Strategic Investment to Support Recovery from Severe Mental Disorders
Severe mental disorders, such as schizophrenia, bipolar disorders, and major depression, frequently lead individual and families into poverty. Homelessness and inappropriate incarceration are far more common for people with mental disorders than for general population, and exacerbate their marginalization and vulnerability.
Because of stigmatization and discrimination, person with mental disorder often have their human rights violated and many are denied economic, social and cultural rights, with restrictions on the rights to work and education, as well as reproductive rights and the right to the highest attainable standard of health. They may also be subject unhygienic and inhuman living conditions, physical and sexual abuse, neglect, and harmful and degrading treatment practices in health facilities.
In the light of huge burden experienced by people with mental disorders and their family, a social investment approach is essential to support recovery of people with severe mental disorders.
Tirto Jiwo is a non-governmental organization specializing in supporting people with severe mental disorder in their journey for recovery through implementing evidence based humanistic programs.
II. High Impact Interventions:
With medical treatment and psychosocial support, people with mental disorders can recover. Recovery from mental disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to achieve their full potential.
High impact interventions directly support people to recover and keep people from relapse, healthy and productive socially and economically.
They are evidence based and evidence informed interventions, which when implemented together adequately, can support people in their journey for recovery:
- Taking anti-psychotic medicine as prescribed by medical doctor.
- Hospitalization during crisis or acute onset.
- Individual or group psychotherapy
- Family therapy
- Psychosocial rehabilitation at an institution
- Supported employment
- Safe and stable housing
In addition to above mentioned interventions, the social investment approach also emphasizes the vital need to invest in critical enablers, which are necessary to support the effectiveness and efficiency of basic program interventions and ensure they have the maximum impact. The critical enablers make program access and success more likely and are essential for effectively overcoming obstacles to successfully implementing and scaling up basic programs. Critical enablers can be divided into two groups:
- Social enablers support people living with severe mental disorder by creating favorable social and legal environments for access to services and that enable them to protect and help themselves. These include: community mobilization and stigma reduction.
- Program enablers enable implementation and effectiveness of and demand for basic program and interventions, program management, capacity building and monitoring of service provision.
The Tirto Jiwo’s investment approach uses a four-step process to develop a sound investment:
- Understand: To maximize impact of the social investment to support people with severe mental disorders, a thorough understanding of extend and dynamics of the type of mental disorder and the existing treatment is required. This includes understanding of key social networks, family conditions, as well as structural obstacles to health care and psychosocial services. Tirto Jiwo will review and assess people with mental illness and their family.
- Design: Based on the evidence, Tirto Jiwo will decide on the combination of interventions to achieving the greatest impact.
- Deliver: to increase impact, the interventions need to be comprehensive, i.e., tackling all aspects of necessary support needed for the person with mental disorder to recover.
- Sustain: The investment approach emphasize that the person with mental disorder and their families empowered to enable them to address challenges related to a sustainable living with mental disorders.
III. Investment Packages
Tirto Jiwo has developed several high impact social investment packages for people with severe mental disorders:
- Medical and hospital services package. By investing Rp. 100,000 (USD 10) per person per month, a people with mental disorder will have access to psychiatrist, free anti-psychotic medicine, psychotherapy and hospitalization (if needed), including free transportation costs. Tirto Jiwo will enroll the person with mental disorder to be a member of BPJS (national health insurance), accompanying them to visit psychiatrist. In case of crisis, Tirto jiwo will assist them to get ambulance to bring them to a mental hospital.
- Family therapy package. By investing Rp. 200,000 (USD 20) per person per month for two years, a person with mental disorder and their family will get psycho-education by a volunteer who has been trained on basic family therapy. The family therapist will visit them in their house weekly in early phase and become monthly in the later phase. The family therapist will be backed up technically by psychologist and social workers. At the end of the second year, the person with mental disorder and their family have been empowered to cope with symptoms, prevent relapse and strive to live fully to his potential.
- Self-employment package. By investing Rp. 2,000,000 – Rp. 5,000,000 (USD 200 – USD 500) , a person with mental disorder will be supported to be a self-employed. Tirto jiwo will train and provide mentoring for them to develop small scale self-employment.
- Psychosocial rehabilitation package. Some people with mental disorder need to live in mental health institution (rehabilitation center) temporarily. By investing Rp. 2,5000,000 (USD 250) per month, Tirto jiwo will provide accommodation and psychosocial rehabilitation to a person with mental disorder.
- Half-way house package. Some people with mental disorder need a temporarily shelter before they able to integrate fully in the community. By investing Rp 2,500.000 (USD 250) per month, a person with mental disorder will live with a ‘therapeutic family”. They will get a room, 3 meals per day and psychosocial support from Tirto Jiwo
- Supported housing package. Some people with mental disorder have been abandoned by their family or want to live independently. They need safe home to live. Currently Tirto Jiwo has land that can be developed into a supported housing complex for people with mental disorder. By investing Rp 200,000,000 (USD 20,000) a supported housing unit for 4-6 persons can be developed.
- Tirto Jiwo Social Enterprise package. By investing Rp. 25,000,000 – Rp. 50,000.000 (USD 2500 – 5000) per package, Tirto jiwo will develop small business, such as farming (chicken, cat fish, etc.), vegetable /fruit garden, handicraft, printing. These businesses can be used as training ground for people with mental disorder. The income from those businesses can provide income to Tirto jiwo.
IV. Individual Donor or Corporate Social Responsibility with Tirto Jiwo
We invite the business community and phylantrophist to support and champion recovery movement for severe mental illness in Indonesia. You can help us learn and implement better, innovate and scale up our impacts. Share your expertise, time and resources to give people with mental illness opportunity they deserve.
You may choose to support an existing program or take our interventions to a new location. We implement 6 steps in engaging corporate social responsibility:
- Let us know your interest or CSR mandate and help us to understand your target audience. Share your expertise with us.
- Tirto Jiwo conducts a need assessment to better understand problems of the people with mental illness and their families.
- A proposal is created elaborating implementation plan and resources required. Tirto Jiwo customize the interventions to match to your interest or CSR policy.
- Detailed plan are discussed and finalized.
- Monitoring and reporting mechanism is decided. Tirto Jiwo believes in focusing on results and measuring in impacts.
- Implement the project. Participation of your organization or yourself in the implementation is encouraged by volunteering in activities.
Please contact dr. Gunawan setiadi (email@example.com) for more information.