Richmond Fellowship Lanka is a non-profit charity engaged in looking after the mentally ill. The philosophy behind Richmond Fellowship Halfway Homes was formulated by Elly Jansen, a young theology student who was also troubled by depression. She found that there was no need for institutional care for those patients who had recovered from schizophrenia or bi-polar disorder, and did not have any overt positive symptoms like aggressive behaviour with any proneness to violence.

She established the first Halfway Home at Richmond, a town near London. It was called a Halfway Home, because it was a way stop between the mental institution that patients were confined and the larger society. She realized that those who had recovered could not immediately go back to their families because they have to be re-socialized. Although they had recovered from the overt symptoms they had during the long periods of confinement lost many skills taken for granted in normal persons.

They were neglectful of their personal hygiene, didn’t like to brush their teeth or shave and had generally lost interest in living. They had lost social skills acquired over a lifetime. They therefore had to be trained afresh in such life skills and social skills. They also had to be proficient in some vocation or profession if they were to get back to normal life in society. Many of them had done some job before they fell ill but had lost such job. So while they had knowledge and skills in a vocation or profession, they had lost the work habit, the need for disciplined hours of work and the ability to relate to superiors, equals and subordinates in their workplaces. Some of course had not acquired any employable skills or knowledge.

Community therapeutic care

Richmond Fellowship aims to rehabilitate these people by providing what is called "community therapeutic care" to these people who are resident for a period of an year or so after which they are expected to be able to get back to society and manage by themselves as happens in other countries. Richmond Fellowship Halfway Homes have been established in many countries like USA, Australia and is popular in India too. Our society was set up in December 1998 and with the assistance of Richmond Fellowship International based in London we set up two Halfway Homes for men and women. We also established a Day Care Centre where those who are being looked after in their homes by their families can be provided day care whenever the family needs a break.

The rehabilitation program involves both therapeutic care as well as the training in an occupation. These therapeutic care techniques like art therapy, music therapy, dance or movement therapy are handled by a team, medical doctor trained in psycho-social rehabilitation in UK, a psychologist and care officers trained in Richmond Fellowship Homes in Bangalore. We have also had the benefit of training by visiting consultants from UK.

Persons who come to the home are on arrival often withdrawn, lacking in self-confidence and tend to be alone. They have lost all interest in life and don’t believe that they can go back to society to do a job and manage their lives. Some of them don’t know how to manage money and tend to bust up any money on frivolous things or buy whatever they see which takes their fancy. They are taught money management by encouraging them to shop under the supervision of the staff.

The daily program includes occupational therapy and they engage themselves in computer skills, in envelope making and candle making. The women engage themselves in sewing, patchwork, quilting and fabric painting. Candle making has become a popular activity thanks to the power cuts and the high quality of the candles produced. Several other activities are planned for the future.

Counselling for the parents of the mentally ill

We place great emphasis on the emotional support from the families of the residents. They are not alive to the fact that they too need counselling to enable them to handle their wards positively. These persons who have recovered from mental illness are unable to face very stressful situations and hence the parents have to be counseled on how to deal with them. The parents also require emotional support which too we try to provide so that they accept the fact they their wards are ill not because of their fault and that they do not have to despair about their recovery since modern medicine has done much to bring the disease under control.

Many parents are ignorant about mental illness and tend to link them to some family circumstance or an emotional problem faced by the patient. These however merely trigger the onset of the illness. The parents have to learn how to cope with their wards and if they do they will not find it so burdensome and thankless. At our Halfway Home we have had success with several residents and they have returned to their families and carry on without a relapse. We have had five persons who have been successfully rehabilitated. We need to counsel the parents and guardians but they do not accept that its necessary. Hence some residents who were rehabilitated have had to return to our Home, which they prefer although it is not keeping with our objective.

There are a large number of persons who need rehabilitation both in the state mental health institutions as well as in society. We have tried to keep our charges to a minimum, being Rs. 6,000 per month, which only goes to meet the cost of feeding them, Rs. 200 per day in fact. But the professional staff has to be paid adequate salaries to prevent them from leaving for better-paid jobs. There is a big shortage of trained professionals like clinical psychiatrists, psychiatric nurses, occupational therapists and we cannot afford to lose our trained staff. So we need support from the public and from organizations like Lions, Rotary etc.

Financial support from the government is necessary

But the government cannot entirely dissociate itself from the need to provide support. We cater only for 20 residents but our aim is to act as a catalyst for the provision of community care for all those who have recovered or are under drug control for mental illness and do not need institutional care. Richmond Fellowship seeks to run a model halfway home so that other communities in the country could emulate us. We are also engaged in training care workers in counselling and rehabilitation so that there would be a pool of trained personnel available for other such homes to be set up in the future. We are presently providing a 3-month training course for volunteer counsellors from the Fisheries Training Institute of Negombo.

We also do some work in combating the social stigma attached to mental illness. Visitors to our home are impressed by the fact that the residents look and behave as normal persons and that they are happy and enjoy life. They sing and dance and socialize not only with other residents but also with the community. This helps to reduce the social stigma. We also seek to establish the rights of the mentally ill. It is said that when they are institutionalized their legal rights are violated and scheming relations sometimes cheat them of their property.

In the long run the government could save a considerable amount of money by reducing the numbers who are institutionalized. It should be a priority for any government to look after the physically and mentally handicapped. The mentally ill have hitherto received less money and attention from the government than they deserve. Many such persons, if rehabilitated, could contribute to the production process and relieve their families of a heavy family burden. It would lead to a more humane society, a society that cares for those who cannot care for themselves but who could be restored to mental health with assistance.