Visit Report: Maris Bhavan Psychosocial Rehabilitation Centre

PG Diploma in Psychology and Counseling

Submitted by : Sajitha Rasheed, Acsa, Lakshmi, Sudha

1. Introduction

The field of psychology and counseling requires both theoretical grounding and experiential
learning to foster empathy, practical skills, and understanding of mental health care systems.
As part of our curriculum for the Post Graduate Diploma in Psychology and Counseling, we
visited the Maris Bhavan Psychosocial Rehabilitation Centre in Kerala. This field visit was
not just an opportunity to witness institutionalized mental health care, but also a profound
experience that provided insights into the intersection of psychology, social work, and
spirituality.

Maris Bhavan, operating under the Institute of the Sisters of Nazareth and the House of
Refuge, is a unique example of a faith-based, community-supported rehabilitation model that
has evolved over decades. This report outlines our observations, key learnings, and
reflections from the visit.

2. Historical Background of the Institution

Our visit began with a briefing by Sr. Candida and Ms. Meena, both of whom play significant
roles in the management of the center. They provided us with a comprehensive history of the
institution and its mission.

Maris Bhavan was established in 1948 under the guidance of Fr. Kandathil and two co-
founders. It began with only eight members, focusing primarily on providing refuge for
unwed mothers who were ostracized by their families and society due to prevailing cultural
norms. At that time, the idea of supporting unwed mothers was revolutionary, given the
stigma associated with premarital pregnancy, especially in conservative communities.

In the 1950s, the institution expanded its outreach with the help of destitute sisters who were
trained to care for the residents. Fr. Chiramel, a significant benefactor, donated his private
property to support the expansion of the facility, reflecting the deep personal commitment to
the cause.

Over the years, Maris Bhavan evolved into a compound comprising six institutions, one of
which is the psychosocial rehabilitation center. At one point, the center housed up to 300
inmates, including children. These children received education at Bal Bhavan, which is
located within the same compound. Many of the children were adopted, often by European
families, and some were married off with the institution's support.

Maris Bhavan also served as a government-recognized center for adoption. Today, all
adoptions are handled through online platforms, with mandatory follow-ups to ensure child
welfare post-adoption.
3. Psychosocial Rehabilitation Centre: Structure and Functioning

The psychosocial rehabilitation wing of Maris Bhavan was established as a response to the
increasing need to care for women with long-term mental illnesses who were either
abandoned or not accepted back into their families.

Currently, the center houses 22 female inmates with chronic mental health issues. Most of the
residents are diagnosed with schizophrenia, while a smaller percentage suffer from bipolar
disorder. The youngest resident is 23 years old, while the oldest is 68.

3.1. Medical Support and Infrastructure

The medical aspects of the center are overseen by Dr. Mary Teresa, a dedicated mental health
professional who regularly monitors the inmates. Her role is crucial in diagnosing,
prescribing, and adjusting medication based on the inmates' progress. Government support
ensures the provision of free medicines, which is a significant relief for the institution.

In cases of emergencies, immediate medical assistance is provided. The doctor visits the
facility regularly to assess the inmates and ensure they are responding well to their treatment
plans. Since schizophrenia and bipolar disorder often involve episodes that may impair
judgment, delusions, or extreme emotional states, regular monitoring is essential.

3.2. Living Conditions and Daily Routine

The inmates live in dormitories, each housing up to eight women. This communal living
fosters a sense of belonging and encourages social interaction, both of which are therapeutic
in a rehabilitation setting.

Each day is structured around a routine that includes personal hygiene, meals, therapy
sessions (informal or group-based), recreational activities, prayer or meditation, and rest
periods. Structured daily schedules are crucial in the treatment and rehabilitation of
individuals with schizophrenia and bipolar disorder, as they help in restoring a sense of
normalcy and stability.

The center's environment is calm and spiritual, with an emphasis on compassion and routine
care, which is central to psychosocial rehabilitation.

4. Student Interaction and Recreational Activities

A key highlight of our visit was the two-hour interaction session with the residents. As
students of psychology and counseling, we were eager not just to observe but to engage
meaningfully with the inmates through activities that promote connection and upliftment.

We organized an informal session that included singing songs, playing a simple group game,
and dancing together in a relaxed and joyful setting.

Many inmates participated enthusiastically, and some even initiated small interactions, asking
questions or joining us in song.
This interaction provided us with firsthand experience of how therapeutic recreation can
positively impact emotional well-being. It reinforced the importance of non-verbal
communication, empathy, and the healing potential of shared moments.

It was also a reminder of how small acts of presence and engagement can make a meaningful
difference. For us students, the session deepened our appreciation of holistic, person-centered
care and the role of creative therapy in rehabilitation.

5. Case Observations and Mental Health Narratives

One of the most striking aspects of the visit was the opportunity to review anonymized notes
written by one of the sisters detailing the lived experiences and psychological states of some
inmates. These notes offer a poignant and disturbing window into the subjective experiences
of women suffering from mental illness. Here are some selected narratives, categorized by
diagnosis, along with brief psychological interpretations:

5.1. Schizophrenia

Case 1:
“She felt that her body was wrapped by a snake. It felt that the snake was biting her.
Sometimes she felt like someone was coming to kill her.”
Interpretation: This case indicates classic symptoms of paranoid schizophrenia—
specifically tactile and persecutory hallucinations. The delusion of physical attack by a snake
may represent internalized fear and trauma.

Case 2:
“She felt like everyone was trying to destroy her; her family, relatives, and friends. She said
that they were doing this to spoil her happiness. She believed they gave medicines to her in
coffee, fruits, and other food items.”
Interpretation: The presence of paranoia and persecutory delusions is evident. There is also
evidence of impaired reality testing and mistrust even towards loved ones.

Case 3:
“Grandmother’s death caused shock and she was very angry and also used abusive words.
She doesn’t sleep at night.”
Interpretation: A triggering event (bereavement) possibly led to the onset of psychotic
symptoms or a psychotic break. Emotional dysregulation and sleep disturbances are common
in such cases.

Case 4:
“She had a relationship with someone and was forced into another marriage by her brother.
She hated her family.”
Interpretation: This history suggests a severe psychosocial stressor. Her condition could
have been triggered by emotional trauma and lack of autonomy, leading to feelings of
betrayal and disintegration of self-identity.

Case 5:
“During her 10th grade she was anxious about her results in school. Her father was
hospitalized and suddenly died. She did not recover from that shock and displayed anger,
throwing vessels, newspapers etc. She believed that her family and relatives were trying to
make her into a mental patient.”
Interpretation: This narrative combines grief, trauma, and developing paranoia, all of which
contribute to psychosis. The onset of symptoms in adolescence, triggered by familial loss, is
not uncommon.

5.2. Bipolar Disorder

Case 1:
“She was very poor in her study. She faced difficulties in studies. 20 teachers shouted at her.
That gave fear of teachers and studies. She failed in 9th grade, after which she was not ready
to go to school. She had lost her sleep. She had bad dreams like she flew over the sky and
suddenly fell down to the floor.”
Interpretation: This suggests childhood trauma, low academic self-efficacy, and possible
hypomanic or depressive symptoms. Sleep disturbances and vivid dreams indicate instability
in mood regulation.

Case 2:
“The death of her child was a shock to her and her husband. He turned to alcoholism and she
suffered in her marital home. She was not given food by her in-laws.”
Interpretation: This reflects the cumulative trauma leading to a depressive or mixed episode.
The neglect and abuse from her in-laws could have worsened the mood disorder.

6. Reflections and Learnings

Visiting Maris Bhavan was both humbling and enlightening. Some of the key takeaways from
the visit include:

6.1. Role of Faith and Compassion in Mental Health Care

The entire institution is run with a deep sense of compassion, service, and spirituality. While
conventional psychiatry emphasizes diagnosis and medication, Maris Bhavan integrates
empathy and acceptance as core therapeutic tools.

6.2. Importance of Structured Environment

A structured environment—timely meals, routines, and interpersonal interaction—contributes

6.3. Reintegration Challenges

Many inmates may never be accepted back into their families. The social stigma attached to
mental illness, particularly in women, remains deeply entrenched. Some residents suffer from
memory loss, making reintegration further complicated. The center becomes their permanent
home, and the sisters their family.

6.4. Impact of Student Interaction

6.5. Role of Government Support

Free medicines and regular doctor visits, enabled by government support, make such long-
term care sustainable. This is a good example of a public-private partnership working towards
mental health care.

7. Conclusion

Maris Bhavan represents a rare model of psychosocial rehabilitation that balances clinical
care with deep human empathy. It addresses the needs of a neglected population—women
with chronic psychiatric conditions who lack familial support. The integration of spiritual
care, structured rehabilitation, and psychiatric support makes the center not just a place of
residence but a space of healing.

The visit was an eye-opening experience that helped connect theoretical knowledge with real-
life complexities. It reinforced the importance of holistic care, patience, and advocacy in the
practice of psychology and counseling. Institutions like Maris Bhavan remind us of the
transformative power of compassion in mental health recovery.