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Work therapy

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LEFT OUT: Most government policies and programmes for the intellectually disabled focus on children and ignore adults

When children with mental illnesses or intellectual disabilities become adults they need to be kept engaged and employed to curb severe behavioural problems.

Love and work are cornerstones of humanness, said Sigmund Freud. This applies as much if not more to those with intellectual disabilities or mental illnesses. The biggest challenge for their parents and caregivers is to find ways and means to keep their children engaged and employed when they become adults.

"Most government policies and programmes are meant for children with intellectual disabilities. Once they turn 18, there is nothing for them. When they are not employed and have no vocational training, they develop behavioural problems. Where will parents take them after that? Caregivers have their lives and other responsibilities, " says Shanti Aulakh, whose 36-year-old son who was born with Down Syndrome. He works at Muskaan, the vocational training centre in Delhi run by her.

Aulakh narrates the story of a 65-year-old widow who lives alone with her 35-year-old intellectually disabled son. He often turns uncontrollably violent. Her attempts to enrol him in vocational training failed as he hit one of the instructors hard across the eye almost damaging it. He would also turn on his classmates. He now refuses to go to the training centre and she is helpless.

You hear these stories often from hapless parents in similar situations. "Many parents come to me because they don't know what to do with their intellectually disabled child who has grown into a difficult-to-manage adult. They can get aggressive or they may have sexual urges which they might exhibit in a socially inappropriate manner. These parents need counselling and support services. Unfortunately, none of this is available, " explains J P Gadkari, president of Parivaar, a federation of parents' associations and NGOs that work with persons with intellectual disabilities in Karnataka.

The condition of being intellectually challenged is not the problem. "The problem is when their emotional and psychosocial needs are not understood or addressed. That's when they develop behavioural problems, become disruptive or aggressive. Through love and positive reinforcement, they have to be disciplined and controlled right from childhood, " explains Aulakh, whose centre trains people of varying levels of disability. Muskaan makes Rs 30 lakh worth of products annually engaging intellectually challenged adults.

The problem tends to compound as parents of children with mental illnesses and intellectual disabilities age. Ratna Chibber, who runs Aasha, an NGO in Chennai run by caregivers and families of people with mental illnesses, says that employment can make a huge difference in such cases. "There are many stories of persons with mental illness becoming exemplary caregivers for their older parents. But there are instances of persons with mental illnesses refusing to take medicine, beating up ageing parents regularly and being generally unmanageable. Being employed and having a regular job makes a huge difference to their lives and how they deal with their problems. That is why we have shops and offices where we employ these persons, " says Chibber.

Almost anyone who works with families of adults with intellectual disabilities or mental illness suggests the same solution - keep them engaged and gainfully employed. "If a person has nothing to engage him throughout the day, day after day, s/he is bound to develop behavioural problems, " says Gadkari. About 70 per cent of those with intellectually disabilities are educable, trainable and employable and most people with mental illness are like people with any other ailment - individuals who with regular care and right medicine can be successful professionals provided they get the right support and environment. Both seem to be in short supply.

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