RAJESH, 28, suffers from schizophrenia. Found roaming on the streets of Colaba, South Mumbai, wearing an overgrown beard and tattered clothes, he was brought to a shelter for the mentally ill in Karjat, 62 km from South Mumbai, by policemen. Having received treatment for five months, on Thursday, with the assistance of mental health activists, Rajesh was accompanied to Jaipur to be reunited with his family after he was able to give social workers directions.
But Moti Chua, 47, has not been so lucky.
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Lodged in Thane Mental Hospital after being brought in by police in circumstances not different from Rajesh’s, this is Moti’s 41st year here. Ten years ago, psychiatrists at hospital say, Moti was cured of schizophrenia, and now has a “stable mind” with medication, but since no attempts were ever made to track his family, finding them now seems impossible.
Like Moti, 324 patients with mental illnesses ranging from schizophrenia to bipolar disorder and depression, brought to TMH by the police after being rescued from the streets, continue to live in the institution even after a successful treatment. At least 80 per cent have been recommended by doctors for discharge and rehabilitation with families.
Of these 324, 241 are women and 83 men.
Overall, 265 patients at Thane Mental Hospital have lived there for more than 10 years. 160 of them have lived at the 65-acre institution for over 20 years. Moti is the oldest occupant, living since 1975. While precise numbers are not available, doctors at TMH said a very large percentage of the 265 who have lived here for over a decade are patients brought in as destitutes by the police.
The information, provided to a social worker under the Right to Information (RTI) Act, has turned the spotlight on the absence of infrastructure and funds to help rehabilitate such men and women. While the police’s role ends upon dropping the rescued patient at the TMH, it is up to the eight social workers employed in the hospital to locate and verify their addresses, and initiate the process to reunite them with their families.
Data accessed by social worker Stefan Nadar shows that TMH has 1,565 patients, 1,241 of whom were brought by relatives and have their addresses noted in the hospital register. However, there are no addresses for the 324 brought by the police. “Under the Mental Health Act, the police is supposed to present the mentally ill destitute to a magistrate who can order hospital admission. It generally takes one month to treat them with medication. Then it is the social worker’s job to find the address of the patient and rehabilitate him,” said Manish Renghe, coordinator of the Maharashtra government’s Mental Health Cell.
But several of these 324 patients have either been abandoned by their families, or have been unable to give a clear and verifiable address. About 20 per cent of the destitutes brought are able to provide their exact address. Yet, with the eight psychiatric social workers at TMH overburdened with treating patients and finding addresses, the latter job has taken a backseat. While the hospital’s policy is against lifelong hospitalisation, two per cent of total patients, who are either physically weak or old, have to be permanently accommodated.
“A few relatives of these destitute have been traced but they are unwilling to come and take the patient away,” hospital psychiatrist Dr Rucha Joshi said. According to her, these patients can easily live in society provided they continue their medication and come for monthly check-ups.
The National Legal Services Authority (NSLA), formed in 2010, is entrusted the responsibility of treating, sheltering and reuniting these patients with their families. However, there is little coordination between the mental hospitals and the NLSA. “We are trying to find a systematic method to send back treated patients living with us for long time. It is under discussion,” Renghe said.
TMH medical officer Dr Anjali Deshpande said the institution is attached to two NGOs, Neptune and Tarasha. “But these have very few volunteers. We first try to send a letter at the postal address that patients give. Only if the family confirms do we send someone to the address with the patient. If there is no response, it becomes difficult to physically send someone to locate the family.”
In some cases, the patient does not remember the address. Sometimes, even after an address is confirmed, the hospital does not have the manpower to accompany the patients back and counsel their families. Occasionally, a class IV attendant is sent to the family, who is neither medically trained nor able to counsel the family on treatment.
On an average, 15 to 20 patients are reunited every year from TMH. “More patients can be reunited if someone personally goes to their native place,” says Dr Bharat Watvani from the NGO Shraddha.
The story is similar in the other three state-run mental health institutions in Maharashtra, the hospitals in Nagpur, Ratnagiri and Pune.
While there are eight social workers at TMH, there are only four at the Nagpur Mental Hospital, 12 at the Pune facility, and two in Ratnagiri. At each institution, the staff says it has no time to physically search and verify addresses of patients brought in by police, especially if they are from outside Maharashtra.