Title: Helping people who are restrained
Course: Non-Communicable Diseases, Emergency Care and Mental Health Part 2 - Ethiopia (Full)

Helping people who are restrained

When you carry out your house-to-house visits, it is important to notice if somebody is chained up or restrained. This person might have a mental illness. Often the families of persons with severe mental illness don't know what to do to help their ill family member. In desperation they may chain the person up. It is essential to find ways to help the family safely release the person.

Now read Case Study 18.1. As you do so, think about the answers to the following question:

How could you convince the family to take off the man's chains?

Case Study 18.1 Mr Lemma

In the course of your house-to-house visits you come across a man who has been chained to the wall of his home by the family. They tell you that six months ago he became very aggressive and accused his wife of trying to poison him. They don't even have the money to take him to holy water and explain to you that they had no other choice but to chain him up. Although he has been calm for the last two months, he still believes that the neighbours are trying to ruin his crops. Because of this, the family has been too frightened to set him free.

The family may be understandably worried about taking off the chains. In your discussion with Mr Lemma's family, you should tell them that they should take Mr Lemma to the nearest higher level health facility (he should be referred by you for this purpose). You can explain to the family that this is where he can receive effective treatment for his condition, and that you have heard (or seen for yourself) that people with Mr Lemma's condition can return back to normal life if they get the right treatment. Lastly, you should explain that Mr Lemma has the right to be treated in the same way as any other human being, unless it is an emergency situation and he is likely to harm himself or another person. So, if his condition has improved then the family should try to remove his chains.