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Here’s How This Organisation Is Helping Mental Health Patients In Prison

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Peacemakers journey as volunteers in the Bangalore Central Prison started about 6 months ago. Our primary responsibility was to work towards mental health recovery of psychiatric patients in Central Prison Hospital. Towards this end, Peacemakers in collaboration with the Department of Prisons, Karnataka and Central Prison Hospital, Bengaluru identified and implemented different activities which were addressed to meet the rehabilitation needs of patients with mental illness in the prison.

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Working Within The Prison Environment In India

The situation of prisons in India is one where nearly 67% of inmates are undertrials; a very small number of individuals have cleared the 10th Board for education; also little awareness on legal aid and access to legal services and lack of financial resources are factors that determine the fate of many individuals in prison. The Bangalore Central Prison houses about 4800 inmates with about 3600+ who are undertrials, further there are 190 individuals identified in need of psychiatric help in Bangalore Central Prison. Peacemakers in partnership with Dept. of Prisons (Govt. of Karnataka) and Central Prison Hospital piloted a mental health and wellness recovery program for 35 patients identified by the Central Prison hospital.

For us at Peacemakers, we individually found several of our preconceived notions changed and perceptions challenged for the better while intervening with this group. Understanding the complex set of factors and vulnerabilities that make many individuals land in prison was one part of the change in us. What started off as an intervention where we could contribute in our modest ways for mental health wellness recovery, soon turned to be something that impressed and moved us by the visible change witnessed in the positive behaviour and wellness among inmates in a  short period of time.

Demystifying Aspects Of Mental Illness Faced By Inmates

A large part of the battle with mental illness is the feeling that one is all alone and a low sense of self-worth. This is often compounded with a sense of immense shame, fear experienced in the prison environment, harbouring deep wounds that haunt them from the past and worry about the future for self and dear ones are prime negative emotions that fill the day. In several cases, a sense of victimhood based on their situation and a deep mistrust of others characterise the illness. These aspects eventually lead to a lack of self-care and a situation where one does not necessarily want to do get out of bed, do anything in particular which further leads to depression or worsening their mental state. One often resorts to substance abuse and numbing all emotions including the positive ones like joy, gratitude, patience etc. In some cases, individuals resort to self-harm and in extreme cases suicide (115 suicides in prison in the year 2015 alone).

The role played by Central Prison Hospital & Peacemakers, Bangalore

A critical role played by the doctors (Dr Girish & Ms Mythilly) and currently with Dr Manasa guided by Dr Uma – played a critical role in the work done here. In addition to Pharmacotherapy, they played an active role in providing care and reassure inmates on the importance of daily activities like bathing; washing; grooming self etc. Further, an active role was played to involve Peacemakers as a partner for conducting sessions every Tuesday and Thursday for three hours per session. Especially the zeal and enthusiasm in the activities bought in by Mr Anthony is wondrous even in a prison community, Mr. Umesh Jadhav with the music therapy and bringing in artists for music sessions in prison and Rabi Jayakaran with the overall coordination from Peacemakers ensured we made a great start to making an impact in the prison community.

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(seated: Ms Mythily, Dr Girish, Mr.Anthony, standing from left: Mr Umesh, Mr Rabbi, Mr Bijoy)

The Peacemakers’ team is represented by a diverse set of individuals bringing in the energy and enthusiasm in different activities being organised within the prison environment. The team comprises of changemakers, social workers, musicians, artists etc. apart from these, inmates with talents in flute, singing or tabla have been actively engaged and involved to be a part of the session inside prisons.

Activities Implemented To Address Mental Illness Among Inmates

35 individuals were identified as in need of mental health care by the prison hospital under the mental health wellbeing program. Different activities were designed prioritising mental health wellness for the inmates:

–  Breathing as a meditational technique to observe the wavering of the mind and experience a calmer state of mind(15 mins);

–  Stretching and exercises (30 mins) as a means to better physical health and its correlation with mental wellness; games on cognitive development,

–  Games & activities on improving hand-eye coordination and cognitive development (45 mins) ;

–  Music Therapy (30 mins) as a means of building a sense of community and healing in the prison environment has worked wonders within the prison environment;

–  Livelihood generation (60 mins) or Art Based Therapy as a means to productively utilize the available time for livelihood generation or in art through painting, sketching and other artwork.

–  Building a sense of community and connection among inmates to feel a greater sense of belonging and togetherness

Active participation and interest from the participants of the wellness program have been both a motivation and an inspiration to continue with the program witnessing visible results along with positive behaviour in a very short period of time.

Sahayana – Journeying Together Within

Health and wellness program is to promote a sense of connection and community among the inmates. Celebrating birthdays of individuals; ensuring personal care and hygiene and supporting one another in daily chores by enquiring and nudging them to undertake those tasks whether it was bathing, shaving, having taken their medication or just helping individuals get out of bed a little sooner. All of these are observed and noted by the Central Prison Hospital.

While brainstorming on a name for the group and the intervention some of the names the inmates came up with include “Navayana” meaning a new journey within and “Sahayana” which means helping each other in our journey within. We finalised on “Sahayana” which seemed more apt emphasising the role that each one plays in helping the other realize that we all are worthy of being helped, cared and loved for irrespective of one’s past. The words of Shannon Alder rings true “never give up on someone with a mental illness. When “I” of illness is replaced with “We” then illness changes to wellness.”

Changes witnessed among the group towards mental wellness

While the Peacemakers team started this initiative in April 2018 with an intention to see the difference we could make in the lives of inmates, very soon we began to see visible changes externally like more smiles, engaging with eye contact, improved personal hygiene and care, improved body language, better self-control on urges of substance abuse etc. However, what has also turned into a reality is a journey each of us has taken through the experience of working with inmates in Bangalore Central Prison.

Indicators in pre and post assessment of mental health program

Some of the indicators in both pre and post assessment of the 35 individuals have witnessed significant improvement with 72% of inmates building required skillsets to initiate a conversation and greet people while meeting; 24% showing improvement in initiating conversation; 81% showed adequate skills in their grooming and self-care ;72% of the inmates have made an improvement to adequate skills in maintaining interpersonal distance; 42% of the inmates have built required skillsets to help one another, with 25% showing an improvement in their ability to help one another.

Journeying together within towards good health & wellbeing

Beyond the medication being taken to address the particular mental illness, the ability to prioritise on factors that contribute to one’s physical, emotional and psychological wellness is key to well-being. A key part of the wellness starts with one believing that one is worthy of love, with the courage to overcome the shame or guilt one holds of the past or present. Faith and hope contribute well as companions to an optimistic future keeping worry at distance.

In the words of Dr Brene Brown, “strong connections involve the willingness to be seen authentically in all of one’s vulnerability. It involves the ability to start enjoying the little or ordinary things in life, making productive use of one’s time, ability to take oneself lightly by embracing the uncertainties in life, accepting ones imperfections and ultimately the sense of being loved and belonging within oneself and others around is an important indicator to measure one’s well-being.”

Step Forward Towards Good Health & Wellbeing Through Sahayana

Some of the key initiatives that Peacemakers is actively looking for partners, collaborators and supporters include the following key initiatives underlined below.

Initiatives in livelihood generation (Green skills) Sahayana  (5 days a week – 3 to 5 hours a day)

Livelihood generation initiative is one which has yielded great results and now there is a hope to further strengthen the same with strategic partners who can promote green skilling and upcycling along with human-centred design for the inmates under the mental health wellness program. The initiative will cater to helping inmates earn a small income, help their families and also be a means of productive utilisation of their time during the week and create useful products which also bear an environmental value.

Strengthening the existing mental health wellness rolled out under Sahayana (2 days a week- 3 hours a day)

The program that has been initiated has yielded wonderful results and the next phase of the program is to continue with activities focusing on meditation, physical wellness, cognitive development, hand-eye movement and activities on promoting connections and sense of community in the group.

Identifying strengths and abilities in each individual to lead in Sahayana

A key way forward for Sahayana is to build on identifying the strengths of each inmate and providing avenues for individuals to lead the group in particular activities. For scaling and replicating this innovative program and reaching the outcome we seek to provide avenues for growth. Other avenues of development through reading, education, the storytelling of inspirational individuals, music etc., will steadily be explored and generated.

Raising awareness of legal aid and services (parole etc.)

Many of the inmates have little information on aspects of legal aid and services, they also come from backgrounds where they cannot afford even a small amount for bail etc. Some sessions would be designed to raise awareness and provide basic legal aid services for inmates in need of the same.

Creating opportunities for inmates to meet their family and loved ones

One of the biggest issues faced by inmates is their inability to meet their loved ones, several factors contribute to the same including the poor socio-economic background, the inability to travel long distances and also the stigma associated with having a family member in prison. Peacemakers will actively play a role in bridging families and remove small hurdles that come between inmates and their loved ones.

Over and above the initiatives a key part of our future interventions is to contribute to the developmental needs of all children irrespective of their backgrounds to help in the healthy growth and well being of the youth and contribute to the demographic dividend in India.

Do visit our work through Peacemakers at http://peacemakers.org.in/about-us/

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