A chilling headline in The Times of India on 23rd October should have shaken up many people. It said that 379 out of 475 individuals, certified as mentally fit, were stuck in mental hospitals all over Maharashtra for over 10 years. Justice Nitin Jamadar and Manjusha Deshpande of the Bombay High Court, remarked “This means you have kept them in detention.”
This fact was revealed in a public interest litigation (PIL) filed by renowned psychiatrist Dr Harish Shetty who has worked relentlessly on creating awareness about mental health issues for decades. He was inspired to file the case after a December 2021 order of Swati Chauhan of the Bandra family court in Mumbai in a divorce proceeding. Judge Chauhan’s tenacity forced the Thane mental hospital superintendent to appear before the court and admit that a perfectly normal woman had remained confined to a mental hospital for 12 long years, from 2009 to 2021, after being admitted. Her husband, who had filed for divorce, had made many excuses to avoid taking her back even after she had fully recovered, or allowing her the freedom to live on her own.
Dr Shetty believes that thousands of fit people are thrown into mental hospitals by their families taking advantage of a corrupt system and those who have recovered after treatment continue to languish there, in very poor conditions, because their families do not want to take the responsibility for them.
Such actions are a result of marriages gone bad, property disputes, or simply the fact that families do not want to care for a spouse, sibling or a relative. Chilling as this is, the PIL may be just the tip of an iceberg. Dr Shetty is on record saying that poor mental health had turned into an epidemic in India. This is due to anger, alienation, social changes and, sometimes, relentless pressure to perform. As many as 35 students die by suicide every day in India; but it draws media attention only when it is political or happens at an elite institution. The effort by celebrities like Deepika Padukone has helped remove the stigma attached to treatable conditions such as schizophrenia.
Most of us would admit to having come across friends and colleagues who narrate stories about mental health issues that are kept suppressed for fear of society’s backlash. Often, these are highly educated people—doctors, scientists, engineers and teachers—from well-placed families, whose condition deteriorates only because it is not acknowledged and treated in time.
An activist friend with ageing parents passed away early and had his schizophrenia discovered and diagnosed too late. A heart-rending experience with another friend, however, led to the discovery that there are more humane solutions than consigning a relative to a poorly funded and over-worked mental hospital. This also applies when people have been cured and need a permanent home, when families abandon them or are incapable of taking on the responsibility for other reasons. It is these situations that have prompted me to write this piece.
Our friend Anshuman (name changed) is an IIM graduate and held a well-paying job in a tech company. He was a loner, single and lived with his mother and had an unacknowledged mental condition that was worsening slowly. He first lost his job and, later, reached a stage where he couldn’t concentrate on his work for even 30 minutes. And, yet, he insisted he was perfectly healthy and had never needed even an aspirin. The only concession he made was to have his eyes checked which was futile. Around 2019, his mother passed away and Anshuman lost his anchor; things began to go haywire and had no job.
His two brothers—one in a senor management person in a large telecom company and the other in India’s most profitable media organisation—wanted to have nothing to do with him. The rented house where he lived with his mother was given up and Anshuman was left roaming the streets of Andheri (a Mumbai suburb), smoking discarded cigarette butts and perhaps living off charity. Many months later, he was spotted by a former colleague who informed us of his plight and we began to hunt for him. As luck would have it, targeting cigarette kiosks helped and we found him. All our colleagues pulled together and got police help to convince him to come with us, make himself presentable and figure out what to do. When contacted, his brother did not want to be involved. It was the same with former classmates—all very well off—who offered plenty of sympathy and nothing else.
This is where information and insight into the right kind of organisations becomes invaluable. We were fortunate to get this from Nishit Kumar, managing director at Centre for Social and Behaviour Change Communication, and Sailesh Mishra, founder of Silver Innings which works with the elderly and people with dementia and Alzheimer’s disease. We were looking for a clean, well-maintained place that would care for Anshuman with empathy. After a hectic search, we discovered what has turned out to be a true find—Anandvan Wellness Centre at Nallasopara, a Mumbai suburb (https://www.anandvanwellnesscentre.com/Home).
Anandvan is a paid facility that charges anywhere between Rs25,000 – Rs29,000 a month (inclusive of food, treatment and a series of activities). At the time of taking him there, we had expected to crowd-source funds. Fortunately, one his brothers, who now has access to all of Anshuman’s belongings (and he did have a good bank balance and shares) agreed to pay. It has been three years now and he has been fit to be discharged for over a year (his progress is evident in the photos below), but his family is not interested in taking him back. At one level, he is fortunate, since we are able to keep an eye on him and one of his brothers continues to pay for him. Anandvan is also far more humane place and has better surroundings than a government mental hospital which is worse than sending someone to jail.
After the COVID pandemic, which was a tough time for all organisations, Anandvan has got itself registered as a charitable foundation and is also looking after people whose families have abandoned them after making some initial payments. We have since helped Anadvan raise money through corporate social responsibility (CSR) for the refurbishment and initiatives to support a couple of women with no financial means. While we have discovered one organisation, there would, perhaps, be more such places that provide humane and positive support along with treatment of those with mental health. Corporate India needs to support such organisations in their own self-interest and for their employees.
Dr Shetty explains that, after the implementation of the Mental Healthcare Act (MHCA) 2017, cases like that of the lady mentioned above would have to be reviewed every six months. But it is clearly not happening and Dr Shetty says that mental health professionals also need to be more proactive to ensure that people are not ‘sentenced’ to mental hospitals when fully fit.
The PIL hearings before the high court also indicate that the state mental health authority had no rehabilitation plans for those who have recovered, other than 12 half-way houses, whose details have to be presented to the court in the next hearing on 11th November. A key issue with recovered mental health patients is that they need to take medicine regularly or there is a danger they could slide back. Often, caregivers at home are unable to ensure this and need a support system, observation and care. They also need physical activities, meditation and occasional celebrations to remain cheerful and in good equilibrium. This is not easy.
Anandvan, for instance, has a hospital with 24-hour care for psychiatric illnesses like schizophrenia, anxiety, bipolar disorder, obsessive compulsive disorder, Alzheimer’s, dementia, Parkinson’s disease, etc. The care process includes treatment, counselling and rehabilitation, yoga, mediation and career guidance under the supervision of trained psychologists and psychiatrists.
Nuclear families and changing social landscape have created a huge need for retirement homes for well-to-do elders. Similarly, issues with mental health, which are also part of the same changing society, need solutions, support, research and layered options that suit different economic conditions. While the State does, indeed, have a duty to care for people or ensure that they are cared for, it is time to stop hiding mental health issues, so that more humane and workable alternatives can be developed through paid, private initiatives supplemented by CSR support.
Comments
advocatebapoomalcolm
10 months ago
The worst thing is that when normal people are incarcerated with the mentally challenged the sane ones become I'll.
Yes I totally agree with Ms Dalai, there are so many suffering like this in salience. I appreciate your efforts towards Mental Health. People like you if raise voice it will help the society at large. Right from awareness to treatment to rehabilitate for quality of life in long run. So good deed & well done .
Meena Mutha
Founder Trustee
Manav Foundaion
Day care psychiatric Rehabilitation Center. Mumbai
WWW. Manav Foundaion.org.in
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Meena Mutha
Founder Trustee
Manav Foundaion
Day care psychiatric Rehabilitation Center. Mumbai
WWW. Manav Foundaion.org.in