Preparing them to step out into society

"In Sri Lanka when someone gets schizophrenia, there are not enough places and people to run to for help," says Ms. Neelanie Goonetillake, Director for Sahanaya's new Lakeside Residencies Rehabilitation Centre.

Her focus is in supporting not only the patient but the family as well in the care and rehabilitation of schizophrenics. Currently, families have the option of sending a schizophrenic member to a day care centre, reveals Ms. Goonetillake, but that is inevitably not enough. Much of the good work that is accomplished during that period is undone when the patient has to return to his home, where his caregiver continues to interact with him or her in the already established pattern.

As a result of this pattern, some patients may never learn to be self sufficient, says Dr. Usha P. Gunawardhana, a psychiatrist at Sahanaya. She adds that such patients are completely helpless if something happens to the primary caregiver. The focus must be on helping these patients reach the point where they are able to interact with the outside world, and attain some degree of independence.

Sahanya's Gorakana Centre has been converted for this purpose. Patients being considered for admission into the programme will be subjected to an assessment that covers every aspect of their health and general condition, says Dr. Gunawardhana. She asserts that "abilities and skills remain," despite the seemingly debilitating nature of the illness, and the assessment is intended in part to uncover these in the patient.

This form of treatment goes beyond drug therapy, as it focuses on making the patient a fully functional member of society. Vocational training, self care, social skills and other basic skills are part of the programme. "We then want to see this person back in society - an independent, self-reliant person," she says.

The programme does not promise miracles, only that "we will try to bring out the best in him and increase his capacity to a better level so that he can go out there and lead a useful life," says Dr. Gunawardhana. In addition, "carers must take part in our programme," she says, explaining that this is essential for the programme’s success. A patient will be expected to spend six months in residence at Gorakana, after which an evaluation will determine whether he or she needs more time, but any extension will not stretch beyond a maximum of 14 months.

"For the first programme we will start with about 10 – 15 people and then perhaps increase up to 24," says Mahendra Weerasinghe, Manager Operations. The setup at Gorakana includes areas devoted to recreation and vocational training. The staff will all be professionals.

Ms. Goonetillake is determined to set exacting standards for the running of the facility. She hopes to break new ground with this programme. "We want to create a model rehabilitation programme which can be used all over the island," she says. The service comes with a price tag of Rs. 30,000 a month. As a completely residential facility, this will go towards meeting boarding and lodging costs, plus the fees of the attending professionals. "We also want to emphasise that this is not a project for the rich," says Ms. Goonetillake adding that she hopes to find sponsors for those who cannot afford the programme. In addition, after the completion of the programme the team hopes to set up half way houses, where participants can live together, perhaps under the watchful eye of a single caregiver.

The centre will also offer a "holiday home” service, says Ms. Goonetillake, which she hopes families will utilize, in the event that they wish to go on vacation, but are unable to take the schizophrenic family member along.

Meanwhile, Sahanaya is looking for patients to form the first few batches. Those interested can make inquiries on 038 -2297702, or write to Sahanaya "Lakeside Residencies," 115/2 Galkanuwa Rd, Gorakana, Panadura.