New Choices

All Russia Society of Persons with Mental Health Disabilities (ARSP)
No. 9, June 2007 Newspaper is issued the time a quarter “If you want to be happy – be happy” Koz’ma Prutkov

With the assistance of our readers we continue to publish thematic issues of our newspaper. Currently a psychiatric care is mostly focused on social rehabilitation (well-being) of patients which implies independency and self-esteem, ability to work and leisure skills. A young person with disability has to learn all this things from the blank sheet. “It is not enough just to acquire knowledge, more important is to use it to your benefit”, said Goethe. And with our children it was a hundredfold return. Editorial board of “New Choices”

Rehabilitation is our mutual concern
Psychosocial rehabilitation implies social skills training, independent living, self-confident behaviour, problem-solving technics and coping with residual symptoms. Unfortunately, the total number of sheltered workshops was considerably reduced. However, there are other opportunities. It is important to open out-patient rehabilitation centers (giving attention to the provision of job opportunities and encouraging social activity of patients). The growing role belongs to the supported housing (e.g. hostels). One of the main patients’ mistakes is associated with their readiness to reconcile themselves with their declining social role and the lower quality of life. Therefore the most important aim of “New Choices” is to restore patients’ motivation to rehabilitate. Involvement of patients in society is regarded as an important step to restore their social positions. Professor I.Ya. Gurovich (the Moscow Research Institute of Psychiatry)

Moscow meeting. The Moscow branch was supplemented by the most active patients’ relatives, Psychiatric Clinic (PC) No.10 Discussing rehabilitation problems

We believe…
From the decisions of the 5th Inter-regional Conference of “New Choices” (2006) Implementation of the right to the high quality treatment: to provide access to atypical antipsychotics for all needed patients which will make it possible to choice optimal psychopharmacotherapy for each patient; to create frames for psychosocial rehabilitation

An invalid’s portrait in the interiors of outpatient clinic and community centre
Up to 60% adult patients with schizophrenia are invalids. More than one half of them are older than 50 years, but they fell ill when they were young and in a few years they became not able-bodied. Every five of them would like to work. 70% have got a working profession. ¼ of invalids are in need of consultations (legal, psychiatric, social). One third of patients do not have an adequate livelihood which is the result of their small pensions and their inability to regulate their budget and to do housekeeping. The Center provides various courses for its patients including housekeeping and communication with other people. Psychoeducational training helps our patients recognize the early warning symptoms of relapse, to improve treatment adherence. The Centre also provides patients with free tickets to a theatre or a swimming-pool. Rehabilitation division offers consultations of a therapeutist, neurologist and instructor in physical training. Emergency social aid division provides material aid and consultations on legal matters. O. Papsuyev, Moscow Research Institute of Psychiatry

Green light to the home-based rehabilitation
Out-patient rehabilitation centers are absent in Moscow. Social care is not accessible to those patients who are unable to leave their homes. There is a need in various types of supported and supporting housing, not only hospital-based facilities. It is not possible to leave a mentally ill person without care. In this case out-patient group home could be of great help. We need more clinical psychologists, social workers and occupation therapy specialists. Young persons in the first psychotic episode are to be given particular attention. They are to be identified and given the necessary treatment in each case. A certain part of psychosocial rehabilitation is carried out by self care organizations but they should not substitute professional care. N.Yu. Muravyova (Moscow).

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New Choices No. 9

Chronicles of our everyday life
Yura Tokarev and the whole century of Stavropol district psychiatric clinic
Guests invited to attend the festival included the representatives of “Dolphin” society of young disabilitied persons, local branch of “New Choices”, Jan Nilsson, chief of the Psychiatric Fund of Norway. Head of the hospital rehabilitation unit A. Bagutsky and director of Rehabilitation Centre O. Buchkova told about invalids’ way to the normal life. Thus, Yuri Tokarev has been seriously ill for 14 years, his relatives made efforts to refer him to a nursing home. For two years a multiprofessional team has been working with Yura and his family. Today Yura is staying with his relatives, he told about himself. After that there was a puppet show performed by the efforts of the Rehabilitation Centre. Patients read their poems and sang songs. It was really a joyful occasion. O.Yu. Kuzova, N.V. Yashin (Stavropol)

Treatment is a pleasure
Patients of Rehabilitation Centre at Stavropol PC about themselves
Independent patients I came to the Centre after hospital. They gave me a warm welcome, listened to my troubles. I have got regular care, started to master a computer. Now I can type texts. Here we communicate with each other, stage puppet shows. Independent actors feel fully satisfied. Victor Zadorozhny I came, saw and did not regret When I came there I was in severe depression, having neither strengths nor hope. The staff was very kind to me: “Come again tomorrow!” I have already known that here I could find pals and professionals. In 2-3 months I felt much better as if I were given the “aqua vitae”. Now I see that my life has sense. I attend psychotherapeutic groups. I want to live and work! Oleg Toropov (28)

Psychosocial rehabilitation in Stavropol Region
A team of professionals (i.g. psychiatrists, psychologists, social workers, nurses) was trained for the male rehabilitation unit within the framework of the Russian-Canadian and Norwegian programmes by the efforts of the PC staff. It was the result of the joined efforts of a day clinic, labor workshops, community facilities, department for labor and social welfare, medico-social expertise and volunteers from the local branch of “New Choices”. Patients are trained in recovering their social and communication skills, art-therapy, group psychoeducation, family therapy and are also assisted in finding jobs. At workshops patients are making artificial flowers and linen. They go to the exhibitions, participate in festive occasions. Their day is usually started with physical training, in particular, football playing. The unit became hostel for homeless patients. Our unit helps to meet the actual needs of patients and their relatives, to reduce rehospitalisations; most patients manage to live independently (with social support at home) and work. This approach is more humanistic and less expensive than typical inpatient care of chronic patients. A. Bagutsky, the Stavropol district psychiatric hospital

Psychiatric education group in St. Petersburg

At the beginning of the road
Among the unsolved problems of invalids in Russia are competition employment, housing, inadequate provision of new generation psychotropics. We have constantly brought these problems to the attention of our municipal and federal authorities. We urge parents of our mentally ill patients to look at the problem from the other point of view: “What actual steps they have to make to help their relatives?” We do not have time to wait for the problem to be resolved in itself; we have to achieve the real results by your own efforts. We are planning a round-table meeting with the involvement of all public organizations of St. Petersburg dealing with the problems of invalids, to discuss our mutual problems, to formulate our proposals and to propose alternative solutions for their incorporation in the Minutes of the general meeting and subsequent submission to the City Government. Leisure and psychological support problems are also important but they are simpler to address. There was also the citywide art exhibition. K. M. Lapteva, St-Petersburg Branch

A school of life and labour
We have won! Football team of the Rehabilitation Center is accepting congratulations of its funs.

Printing circle of “New Choices” has been meeting weekly for five years. A grant extended by the Embassy of Canada was used to

New Choices No. 9
buy the necessary equipment. The circle is headed by professionals. We managed to make all working operations within the powers of our children. We try to involve each of them in various operations and links of the technological process. Our circle is a source of active communication and modest leisure. Alexei Kulikov, Moscow

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Making my life a new
I was left without my relatives and my flat. I had nowhere to go, four years I lived in Psychiatric hospital. When a rehabilitation hostel was opened I was glad to remove there. Comfortable environment contributed to the improvement of my mental health state. I learned to make toys and children’s things. Then I was taken to a day care clinic. There we had group training in everyday and communication skills, I learned to operate a sewing-machine. During my three-year stay at Workshop I was sewing bedding and special cloths. I like it very much and try to do my best, now I am going to learn to cut out. We have a good group and instructors. My salary of 1.300 rubles is a good second helping to my pension. We also have festive events, go to the theatres and circus. For two years I with two other patients have been living in the rehabilitation (supported) flat. We do cooking, cleaning and even managed to do small repair. I want to go to school to be a dressmaker. My life is getting better, hospital is becoming a thing of the past. Svetlana Klipova (33)

Printing circle

Board of honour
I have been working at workshop for 10 years. Our workshop was making albums, raincoats and other things. Our salary was 120130 rubles. The break-down of the Soviet Union was a heavy blow for our hospital. To my regret I had to change my job. When it became possible I returned to the furniture-making workshop. I like my job as I was used to work hard. Before my illness I was a driver and in my free time I liked to make wood articles. At workshop I was awarded special papers of honour and gifts, my photo was put on the board of honour. We have a remarkable group, good relations with our instructors. My salary is 1,300 rubles but the most important thing for me is my job. Gennady Lebedyev. Note of the Editorial Board: according to the sociological surveys not more than 10% of people in Russia go to and from work with pleasure. Among them Gennady Vasilievich

Rehabilitation in Sverdlovsk Region: not easy achievements
Timber-processing and sewing workshops at the Workshops (LW) are working to equip our local renewed psychiatric clinic and its hostel. It is proposed to open a Centre for Medical and Social Rehabilitation where invalids could have a chance to earn. Realization of privileges under the ineffective laws could contribute to the increased LW efficiency and give a chance for invalids to find a job. Premises for the proposed hostel are found in the Psychiatric Clinic and other medical services. In autumn a hostel will be opened in Yekaterinburg. It is very important to establish links between the psychiatric services and public organizations (volunteers, anti-stigma programme, supported working places). Only in the city of Nizhny Tagil there are more than ten such organizations in the field of mental health protection, but all of them are operating in isolation. Rehabilitation is a success if medicines are good. However the Region feels deficit even in the provision of the low-cost medicines. A.P. Potashova (Yekaterinburg, Urals)

Hello, smile, we have been waiting for it for a long time
Chronic illness is severe because you fall out of the community. Even during their remission many patients shrink into themselves and are unable to find their place among other people. As a result most patients get unemployed, their contacts are limited to their family, their activity is falling down. Our organization actively supported the idea of a rehabilitation centre and we try to do as much as possible to help with it. Any patient or invalid could come to this centre and will be given attention of its physicians, psychologists, nurses and technical workers. Not all work is paid. The staff and patients are unified thanks to their mutual efforts. There are various circles such as knitting, fine arts, theatrical, toy-making, housekeeping and planning the household budget. Psychologists and society members provide training in special communication and psychoeducational groups, there are dancing classes. We have five-o-clock together. The District Committee for physical training and sports provides us with free season-tickets to swimming-pool“Dolphin”. After swimming we all have ice-cream. Our ‘children” try to keep

Giving the floor to the staff of LPW in the city of Nizhny Tagil
I did not resign myself After my mother’s death my neighbours seized my flat and I was taken to a nursing home. I did not submit and with the help of a lawyer Yulia Malyeeva I managed to get out of it. She and physicians recommended a rehabilitation hostel. My flat was returned to me by the decision of a court and now I live there. I have been working at Workshop for 4 years, my salary is 1.400 rubles (40 EUR). I can communicate with people, solve my problems and feel much better. I am very grateful to Mrs Yulia, the hostel head Natalya Alexeevna and other people. Sergei Trefilov (48 )(Nizhny Tagi, Urals)

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New Choices No. 9
should not be neglected or paid off with a scanty welfare benrfit, they are to be given a chance to show their worth. The staff of this particular printing-house was able to understand it.

We arrange festivals
Our outpatient clinic has a special social and legal service. We arrange festivals, tours around sacred places, there are also musical and fine arts circles. T. Koskova, Voronezh Branch

Life is going on!
20 years ago I spent my time in meditations and tears. My condition was getting worse and worse, I felt acute pain in my soul as if from a knife. As a result I was hospitalised. At first my sleep was restored, and my fears, oppressive and obsessive recollections disappeared. Mental balance and perception of the world’s harmony was restored. Today I have a job at one bank, study English. I have got a flat and made it comfortable. I am still receiving psychiatric and psychotherapeutic treatment because insomnia is still with me. I am sewing and knitting for my mother. I hope that in future there are a lot of pleasant events, meetings with people, new cities and countries. I want to BELIEVE, WAIT AND LOVE. Natalya from the city of Tomsk (Siberia)

Living with a song (a concert at the Rehabilitation Centre in N. Novgorod

themselves in good order, their eyes and talks changed to become calm and friendly. When they go along the streets it is difficult to tell them from healthy persons of the same age. At home they are more communicative. It is a pleasure for them to call to each other before they go to the swimming-pool or gather at the centre. In the plans of our centre and organizations are excursions and rest in the countryside. Chairman of Nijny Novgorod (upon Volga) Branch of “New Choices” N. Nosova From the Editorial Board: Our children from Moscow Branch look so “different” in the days when they visit a swimming-pool and classes. Still very shy they try to smile and the life like a mirror gives them its smile in return.

My Alyosha
I wish my son could return to the social life. He is a very good boy. He has been taking atypical antipsychotic for 10 months. Now he is able to read every day for 10 minutes, go to the shop to buy some milk. Unfortunately, there are problems with his memory, though earlier he was a student of a medical college. Marina Petrovna, Irkutsk Region (Siberia)

You wrote to us
How we sought and found a job
I would like to share with you my happiness. I managed to find a job for my daughter. The last seven years when my daughter worked at LPW I spent every day looking through the newspaper ads seeking for a vacancy. But all my efforts were in vain. For 2.5 years Yulia remained unemployed. I was running in search of a job around the city but everywhere I was refused. However, our persistence was rewarded. Yulia was offered a job at the printing-house. I was also given a table near Yulia’s table to control her work and to help her, if necessary. The staff was friendly to Yulia, ready to help. Now my daughter has her earnestly earned money. N. Klomok, Tver (near Moscow) From the Editorial Board: This kind of approach achieved through Yulia’s and her mother’s suffering that helped without preliminary preparations find an ordinary job provided with the subsequent training and support is recognized in the world as the most promising way to return patients to the common work. A number of regions have special multiprofessional teams dealing with the problems of employment. Their staff has close relationships with community occupation centres and direct contacts with employers. However, usually successful employment is a result of efforts of patients themselves and their not indifferent relatives based on their personal initiative. An example of Yulia’s work showed one more important thing – it showed that persons with mental problems

International exhibition “Art is consolidating us” is to be opened in St. Petersburg in July 2007. Among its participants will be three members from Moscow “New Choices”. “Art is consolidating us” is an international exhibition of amateur painters to take place in Smolny, St. Petersburg In October a meeting of the Public Council to discuss the problems of in-patient psychiatric aid is to take place there. We are going to propose new rehabilitation programmes. EUFAMI Congress and the city of Torun, Poland (birthplace of astronomer and physician N. Copernicus) invite all interested persons to attend this event from 14 to 16 September, 2007. We work to improve the quality of treatment and life of mentally ill persons and their relatives. Andjey Varot, Chairman of the National Organisation of mentally ill persons and guardians in Poland “POL-FAMILIA” www.eufami.org.congress2007 Printed by ARSP “New Choices” Poteshnaya str. 3, Moscow 107076 Russia Tel.+7 495 9631435, fax +7 495 9637624 e mail: levinan36@gmail.com website: http://www.nvm.org.ru

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