CFMH / Sir CJ Institute of Psychiatry

(The program was supported between 2004 -2019 ) 

Our aim was to provide consultation, support and change the culture for delivery of care.

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The red building, in -patient facility has been lovingly restored by CFMH. We have 20 in- patients, capacity for 44. We plan to incorporate the rest of the hospital in our treatment approach.

The Sir CJ Institute is a psychiatric hospital with 300 inpatient beds. It was commissioned in  1847 by Sir Cowasjee Jahangir, Civil Engineer and Master Constructor of Bombay, on land donated by the Gidwaney Family, with care and sincere intentions. It serves most of rural Sindh. Unfortunately, the nature of mental illness, its chronicity leading to poverty evolved into the hospital becoming a place to abandon sick relatives, hope ebbed, newer approaches in the treatment of mental illness were not adopted, they were using chains and incarceration to manage difficult patients.

Concern for Mental Health updated services for psychiatric treatment in a dedicated portion of the hospital. Day care, involvement of family, rehabilitation, de-stigmatization, awareness of patient's rights, were at the core of our efforts. We collaborated with Aman Foundation and Basic Needs in 2016 to develop the services through input of executive expertise, organizational skills, hands-on presence to provide an ace service to clients suffering from mental illness.


The focus was on:

  • Changing the culture of how the chronic mental illness sufferers were treated.

  • A move away from families abandoning their sick relatives in the hospital (jama karana)  

  • Using medications, not chains to manage the acute stages of mental illness

  • To move a patient from acute to mid-level care open wards for recovery

  • Offer day hospital rehabilitation and incorporation back in the community

  • Develop skills to find employment in the community through training and rehabilitation

  • To retrain those those patients who were abandoned by their families, but had recovered, and employ them in the Volunteers program within the hospital. They would be provided hostel facilities and honorarium to give them self-confidence and independence. They would no longer have to live in a locked ward with acutely ill patients.

  • We provided a beautifully renovated in- patient ward and day hospital /rehabilitation facility and trained staff knowledgeable in medical advances and ideology.

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Executive Committee in Hyderabad. The new in-patient ward. Medical check-ups are an integral part of treatment

The old ward

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The new in-patient ward, inside the room.

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Dr Ansari, Dr Sara Sheikh and Chief Admin Officer Nadeem


The Treatment Program

treatment.pngPatients come from other in-patient wards, and as outpatients. They learned basic self-care skills, participated in activities to enable them to stay busy, recover and learn to start living life constructively outside the hospital, with their families, in their communities. It provided new hope and self-esteem for the patients.
 
A Self-help Group, named “Humdard” involved the patients in day to day activities as part of the Rehabilitation program. Subcommittees were created; each committee was chaired by a patient dealing with one area i.e. sports , washing, general cleanliness, personal hygiene. The attendants and nurses provide back-up support to these committees. Indoor and outdoor Games, morning exercise were encouraged. Adult literacy classes, reading and a library were available. Psychological group support was provided .


Training that would help the patients get jobs and earn focussed on developing skills in Gardening, Candle making, Chair Knitting etc.

End of our involvement

We had hoped to incorporate the rest of the hospital in our plan for modernizing treatment. Optimism and the use of the latest evidence based treatments were at the core of our philosophy. The memorandum of agreement with the Government of Sindh to upgrade the care of the patients at the institution became obsolete with the introduction of new laws for Government / Private Partnerships. We continued to help until June 2019 on a good faith basis. We withdrew our involvement at that juncture as it was not feasible to progress without an official agreement. We hope the Institution will continue with the programs and ethos.