Background Information of the Organization :

According to the recent survey done, about ten % of the total Nepali population suffers from one or more various universal mental health disorders. Often, Nepalese families do not recognize a disorder when signs of illness first appear. In many cases the family of a mental patient believe the illness is a curse from God. As a result, very few mentally-ill patients reach mental health facilities for treatment and care. The facilities and trained professionals that are available are few, and centralized in the Kathmandu valley. Out of twenty three psychiatrists in 75 districts only six work outside the valley in districts which have mental health facilities.

Forced to utilize the help available and affordable, the families of patients often resort to locking their loved ones in rooms and; or chaining them when they become excited or violent. When and if the mental condition of a patient does improve, families often hesitate to receive them back into their home. For this reason many mentally-ill patients are jailed and never treated. They are humiliated and neglected, left to suffer physically and emotionally alone inside jails.

In view of the inhumane situation, the Maryknoll Nepal Board in cooperation with the Sisters of Charity of Nazareth (SCN) launched a program geared toward women. May 16, 1993 families of mentally-ill women in prison were contacted and rehabilitation began. Initially six patients were brought to the sisters residence, Navjyoti Center, from the prison. At that time there were 46 mentally ill women in prison. Today the number has decreased to two.

Traveling throughout the country to find the homes of patients, Aasha Deep team members dispelled many popular myths by educating villages and families about work with the mentally-ill. Long days of travel to remote areas were more than compensated for when the team members witnessed the joyous reunion of a family and patient.

A bi-monthly mental health clinic was also established for women in prison. The center became a place of therapeutic community living where medicine, psychotherapy and various activities improved patients skills.

Aasha Deep :

In May 1994, under the management of Maryknoll Nepal, a local NGO duly registered with HMG, the Kathmandu Central District Office and the Social Welfare council, developed an ongoing well-fare program and transferred to a larger facility. The treatment and rehabilitation center was designed as a therapeutic community living space and named Aasha Deep (light of hope). In October of 1995 Aasha Deep began to accommodate men becoming a home away from home. The patients presently cared for come from diverse locations. Many are from the jails, others are chronically-ill patients referred to Aasha Deep by the Mental Health Hospital and still others are picked up off the street and given a place to live. Beginning its 6th year, Aasha Deep is capable of accommodating 40 male and female patients.

Goals :

Aasha Deep is a therapeutic community. The goal is to help patients rejoin their families and society. It tries to provide emotional support, love and care. It is a home where clients can live in a family situation and also receive treatment. Aasha Deep maintains a family atmosphere marked by service and care for the mentally-ill.

Objectives :

The main objective of this program is to reintegrate the client into their family and society. In addition, Aasha Deep :

* Raises awareness among people about mental illness, its nature, symptoms and treatment.

* Nurtures broader understanding among clients, families and communities.

* Provides a healthy family environment for the clients.

Background of the Proposals :

January 15, 1997 marked a revolutionary development in a new facet of Maryknoll Nepal / Aasha Deep. Opening a Day Care Center in a rented facility for 25 clients the goal to integrate patients into ordinary working situations was achieved. Our existing Day Care Center is located in Patan area which is about seven kilometer far from the city. Despite a patient's illness and the side effects of his/her medication, it has been the experience of Aasha Deep that many clients are able to maintain themselves in an independent state. Hence, relapse time and family frustration is reduced. This year Aasha Deep Day Care Program added 12 new clients. Eight of these patients were male and four were female received from different sources.

Over a three and half year period, Aasha Deep Day Care Center in Patan has been able to provide it's day care facilities to a total of 62 clients, 38 males and 24 females.

General Daily Activities of Day Care Program :

General daily activities of Day Care Program include medication, outings, counseling, recreations, vocational training, occupational therapy etc.

Clients are provided with regular medication free of cost during their attendance and also at their home depending on their situation.

Recreational activities include outings and picnics, dancing and singing, sports events, playing dramas, quiz contest, reading and writing, group discussions as per the weekly routine. Vocational activities include incense making , envelop making, knitting, sewing and craft works.

Clients are encouraged to do the shopping for house, gardening, taking care of their own personal hygiene, cooking on their own as a part of this program.

Outreach activities of Day Care Program :

Outreach activities of Day Care Program includes parents' meetings, out-side training, clients and their family welfare, community awareness program, information exchange program and etc.

Home visit program, is given more emphasis as an out each activity. Besides, other activities like visiting hospital every twice a week and assist patients and the family during their visit in the OPD clinic, meetings with local community people and share information, providing stipends to the clients who are very poor to encourage attend our program on a regular basis are also include in this activity.
Aasha Deep Day Care Center at present has three staff members (2 female and 1 male). Total of three, one patient attending our program on regular basis is being enrolled as staff member. These staff members are equally given opportunity for exposures, short term training, attending workshop and seminars along with staff members in residential program.

The outcome of this program is very encouraging to us. The program has been able to share burden with the families, community and the society. Patients have started getting attention and respect from their relatives and in the community. Also, we observe progress in their life style, behavior and in their daily working pattern.

This program at present covers only one area that is Patan. We experience that, it has become a need of opening-up another day care center in Kathmandu city area in order to provide services to more mentally ill patients from this area. But due to our own financial constraints, we have not being able to extend or expand the program. Due to the distance and limited means of local transportation patients from Kathmandu area are unable to attend day care facility in Patan on regular basis. Thus, there is high chances of relapse. In order to avoid this situation we feel that, it is better to have day care facility in Kathmandu city itself. Also another reason behind opening a day care center in Kathmandu city is, there is no any other day care facility for mentally ill in Kathmandu. Second reason is according to the Patan Mental Hospital record, mentally ill patients from Kathmandu area attending OPD clinic are more, in comparison to the number of patients attending from other locations. Opening Day Care Center in this location means clients from out skirt of the valley also would benefit from the service. We intend to start the program from July 17, 2001(beginning of the Nepali fiscal year). We therefore, request you to fund the program for five years starting from July, 2001 till July 2006 (see attached budget).

Monitoring and Evaluation :

Every once in a six month, an evaluation report regarding the progress of the project along with financial statement will be submitted to the donor. We also encourage donor to visit the project and see the progress as such, mentioned in our report.