Table 2 Other stressful or scary events that caused emotional suffering or distress

Restraint

Descriptions of or concerns about the person with SMI being tied up, chained, restrained, or kept inside or hidden involuntarily

“I: There are caregivers at the holy water place. R: Yes. He was tied with shackle… and his feet got worm. Finally his feet got worm… he got wound. Yes. He got wound and worm.”—Caregiver #9, Mother of a man living with SMI

“I: Have you ever tried to chain her or shackle her? R: No. Never. But I kept her in a locked room. I still lock her in sometimes. Sometimes, she drives me really crazy until my mind works no more. Then I keep her inside and keep the door locked. Don’t you ever think she stays quiet when locked in. She knocks from the inside nonstop. Then I open it and give her coffee and food. She eats. This is how my life is.”—Caregiver #5, Daughter of a woman living with SMI

“R: They took me to the holy water when they noticed that I was ill. I: were you chained? I: Yes. I was chained for some three days. They had to put me in chain when I bothered them. I don’t remember details but they told me that I was chained. I was first chained, then taken to holy water and finally went to the hospital.”—Person Living with SMI #6, Male

“I: Have you or your son been chained up? R: I had been chained up for long. My wife used to tie my hands with a rope. My son has never been chained up because he never left the house. He isolates himself when the illness comes.”—Caregiver #12, Father of a man living with SMI (secondarily a person living with SMI)

Verbal or emotional abuse

Descriptions of or concerns about the person with SMI experiencing verbal or emotional abuse

“R: No, rather it gets me angry. If I had to go get something from the kitchen, she may destroy something for the time she wasn’t supervised. My job is to attend her. When I get angry, I tell her I will kill you and then kill myself. That is when I feel so bad. I really feel bad about myself but I never imagined other people looking me down.”—Caregiver #5, Daughter of a woman living with SMI

“R: No one would take him seriously. They do not consider him equal with themselves. Even in the family, they do not consider him seriously. Everyone ignores him or whatever he would say. It doesn’t matter if he is talking about something good or bad, no one listens to him.”—Caregiver #11, Father of a man living with SMI

“R: Some people call me crazy. I just forgive her because I know that I am not crazy myself. Some woman in my neighborhood calls me a goat. I do not try to argue with her because arguments are not good for my health. My mother is my confidant. I talk to her and she would tell me to ignore such people.”—Person living SMI #4, Female

“I: Have you ever been chained? Abused? R: I have never been chained up but people say to me all sorts of things. They like to annoy me and that worsens my illness. The insults and curse words they say to me are not many after I received the treatment. But there are still some people who like to tease me. I just try to ignore them. What more can I do? What power do I have? When I tell them about my illness, they underestimate it and tell me that I will be ok.”—Person Living with SMI #1, Male

Exploitation or Disenfranchisement

Descriptions of or concerns about being forced or unpaid labor or being taken advantage of

“R: I think a lot about his mental health and what other people had done to him. They fool him to work for them for free. I could have sued them but I want to live in peace with my neighbors. I enter into fights with people when they let him work for them for no pay. I know there is a law to protect him but I did not want to fight with all the people who I respect. Over the past two years, he has not worked for me. He did not even change his clothes. He has no friends.”—Caregiver #7, Father of man living with SMI (previously husband of a woman living with SMI, who has since died)

R: “I have no one to think of from our neighbors. If there should be someone held responsible, it is my sister in law. All my mother’s land ownership documents had been transferred to my brother. We had a fight with my brother because he cannot be the only one to inherit. We also asked him to support our mom as he owns the land.”—Caregiver #5, Daughter of a woman living with SMI

Forced treatment or care

Descriptions of or concerns about being forced into or forced to take treatment against the person with SMI’s will

“R: He won’t agree with me. He won’t go. Last time I took him, we rented a Bajaj [motorized rickshaw]. The Bajaj waited for us by the main road. The driver helped us to put him in. My daughter was with me. There was also another man, a relative of ours. We took him but he was not willing. We had to struggle every step of the way. He would not cooperate with anyone but that day he was submissive. But he got nervous when people held him to put in the Bajaj. He was soaked in sweat. Then we tried to convince him that we are actually taking him to the market to buy him clothes. He believed our relative when he said he will buy him clothes and went in the Bajaj with him. Then the Bajaj dropped us off at the health center. He refused to sit there. May God bless the health professionals. They did not keep us waiting. They asked me different questions. Then they gave me some money to buy soap.”—Caregiver #4, Mother of a man living with SMI

“R: Yes I went with him. They gave him tablets. I tried to give him but he refused. He did not cooperate to swallow the pills. I tried to dissolve it in the water he drinks and also hide it in his food but he did not want to take it at all. I think the pills could make him feel better but he resisted. The pills really helped but he resisted. What can I do if he refuses to take? He doesn’t want to take anything at all. He gets irritable and tries to beat me when I tell him to take his pills. I tried really hard to help him finish the first round of tablets he was given by dissolving his daily dose in his tea, coffee or water. But I did not go back to get him the refills because I can’t continue doing that as he kept on refusing. He took his medications for a month.”—Caregiver #1, Mother of a male living with SMI

“R: His brothers live a bit far. I do not have anyone else close by who can help. Taking him to the health center could have been easier if he was chained up and shackled. He might disturb the cart driver otherwise. The cart boys do not want to take someone with mental illness. That was why they raised the money to 80 birr last time.”—Caregiver #14, Wife of a man living with SMI

Chased or run off

Descriptions of or concerns about the person with SMI being chased away

“I: Generally speaking, what should be done? R: There should be counseling. Someone should work with him and his mother so they can be at peace again. I tried to counsel him but he does not listen. I even chased him out of the house when he does not listen but he slept on the streets. I do not know what to do. The injection also makes him look disfigured. He would sleep till 3 pm when he was taking the tablets. He does not eat well even after he wakes up. He won’t be able to eat if he does not work because we do not give him food. We do not have enough food for ourselves. He is 19 years old. He should be able to support himself.”—Caregiver #12, Father of a man living with SMI (secondarily a person living with SMI