The coronavirus disease has hit the four government mental hospitals in the state at Thane, Nagpur, Pune and Ratnagiri hard, with 21 patients and 50 staffers infected by the virus till August 19.
While all the facilities have suspended group therapy and called off family visits to prevent the virus from spreading further, doctors said, maintaining physical distance and implementing habits, such as hand hygiene and wearing face masks, among the mentally ill patients has been difficult. Restrictions on travel during the lockdown, meanwhile, have also forced a large number of patients, declared fit for discharge, to continue to wait at the facilities inducing restlessness in some, they said.
At the Thane mental hospital, which houses 807 patients, so far 17 patients and 22 staffers have been afflicted by the coronavirus disease. In May, a female staffer had succumbed to the virus, while two patients died in June.
According to staffers, at least 40 patients share a ward at the hospital, sleeping within a foot of one another, some on mattresses others on the floor, which makes maintaining three-foot distance impossible.
“Serious patients of psychosis, schizophrenia and bipolar disorders do not understand how or why to wear a mask. They keep throwing it away,” medical superintendent Dr Sanjay Bodade said.
Dr Sadhana Tayade, the director of Directorate of Health Services, said there was a risk that mentally ill patients can swallow hand sanitisers if dispensers are installed in the wards, hence a caretaker makes them wash hands before every meal.
With 30 per cent staff vacancy, ensuring individual attention to patients at the Thane mental hospital has been difficult. The hospital said it has already stopped group therapy sessions to avoid crowding and also prohibited visitors since March. The 17 female patients, all from the same ward, who had tested positive for the virus, were suspected to have got the infection from a female staffer who lives outside the hospital campus.
At least 110 patients at the Thane facility are fit to go home, records show, but their families either live in a containment zone or do not have means to travel since local trains allow only government employees to travel. “We have been calling the family members of these patients. But since March we are hearing the same excuse,” superintendent Bodade said.
At Nagpur mental hospital, a patient and eight staffers have been infected with the coronavirus. Superintendent Dr Madhuri Thorat said they have started arranging for vehicles to transport the patients, fit for release, home if families cannot make it. “We arrange transport within Nagpur and to nearby districts like Amravati, Chandrapur, and Wardha. We have to send these patients home as they have become restless during the lockdown,” she said. There are still 40 patients who have been declared fit but are yet to go home.
At the Pune facility, one patient and at least 20 staffers have tested positive so far. The hospital has 1,100 patients, of them 70 are fit for discharge. “Some families are coming to get their kin discharged, but not all,” said Dr Abhijeet Phadnis, medical superintendent. Phadnis added they do not have enough space to maintain social distancing. “Since staffers come from outside, we are training them every week on how to maintain a safe distance from patients,” he said.
In Ratnagiri, two patients at the mental hospital tested positive on August 18. Of them, one was admitted to the institute just 10 days ago. “We are now testing all close contacts of those patients. We expect the swab results by tomorrow,” superintendent Dr Sanjay Kumar Kalkutgi said. Hospital authorities said as their major concern was to prevent Covid-19 infection in patients, psychotherapy sessions have taken a backseat.
Social workers said since families are not allowed to enter hospitals and meet patients, recovery of patients has been affected. Social rehabilitation sessions have been reduced for NGOs working at hospitals in Ratnagiri and Nagpur. “We are noting a behavioural change in patients. Since March, we have not managed to meet these patients and hold sessions for them,” an NGO worker in Nagpur said.
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