “The audience
today seemed captivated by sentiments in the poems. This undoubtedly was an effective
approach as it led the audience to discard the stigmas revolving around mental health and
accept the nuances of emotional well-being,” she said.

One of the reasons why ‘Unlocking the Mind through Poetry’ became an exciting place to be was
because it embraced a powerful idea that arts and other forms of expression are oftentimes
effective in relieving emotional burdens. Adding to the artistic ambience of the event, five videos
were displayed to raise awareness on the topic.

By the end of the event, audiences walked away with essential information on how to tackle
suicidal temptations as well as helpline and hotline numbers to reach out to when people
around are dealing with suicidal thoughts.

The program was ended celebrating the birthday of one of the founder of PNN, Kripa Sigdel whose birthday coincided with the birthday of the organization. Some of the pics of the program are:

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This is the link to the news report of the event :  mind_unlocked.

 

 

‘Psychbigyaan- Kurakani-June series: Power of Speaking to Lead’

As a  part of our Psychbigyaan Kurakani Series, we had Ashish Silwal to give a talk on the topic – ‘Power of Speaking to Lead’ on June 30, 2017 held at Innovation Hub, Teku. The program saw about 30 participants from diverse backgrounds. Ashish talked about the ways in which we can speak convincingly, confidently and persuasively. Along with that he also gave tips to make our presentation attractive and eye appealing. Below are the pictures of the event:

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‘3 Day Workshop on Research and Proposal Writing’ Held

‘3 Day Workshop on Research and Proposal Writing’ was successfully organized by PNN from May 4 – May 6 at Oscar International College, Sukedhara. The program saw 35 participants from different social sciences background. The program was divided into Qualitative Research, Quantitative Research and Proposal Writing sessions. The program was conducted by two professionals who are well known in their line of Profession.

The first day of the training was conducted by Liana Chase, Phd Candidate, SOAS – University of London. It was very informative and the participants learned about the foundations of qualitative research.

The second day of the training was conducted by Sanjesh Shrestha, Lecturer/Researcher-Tribhuvan University. It was very informative and the participants learned about the foundations of quantitative research and research process.

The third day of the training was conducted by Liana Chase, PHD Candidate, SOAS, University of London in the first half where Participant learned about the Proposal/Grant writing.

In the second half, the film by School Foundation Nepal : Signature Movie Cum Stop Negative….Think Positive: Signature Global Campaign was featured by Social Foundation Nepal.

We would like to thank our Venue Partner, Oscar Intl. college of Film Studies, School Foundation Nepal and special thanks to Nepal Association of Humphrey’s fellow and US Embassy Nepal for supporting and encouragement for this event. Lastly, thank you dear participants for joining us these 3 days.

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