How confident would you feel doing the following?

This first question assesses the person’s level of experience/knowledge/skills in working with people with mental illness/intellectual disability – there is no “right” answer, but the answers will help in gaining an idea of the skills level within the home, and thus will help you develop training according to the skill level that exists.

Very un-comfortable It would be OK Very Confident

1 2 3 4 5

I I I I I

Explaining to someone with schizophrenia what their symptoms might be

1 2 3 4 5

I I I I I

Assisting a resident to shower

1 2 3 4 5

I I I I I

Visiting the home of a lady with a mental illness and giving ideas to the parents regarding what might make it easier to care for their child at home and assist her to maintain her friendships and employment.

1 2 3 4 5

I I I I I

Teaching a slow learner skills like dressing

1 2 3 4 5

I I I I I

Teaching one of the residents a new skill that you already know like sewing or fishing

1 2 3 4 5

I I I I I

Speaking on the radio about what mental illness is and what can be done to assist someone who has a mental illness

1 2 3 4 5

I I I I I

Speaking to children at the primary school in Guraidoo about the people who live at the HPSN

1 2 3 4 5

I I I I I


Tick whether you think the following statements are true or false

STATEMENT / TRUE / FALSE / DON’T KNOW
Disability is due to Black Magic / x
Most people who have a mental illness will never return to “normal” / x
Someone who has a disability could not get a job / x
Residents should be allowed to assist with the cooking at the HPSN / x
Someone with schizophrenia has the same symptoms as someone who is a slow learner. / x
People with intellectual disabilities can be at a high risk of sexual abuse. / x
A worker should not discuss suicide with a very depressed resident as it will encourage them to do it.
/ x
People with mental illness can live alone. / x
STATEMENT / TRUE / FALSE / DON’T KNOW
People with disabilities can get married. / x
It is OK to hit people with disabilities when they do something the wrong way. / x
Schizophrenia can be hereditary. / x
Someone who is always aggressive should probably be given more medication / x
Children should not learn about Mental Illness in school as they are too young to understand properly / x
It is not possible for someone with a disability to change their behaviour / x
What are the main tasks in your current position?

Case study. Aishath is a 17 year old girl who has started behaving strangely. For the last few months, she has stopped doing any of the things she used to do, eg helping with the cooking, sweeping, and weaving. She has also stopped doing things she used to really enjoy, like reading, and spending time with her sisters and friends. Nowadays, most of the time, she walks around the village by herself, laughing and talking softly to herself. A week ago, she started crying a lot but when her older sister asked her what was wrong, she screamed a bad word and ran away. Later, she was found outside a neighbours house at night, staring in the window. When the neighbour asked her to leave, she screamed more bad words and threw rocks at her neighbour. Her father punished her by beating her, and the neighbours complained to her parents that if this behaviour continued, she would no longer be allowed to live in the village. Last night, Aishath was found roaming around the village with no clothes on. Her family members chased and caught her, and she reacted by hitting, punching and scratching the people who caught her, wounding her younger brother. The authorities and the family believe that Aishath has been possessed by black magic and have decided they do not want her living near them anymore. They have brought her to see you.

1.  What do you think is Aishath’s disability?

Mental illness – specifically, schizophrenia

2.  How do you know that?

·  She is talking to herself – therefore may be hearing voices

·  Behaviours are out of character for her – eg crying, screaming, throwing rocks, violence, wearing no clothes

·  Many people with schizophrenia experience their first episode around age 17.

3.  In the short term, what would you do to help Aishath and her family?

·  Admit for review and treatment – counseling and medication.

·  Counsel the family – educate them regarding the causes, symptoms and prognosis of Aishath’s illness

·  Plan for Aishath’s discharge back to the family

4.  In the longer term, what do you think would help Aishath and her family?

·  Continued provision of medication (if required) and support to Aishath and her family from a trained worker

·  Education of the community regarding mental illness

·  With Aishath, development of an individual rehabilitation plan to help her join in family and community life.

·  With Aishath, building links within the community to find ways for her to participate – e.g. through work, education, cultural activities etc.

5.  How would you explain Aishath’s problem to her family and friends?

·  Explain symptoms – hearing voices, believing things that we know are not true, odd behaviours

·  Explain causes – can be hereditary, can be stress, causes are not always known but are never due to black magic.

·  Explain the future – Aishath can live a full and healthy life if she gets the right support – eg medication, care and love, counseling, support to be involved in activities she is interested in.

·  Many people with schizophrenia, with the right medication and support, can live full and productive lives.

6.  What could Aishath’s family do to help her?

·  NOT blame her for her behaviours.

·  Talk to her about how she is feeling.

·  Involve her in family activities.

·  Welcome her back into the home.

·  Ensure she takes her medication (if appropriate)

·  Be proud of her and help to educate the community

·  Look for activities for her to be involved in outside of the home.