TEACHER'S REPORT

Some children have to be examined by a Psychiatrist. Psychiatrists evaluate the case based on detailed history of the child’s development, behaviour and performance in all environments.  Observations and inputs from school are important for proper evaluation of a school-going child.

‘Teacher’s report’ is a description of the child’s overall behaviour (in school) and academic performance.  It should include the following:

General Information

1.       Since when is this child a student of your school?

2.       Attendance- Percentage in last term, and regular or irregular

3.       Appearance and Grooming of the child

4.       Any other general observations

Observation-

1.       Activity levels- average/ dull/ overactive

2.       Attention span- average/ distractable

3.       Does he mostly follow instructions?  Yes/ No. If not, why do you think he does not follow instructions? Is it due to not understanding, or purposely, etc

4.       Overall academic performance. Average/ below/ above

5.       Difficult subjects

6.       Very good at

7.       Discipline and rule compliance. Satisfactory/ not satisfactory

8.       Relation with peers- adequate/ poor

9.       Relation with teachers/ other staff

10.   Any other

Your inputs

1.       Your efforts in school

2.       Do you have a counsellor?

3.       Any suggestions/ other inputs

 

The report should be compiled by teachers/staff who closely interact with child and data should be about the month immediately preceding the reporting period.  The report is a combined effort of all teachers and staff seeing the child in school, and statement of observations should be arrived at by consensus of all observers.  The Teacher’s report should be issued on the school letter-head with a signature of the class teacher, counselor and Principal.  A copy should be retained for records. The school report should be handed over to parents in an open cover.  

Some schools are hesitant to issue school report as they fear it may offend the parents and result in conflict. Parents are afraid that school teachers may be biased against their child or are victimising the child. Most schools issue reports only upon parents’ request. School report should be always issued after taking the parents into confidence, and after taking their consent. Schools should take assistance of school counsellor for making the report. Parents should be explained that the observations are not of one person, but are done by many persons interacting with their child over a period of time. This eliminates possibility of bias or victimisation. Parents should be explained, it is only to assist in helping the child and not for ‘grading’, ‘judging’ or ‘branding’ the child. School report should be drafted in proper technical language, in a respectful tone without using any pejorative terms.  Observations regarding parents should not be included in the report.

One should never lose sight of the fact that the report is for benefit of the child, and nothing will be gained by alienating child or his parents. At the same time much will be lost by not stating problems in clear terms due to fear of backlash from parents. If the parents still object to the report, one has to stand by it and advise the parent to hand over the report to the Psychiatrist along with their objections. They may even choose NOT to give the report; this choice has to be respected, with the offer of issuing another report whenever the parent again requests for it. (Parents sometimes get convinced later). There would be no scope for suppressing or altering the report, as it will defeat the whole purpose.

 

 

 

 

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MARRIAGE AND MENTAL ILLNESS

The association between marriage and mental illness is multi-faceted.

Mental illnesses often affect persons who are single or of a marriageable age. In India, marriage is regarded as a panacea for psychological disorders. Some patients may feel better off after marriage because of the enhancement of social status and the companionship. But marriage is NOT therapeutic for mental illness. Mental illness requires treatment first, and then one can think of marriage.

Even after recovery from mental illness, the question of marriage is a vexing one. Marriage can be thought of, only if the person is fit for marriage and is desirous of marriage. Relatives should make sure that these two criteria are met with, before thinking of finding  a match. It is fairly easy to determine the desire for marriage- one needs to simply ask the person. Dont ever force the marriage, if the person is not willing. A person is determined to be fit for marriage only if he or she can be emotionally and sexually involved with the marital partner.

Mental illness has a significant stigma. Even if the person has recovered completely from mental illness, he/ she will find it very difficult to get married upon declaring the fact of mental illness. Inspite of this fact, I always recommend that one should declare before marriage about the mental illness. This is legally essential- marriage is a contract, and cannot be entered into on a false premise. The other party can easily get divorce as a technically 'insane' person is not allowed to enter into a contract. Morally, it is not right to hide such a critical piece of information from your future life partner. Practically, it is dangerous for the patient because it may lead ot abuse, abandonment and worsening of health condition. Still, I admit that I have come across cases where the spouse continued with the marriage even after discovering about the mental illness. In most cases, this was not a happy marriage.

Persons with mental illness often recover sufficiently enough to be able to make good spouses. While evaluating a person with mental illness as a life-partner, one should consider the type of mental illness, effect on the personality, severity of mental illness and the family history. If you are satisfied that the person is loveable, responsible, in good health and taking medicines regularly and responsive to you- there should be no major problem for getting married. You need to sit with a medical expert to determine the risk of heritability of the mental illness and impact on unborn child of the illness and medicines, as you may want to think of starting a family with this person.This scenario is applicable if you have found someone nice, then discovered about the mental illness and want to take an informed decision.

If you have a mental illness and want to get married, make sure you have all the imformation about your condition and medicines. Take treatment very regularly and dont allow your mental illness to increase. Cultivate a healthy lifestyle free of alcohol, drugs, sleep-deprivation and learn all measures for stress-management. Ask yourself whether you genuinely feel interested in the other person emotionally and sexually? Are you sexually capable? Will you be able to give consideration to the other person?  Do you have the resources needed to establish a new family and maintain it? Take the help of your doctor to find these answers. If you are not found to be fit for marriage, then pursue to goal of fitmess and then only act on your desire for marriage.

A stable and happy marriage improves the quality of life of any individual. But marriage is not a form of treatment. Persons with mental illness should not be shunned from marriage. At the same time, marriage is not a one-way street. It is not about as about organising a legitimate care-taker for the person with mental illness. Life has many possibilities. It is important to take one step at a time, be well-informed and insightful and also have a positive attitude.

MENTALLY HEALTHY

The following things have been found to greatly help in preserving mental health

1. Good genes with low vulnerability to mental and physical disorders
2. Good physical health
3. Average or below average stress in life
4. Absence of any addictions
5. Regular moderate exercise
6. Regular work
7. Adequate sleep
8. Opportunity for leisure and recreation
9. Good relationships
10. Positive attitude

 

CENTRAL GOVERNMENT SCHOLARSHIP FOR DISABLED STUDENTS

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VOLUNTARY WORK

This is a list of NGO s working for specific causes. It is a resource for persons who want to do voluntary wor; so I have scanned this list from a newspaper and putit up here.

IS YOUR RELATIVE SUICIDAL?

Any patient with a risk of suicide is gnerally hospitalised under the care of  a Psychiatrist, till his suicidal impulses subside to safe levels.

Sometimes hospitalisation is not possible. Or immediately after discharge, the patient has to be cared for, at home.

Suicide risk is a serious medical condition like stroke or heart-attack and hence such a patient is not fit to care for himself/ herself. The patient should remain in a restful and supportive environment, which is mostly at home with a trusted relative or friend. One must remove all poisonous materials, sharp objects and ensure that all windows/ balconies have safety grilles.

 Patient needs constant watchful companionship, and should not be allowed to be alone at any time. Patient should be protected from psychological stress and the care-taker should listen patiently and sympathetically to him/ her. Medication should be closely supervised and regularly given. Patient should be taken for regular check-ups to Psychiatrist/ counselor.

Care-taker should not attempt to counsel or 'pep-talk' the patient-leave that to the experts. Just be available and watchful.

Patient should be encouraged to follow a schedule with self care tasks, normal/ usual diet, some intellectual activity, moderate physical activity and positive social interactions. Patient can do as much of routine work or study, as he feels enthusiastic about. Ardous physical or mental effort should be avoided.

This is applicable to men and women; children and seniors also.

 

SUICIDE- ACT OF BRAVERY OR COWARDICE?

A recurrent scenario in my practice is that people believe that suicide reflects one's character- either that a person who does suicide is brave or a coward. I sometimes have to counsel a relative about the risk of suicide and the care to be taken, and the other party is busy assuring me that 'no such thing will happen as the patient is quite timid'. However, the reality is that: anyone can be affected by suicide. 10 year olds, whose personlity is not yet developed-have done suicide. whereas very old persons, who have nothing more to prove in their character have also done suicide. So suicide does not reflect one's character at all.

Suicide is neither an act of bravery nor of cowardice. It is merely an impulse, and a symptom of a mind tired of living. This impulse can arise is any  mind with sufficient despondency caused by disease, personality pattern or social problem.

Recurrent thoughts of suicide and every threat or talk of suicide increases the probability of suicide. Any family member, friend, parent, employer or family physician should take the talks of suicide very seriously. If any of you or your near and dear ones have been thinking or talking about suicide, they surely have a problem that needs to be addressed. The least you can do in this situation is to take that person to any mental health professional such as a social worker, counselor, psychologist or psychiatrist and get him/ her checked.

Suicides are rare events. But you surely don not want one to happen in your vicinity. Suicide is a horrible event for the person and the people around.

But most suicides are preventable. All persons doing suicide give prior indication of an attempt. All the talk about 'he was very normal' 'he was very cheerful' 'he had no reason to do so' are complete non sense.