A 25 year old woman, eldest daughter in the family, hailing from a lower middle class family residing in a VDC of Sindhuli returned back to Nepal from Malaysia after 8 months of migration. She was a migrant worker employed as a maid in a city. She studied upto the eighth standard and went abroad as a migrant worker to support her family.
On arrival to airport, without any information to the family members, she was escorted back home by the police. The family members were perplexed when they saw that she had rummaged her appearance and hygiene and had a number of bruises all over the body. They were deeply hurt to find their daughter in a pathetic condition and started weeping inconsolably for hours. People in the community managed to take care of them and provided emotional support to the family. They were unknown of how it happened.
After coming back home, she started showing changes in her usual behavior. She started wandering away from home without informing the family members and would not return back in time. She would smile and weep at times without any apparent reason. She would not response when entertained by people. She often showed aggressive, abusive and assaultive behavior and at times was difficult to control. She frequently assaulted her family members especially father and mother without any apparent reason. She would often say that she would kill them and eat their flesh. At times, she was restrained due to excessive violent behavior. She started having suspicion towards people in the community and at times shared that she would not go to the market because they were persecuting against her. She would often spend hours playing with flowers, mud and pebbles on a road. She had few disrobing episodes when she walked naked around the village. She did not fall asleep at night and used to move around restlessly.
People in the community advised them to take her to a traditional faith healer in the village where she underwent rituals but did not improve. The family almost spent 2 lakhs in traditional faith healing.
Ultimately, the family members came to know through the community awareness campaign organized by TPO Nepal in the village that those symptoms occur in psychosis and then was taken to a health post in the VDC. She was evaluated by a prescriber who had been trained by IMC and TPO Nepal and was and diagnosed as having Psychosis. She was started on Tab Chlorpromazine 50 mg increased gradually to 300 mg over 3 weeks. She started improving gradually. She was referred to psychosocial counselor for psychosocial support, psycho-education and reduction of expressed emotion on part of the family members. In addition, HBCW provided basic psychosocial support and monitored compliance and family support to ensure appropriate treatment.
She started sleeping quiet well and was manageable at home. She ate well. She started behaving normally. She started assisting her parents at home within 1and 1/2 months. She is now leading a normal life under regular follow up with prescriber, psychosocial counselor and home based care worker. The family members are very happy to see their daughter back to normal life and expressed their gratitude to IMC and TPO Nepal for their contribution to their daughter. Her family members pray god wishing that this sort of mental disorder should not affect anyone not even their enemies.