A 25 year old farmer hailing from a lower middle class family residing in a VDC of Sindhuli, is the only son in the family and has a lot of expectations from his parents. He studied upto secondary level and had been working as a farmer in the village. Due to economic crisis, he planned to go abroad as a migrant worker taking loan from a landlord in the village.
He went to Qatar 1 year back. He became ill after he went abroad and was sent back after 6 months by the organization regarding him as unfit for the assigned job. This added extra burden to the family. As he came back, he started showing abnormal behavior. He started wandering away from home without informing the family members and would return back in unusual time. He was out of contact from the family for 7 days during which he lived in a nearby jungle. He had been walking as a nomad in the village. He began collecting flowers, rice grains and piles of stones and sat on a road where he started behaving as a traditional faith healer “Dhami-jhankri”.
He started staring vacantly for hours and was not bothered to look around what had been ongoing. People in the community were astonished by his changing behavior. He would not fall asleep at night and move around restlessly. He started having suspicion towards the family members that they were persecuting against him. Due to this, he often showed aggressive, abusive and assaultive behavior and at times difficult to control. He started muttering to self at times but was incomprehensible. These symptoms continued for 2 months. He was taken to a traditional faith healer but did not improve. Neighbors and the family started believing that he would not be treated.
Ultimately, he was taken to a health post in Makawanpur and was started on psychotropic medication. But he did not improve. Later, the family members came to know that certain health facilities in the district had been providing mental health and psychosocial support services to mentally ill patients under technical support from TPO Nepal and financial support from IMC. He was seen by a prescriber in health facility in the VDC and was diagnosed as having Psychosis.
He was started on Chlorpromazine the dose of which was built up gradually. He started showing improvement in symptoms over next 2 weeks. He started sleeping quiet well. He was manageable at home. He started behaving normally. He ate well. He returned to work within 2 months. His family members and neighbors were surprised to see him back to normal life. Psychosocial Counselor and Home based care worker had been doing regular follow up and providing basic psychosocial support to the patient and family. He goes to the health facility for regular follow up on his own every 2-4 week and gets medication. He has now started advocating in the community on mental health and psychosocial support services provided by the IMC project and a number of patients have come to the health facility to seek help after this.