Under pressure to comply with a Supreme Court (SC) order to rehabilitate homeless, mentally ill patients languishing in mental hospitals, the state government has decided to shift several to beggars’ home, apart from old-age homes and shelter homes for women, while observing that it lacks the infrastructure to accommodate so many patients. This is despite a top court directive to states to either expand existing rehabilitation homes or construct new ones.
At least 215 mentally ill patients will be moved out as part of the “rehabilitation”. Of them, 85 will be moved to beggars’ home in the first batch. On Friday, at least 190 patients were discharged, several against their consent, from four mental hospitals in Thane, Ratnagiri, Pune and Nagpur.
A 37-year-old homeless woman, who was admitted to Nagpur Mental Hospital since 2011, was among the patients who were shifted Friday. When Health Secretary Dr Pradeep Vyas had visited the hospital Thursday, a day before she was shifted, she had cried and pleaded that she should not to be moved to a government home.
At a Ratnagiri hospital, from which 10 patients were moved to beggars’ home, a social worker said, “There must be some preparation to counsel them to live in a beggars’ home, but we got no time. Several of them are old and will not get used to such a place.”
A beggars’ home is a government custodial centre where people found begging are detained.
“There is no provision to have counsellors trained in tackling mentally ill patients in beggars’ home. These are institutions for serving sentence, not treatment. Inmates are paid Rs 5 per month for work they do inside the home,” Mohd Tarique of NGO Koshish said.
Mental health activists fear that mentally ill patients shifted to such beggars’ homes will not only suffer from the lack of counselling and skill training, but their mental condition may deteriorate further. “Shifting them to beggars’ homes will undo all our efforts. Several were recovering well through skill training at mental hospitals. All that work will come to a full stop,” a social worker at Nagpur Mental Hospital said.
The Maharashtra government’s decision to shift homeless and mentally ill patients follows a 2016 writ petition filed by one Gaurav Kumar Bansal in the top court, raising concern over a need to set up rehabilitation homes for mentally ill persons.
The Supreme Court, in its 2017 order, directed all states and Union territories to set up rehabilitation homes for abandoned and treated patients, patients who don’t need hospitalisation, and homeless patients. The states were asked to comply within one year. In 2018, Bansal had filed a contempt petition stating non-compliance of the order by several states.
In July, the top court granted time until November 30 for states to comply with the order. The court also observed that state governments should either expand existing homes or construct new homes at their own cost for rehabilitating such persons.
Documents accessed by The Indian Express show on October 14, a month before the Supreme Court deadline, a meeting was held to discuss alternate homes for mentally ill patients. Maharashtra’s four mental hospitals have a huge load of treated patients who continue to remain hospitalised since decades due to abandonment.
A 2016 Right to Information application shows there were 911 mentally ill patients living permanently in all four government mental hospitals. Of them, 425 were living in hospitals for more than 20 years.
On October 23, Maharashtra chief secretary passed an order to transfer homeless, mentally ill patients, who were fit for discharge, to beggars’ homes, old-age homes, half-way homes and rehabilitation centers. Half-way homes are centres where mentally ill patients get to live outside hospital, but in a monitored environment. These are mostly run by NGOs.
Maharashtra works with one such NGO, The Banyan, that has absorbed a total of 12 mentally ill patients. “We desperately tried to rehabilitate as many as we could. But with limited infrastructure, we could only take four patients,” senior team member of The Banyan Lakshmi Narasimhan said.
Narasimhan added that the move to shift patients to beggars’ home “is moving them from one institutional care to another without offering them a choice because they are poor”. “How does this rehabilitate them?” she asked.
Meanwhile, the state government officials said that the move to shift patients to beggar’s home is “temporary”. On November 6, the Social Justice and Special Assistance Department wrote to State Health Department to construct new rehabilitation homes within six months.
“But it is impossible to construct all this in such a short time. These patients may end up living permanently in beggars’ home,” said an official from the Directorate of Health Services, without wishing to be identified.
According to Mental Healthcare Act, 2017, patients must be provided regular counselling, close monitoring of medication and skill training. Old-age homes and women’s homes are not equipped to handle mentally ill patients.
On Friday, 15 mentally ill women were shifted from Thane Mental Hospital to Kasturba Home for Women in Chembur, which has a capacity of 40. Superintendent Namita Shinde said currently they have no staff trained in handling such patients.
“We will write to government to provide us training. Our home is not equipped for mentally ill patients,” she said.
When The Indian Express contacted Chief Secretary Ajoy Mehta, he did not comment and asked to contact Health Secretary Dr Pradeep Vyas, who did not respond to repeated calls. Sanjay Patil, deputy secretary in Social Justice and Special Assistance Department, also did not respond to calls and messages.