Pioneering Psychiatric Rehabilitation in Pakistan

In 2009, Shaheen Ahmed, a member of PRA’s International Committee, opened the doors of the first psychiatric rehabilitation (PSR) program in Pakistan. In Pakistan, mental health services primarily consist of clinical treatment in a hospital provided by psychiatrists who then send “patients” back to their families upon achieving sufficient medical stability. Shaheen, who has lived in the US for almost all of her adult life, has been determined to bring community-based, recovery-oriented PSR services to families in Pakistan. She turned to the people she met through her participation on PRA’s International Committee, which afforded resources and exposure to the training and technical assistance needed to generate the capacity to initiate Recovery House.

Shaheen and her brother, Khusro Elley, brought together a set of trustees in Pakistan to provide leadership and resources for the creation of Recovery House, the first recovery-oriented and psychiatric rehabilitation program in Pakistan, located in Karachi. The two traveled back and forth between their homes in the US and Karachi to facilitate the many practical necessities of developing this pioneer PSR program. With highly committed leadership, the team obtained fiscal resources, donations, a venue, and personnel. To date, Recovery House has provided PSR services for 130 people and their families through its residential services designed for 15 men and women, and a site-based PSR program. The site-based program is for those who choose to continue to make use of PSR services after their residential experience, or as a starting point for these new services.

Together with Shaheen and Khusro, the trustees sought out administrative and professional personnel to create the program. The trustees made use of the many materials available for PSR and the current best practices in providing PSR services. A major challenge, of course, is that in Pakistan there is neither a PSR workforce to obtain qualified professionals nor PSR programs to provide guidance on how to provide PSR services. Instead, Recovery House’s founders have had to “sell” PSR to those who have already obtained professional credentials in psychiatry, psychology, and nursing. Their response to these challenges has been to bring training opportunities to Recovery House staff to help them create and adapt this westernized service approach to Pakistan’s cultural context.

It has only been three years since Recovery House opened its doors, but they have already served 130 individuals through both their residential and PSR programs. Community integration is a common thread as individuals return to their very large extended families. Shaheen, who is a National Alliance on Mental Illness (NAMI) Family to Family trainer, knows the value of bringing families into the conversation about recovery, since in Pakistan the family is the dominant way of experiencing everyday life. Families are large and close, thus providing an excellent resource and support for Recovery House participant goals. Shaheen has already initiated family training/psychoeducation through Recovery House, engaging family members to learn about recovery and the role of psychiatric rehabilitation in returning back to their families to facilitate recovery.

Anthony Zipple, a member of PRA’s International Committee, connected Recovery House with Michele Blankenberger from Thresholds in Chicago to provide support and guidance in the startup with Recovery House’s Director and other staff, making use of electronic resources such as Skype sessions and emailing PSR program materials as implementation examples. Recovery House staff selected IMR, which they call Wellness Management & Recovery, as their first evidence-based practice psychoeducation tool for implementing their PSR services. In addition, they have learned about the Wellness Recovery Action Plan (WRAP) and added this tool to their programming. Currently, the Recovery House’s trustees have developed an agreement with Dr. Veronica Carey, CPRP, an associate director at Drexel University, and Dr. Barbara Granger, CPRP, a private consultant, to support PSR training of professionals and assessment of the current program structure. Both Dr. Carey and Dr. Granger will visit Pakistan in Fall 2013, sponsored by Recovery House, to offer pro-bono support to the administrative professionals, training for the Recovery House teams of staff, orientation to family members, and readiness support to program participants. In addition, there are plans to engage local hospital and university representatives in PSR. Clearly, PRA’s International Committee has provided valuable facilitation to promote the pioneering of PSR in Pakistan.

Originally Published at

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