Innovation summary

There are two primary problems with regards to mental health care in Sri Lanka. These include the lack of mental health services to cater to the vast and growing need in the population as well as the lack of knowledge and stigma surrounding mental illness. As a result of these factors, there is a large gap between those needing and those receiving mental health services. Of note among the vulnerable populations required care are children, adolescents and young people, especially in post-civil war, which left many families vulnerable to loss, economic hardship and trauma1.

The Child, Adolescent and Family Services (CAFS) was established with the following aims:

  • Addressing the gaps of mental health services in terms of diagnosis, assessment, intervention, and prevention
  • Providing comprehensive psychological support for children, adolescents, adults and their families in Sri Lanka.
  • Promote knowledge and reduce stigma surrounding mental illness through engaging with public awareness campaigns on different topics throughout the country.

Impact summary

  • 6 awareness campaigns carried out including two annual campaigns since the commencement of the project two years ago.
  • Facilitated 16 workshops covering a wide array of topics for beneficiaries
  • CAFS receives approximately 50 service users each week, seeking treatment, care and support.
  • The operations cost for sustaining CAFS’s work is approximately LKR 150, 000 – 200,000 (USD $ 825 – 1,100) per month

“The workshop was very useful for us parents in terms of understanding how to deal with children who are having incurable diseases, how their mental health and carers mental health is affected and how we can cope up with difficulties faced”

- Parent who attended the scribbles workshop at the national cancer hospital

Innovation details

CAFS is run by a team of psychologists who are supported by a group of volunteers and interns. The organization also maintains collaborations with other professionals in the field who lend their expertise and support in carrying out the services and activities initiated by CAFS.

  1. Environment - In order to encourage use of services and reduce the stigma on mental health CAFS aims to provide a non-intimidating homely space to help individuals feel comfortable and at ease when coming to seek help. The centre is carefully designed with a warm, cosy and friendly atmosphere, far from the traditional clinical setting.
  2. Clinical Service - Has a team of professionals in different disciplines and therefore a broader range of expertise; CAFS provides assessments, tailor-made interventions and management of a range of mental health conditions for children, adolescents, adults and their families.
  3. Awareness Campaigns- In order to increase knowledge and reduce stigma surrounding Mental health, CAFS also conducts awareness campaigns around the country that address various topics on mental health. Some of these annual campaigns include,
    • ‘Think Blue’ - an Autism Awareness campaign,
    • ‘Live’ - a Suicide Prevention campaign and
    • ‘#iamwithyouSL’ - a campaign to reduce the stigma surrounding mental health.
  4. Outreach - CAFS organizes and designs specialized workshops for communities, schools, and institutions around the country that are in need of mental health services but are not able to reach out or afford to receive professional help. With the assistance of interns and volunteers, CAFS initiates monthly workshops under different areas of interest, in the hopes of reaching bigger communities.
    • “Scribbles” is one of those series of workshops designed using creative methods as a form of expressing psychological and emotional needs, focusing on both children and parents with and without special needs, aiming to bridge the gap in communicating and expressing oneself. Being one of the oldest workshops initiated by CAFS, it has reached preschools. schools, child welfare centers, parents and children from different walks of life, both in and out of Colombo, the main city in Sri Lanka
  5. Training - CAFS also engages in providing internships and supervised clinical exposure for fresh graduates in the field of psychology. By doing so, CAFS builds a platform for their growth and development, in terms of training in assessments, supervision, and practical exposure; guiding them to pursue their higher studies aiming to be future psychologists.

Key drivers

Volunteerism

  • Being a not- for- profit organization, a large burden of work involving planning and executing awareness programs and other projects is made easier by generous volunteers who invest their time and efforts in order to help us successfully implement the projects.
  • Each program has a set of volunteers and interns assigned, who carry out background research on related topics, generate ideas, identify sponsors, manage approvals and logistics and are overlooked by the directors in order to make the programs run smoothly.

Collaborations

  • CAFS believes it is important to build a solid network of individuals including professionals in the field of mental health, regulatory bodies, media, government/ non-government organizations and other stakeholders in order to create better mental health awareness, implement policies and make services more accessible to the general public. Therefore, with each project or program initiated, CAFS invites different individuals with different interests and expertise to take part and collaborate in order to give out better output.
  • CAFS also participates in events organized by other organizations related to mental health stigma reduction and awareness, while taking part in annual mental health day activities conducted by the National Institute for Mental Health in Sri-Lanka.   

Challenges

Stigma

  • The Stigma surrounding mental health in the country is the biggest challenge in encouraging individuals who are in need of it from reaching out and seeking mental health services.

Funding

  • A lack of sustainable funding has remained the main challenge in maintaining and further implementing all of the services, and programs provided by the organization. Currently due to these constraints, there is only one clinic in Colombo.
  • CAFS is run by Psychologists who coordinate between Clinical and administrative duties thus limiting the amount of potential work that could be carried out by the organization, However, due to the lack of funding, expanding the core team has remained a challenge.

Continuation

CAFS hopes to expand and provide services to other parts of the country upon addressing specific challenges to sustainability. CAFS is also currently working with Ember to address a number of challenges.

Partners

Funders

  • Leo Wick and B&B Health Grant Scheme, Australia

Evaluation methods

The organisation is currently in the process of putting together a plan to carry out the following M&E activities with the support of Ember.

Client progress monitoring

While CAFS maintains client records, the team is currently in the process of developing standardised questionnaires to evaluate the level of each individual’s improvements, changes in their conditions and assess the service standards on a monthly basis.

Feedback forms for trainings

At the end of each workshop, CAFS collects information on the workshops held in terms of delivery, knowledge gained, areas of improvement, ideas and suggestions in order to design better workshops in further efforts. The organisation is in the process of developing a system to input this information in a manner to support the process of monitoring and evaluation.

Cost of implementation

  • The approximate operations cost for the organisation is at LKR 1500,000 – 200,000 (USD$ 825 – 1100) per month.
  • The cost of facilitating workshops and trainings is LKR 10,000-12,000 (USD$ 55 - 66) with rising costs anticipated if these workshops are carried out in locations outside of Colombo.
  • The cost of one annual awareness campaign stands at approximately LKR 200,000 (USD$ 1,102) however support from sponsorships aid in covering most of this cost apart from administrative costs.

Impact details

  • CAFS has currently carried out 6 awareness campaigns on the topics of Autism, Suicide prevention and reducing stigma around metal health with our Autism awareness campaign in the past two years covering areas within and outside of Colombo in order to reach a wider audience.
  • We have also carried out workshops for children under our ‘scribbles’ project in 8 different areas in Colombo as well as out of Colombo. These include workshops at schools, pre-schools, children’s homes and community centers.
  • We have facilitated 16 workshops on different topics in the field of psychology, for students, professionals and the general public. These workshops covered topics in clinical psychology, special learning needs, research and awareness of mental health.  
  • In terms of clinical service CAFS has approximately 50 service users including both adults and children coming in per week approximating 200 sessions per month and 600 service users per year.

References

  1. Chandradasa M, Kuruppuarachchi KA. Child and youth mental health in post-war Sri Lanka. BJPsych international. 2017 May;14(2):36-7.

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