Community therapy to fight stigma

By Malini Balasingham 

There have been improvements since then - more awareness of the causes and consequences of mental ill health; a curbing of prevailing stigma and responsive efforts to meet the escalation of mental illhealth. But essentials such as the availability of professional services, hospital facilities in rural areas and the lack of a current, well co-ordinated national mental health plan, are a few of the inadequacies that continue to plague this component of health care. 

When Elly Jansen, the founder of Richmond Fellowship International (RFI) visited Sri Lanka two years ago, the impression she gathered was that plans were in the offing to raise the status of mental health to that of priority concern. A national Mental Health Week had been declared and strong support provided by the media. 

Ms. Jansen visited the Deltota Rehabilitation and Training Centre and expressed the hope that many such centres would soon be available to accommodate the hundreds of people who needed rehabilitation. On her return to England the first initiative she took was to work towards the setting up of an affiliate, the Richmond Fellowship Lanka (RFL). 

The purpose was to set up a much needed halfway house (stepping stone), which would enrich the cycle of recovery and provide a suitable transit environment for persons recovering from mental setbacks to regain their self-confidence and ability to fend for themselves, on returning to their families and occupations. 

Therapeutic community

As such, the difference between residents and staff is seen as one of function and not of value, thereby shaping informal and warm relationships that typify a therapeutic community. Such communities work towards helping residents to resolve conflict, and to take more decisions themselves, to become more creative, to relate to others more productively and to achieve legitimate satisfactions in their lives. 

Fundamental to this concept is the belief that mental illness is just like any other illness. Recognised in time, treated suitably and followed up by a period of appropriate rehabilitation, recovery is well within the reach of numerous persons who would otherwise continue to be labelled as "abnormal" and shunned by society for the rest of their lives. 

Role of family

The need for rehabilitation, which consolidates recovery from a mental or psychosocial disorder is gradually gaining ground. There are many teething problems to be overcome, since the established practice here is to go back and forth between hospital and home, depending on the severity of an episode and the period of remission. The possibility of spending some intervening time in a transit home which reinforces positive qualities of "ego strength" is one that requires to be explored further and accepted. 

Thus setting up a halfway house is but the first step in a journey of a thousand miles, till finally a network of such homes is established throughout the country. However, it is worthwhile taking this initial step, in view of the thousands of lives that will benefit from regaining a mastery of their emotions and self development. 

It is interesting that the learning that takes place in the therapeutic community also affects the wider community of which the halfway house is an integral part. Integration is needed so that residents may be encouraged to take their place in society. However, the neighbourhood also gains in that it promotes the values of honesty and courage needed to explore and understand problems and prevent breakdown. 

In Sri Lanka we are fortunate to have a rich fund of research and referral material to draw on, since the therapeutic community approach has been introduced and has gone through a period of trial and error in many countries and proved its worth. 

Violation of human rights and public discourse

By Rajpal Abeynayake

For instance, in a fairly celebrated case, Visvalingam V. Liyanage, which was heard sometime back, the publishers of a certain newspaper 'The Saturday Review' challenged the closure of this newspaper by the then Competent Authority acting under Resolution 14 ( 3) of the Emergency Regulations in force. 5

In this case, the judges held that "the fundamental rights of the publishers of the 'Saturday Review' have been lawfully restricted by the Competent Authority and accordingly the fundamental right of the petitioners as readers and contributors have also been lawfully restricted. The petitioners' claim under Article 14 (1) (a) thus fails. ''

The 'Saturday Review' case therefore becomes an important point of reference, because around it can be woven some of the facets of how the media coverage and reportage of human rights violations in the North East has trailed off. 

The 'Saturday Review' was one example of a newspaper which was in situ, because it was being published from Jaffna in the heart of the North where the ethnic conflict was raging. 

It was edited by a Sinhalese, and as an English newspaper, it was widely circulated in Colombo where the powers that be and the "power elite'' congregate. 

Therefore it was a vital conduit of information that could bring notice of human rights violations to the people concerned in the power centre, who could do something about these violations if they were sufficiently embarrassed by them. 

But, the judgment referred to did not offer any redress for the publishers of 'Saturday Review,' and therefore, this newspaper closed down , and the Editor subsequently passed away, his life mission unaccomplished. 

Reporting in situ

But, the 'Saturday Review' case also brings up the issue of the lack of newspaper reporting in situ of the situation in the Northern Province. Whatever little news that the Colombo based national newspapers garner of the situation in the North-East is through a few correspondents who are part-time contributors scattered in the region. 

It is a fact that these part-time stringers cannot adequately report or investigate the events and incidents that transpire in a conflict situation, and in the absence of any other alternative, the national newspapers depend on hearsay reports either from sources in the Sri Lanka army or from sources via telephone in the North and the East. 

The fact is that non–existence of in-situ reporting of the conflict in the North– East (needless to say) hampers the coverage of human rights violation in that part of the country, and these human rights violations often are of refugees , displaced, persons, minors or women or the most vulnerable sections of society. 

Even foreign newspapers which have stationed correspondents in Colombo have not been able to station correspondents in the war-torn areas, and this may give some indication of the difficulties involved in having in-situ reports of the conflict in the national newspapers.

But, sans such in-situ reports the exposure of human rights violations etc., are not methodical, and therefore the effective resolution of this lacuna in human rights reporting in Sri Lanka needs to be addressed in some way. 

The fact that incidents of human rights violations were not reported thoroughly during the duration of the southern conflict where there WAS in-situ reporting in place is acknowledged; but the situation in the North– East is far worse because there is almost no reporting that emanates from the vortex of the conflict. 

But, also of importance in conflict areas, and even areas that are recovering from conflict, such as the south is that substantive human rights may only be sporadically recognized; there is no sensitization of the public about certain rights , for instance "the right to life', which has "finally been recognized in the new draft constitution".

Legal recognition

It is almost absurd that much space has been devoted to the absence of the right to life clause in the Sri Lankan constitution, because the right should obviously be guaranteed by implication, considering the fairly exhaustive listing of rights of individuals in the constitutional provisions. But, the debate on the other hand underlines the fact that the Sri Lankan polity demands unequivocal constitutional and legal recognition of rights before these rights are sought to be enforced. 

The new draft constitution of Sri Lanka for instance, which of course the present Sri Lankan government has been trying to make into law, so far unsuccessfully, "is unfortunately a perpetuation of the same old model, one that recognizes constitutionally guaranteed fundamental rights as only civil and political rights, and one that relegates economic and social rights to the backburner by including them merely in the directive principles of state policy". 6

The fact that there is little sensitization on these aspects, of social and economic rights in the media, has perhaps resulted in these aspects being almost ignored insofar as the human rights situation in rural Sri Lanka is concerned. But, what are the social and economic rights of the refugees for instance, or of displaced persons, displaced due to intransigent territorial claims on both sides of the divide in the North East conflict?

These are issues of gigantic scope, and they have not even touched the surface of the Sri Lankan consciousness, largely due to the fact that the media or the polity does not recognize these rights as rights any longer in the conflict areas, because repeated transgressions of these rights (by the creation of refugee communities for instance ) have leaned to the idea that the tenuous existence of social and economic rights in a war torn theatre is an inevitability in the social process. 

Footnotes

5 Reported F R D 2 529

6 Deepika Udugama, in "The Draft Constitution of Sri Lanka Critical Aspects,'' ; Law And society Trust, Colombo.

Continued next week

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