‘When someone is diagnosed with mental illness, families should engage them in simple tasks to keep them from wandering away'

Raagini Devi Singh knows she is from Punjab and that she lived with her brother's family in West Bengal; she recalls expressively the physical abuse he heaped on her after his business ran into losses. But from here on her narrative in Hindi becomes vague when she recounts her lone journey to a temple in Jammu and Kashmir, after which she boarded several trains and found herself in Tiruchi. “Back then, I used to hear voices that often threatened to kill me and cut me into pieces,” she says.

Today, she is among the 48 persons rescued by Anbalayam, a voluntary organisation that works with wandering mentally ill persons like Raagini in the city. “The voices are still there…but I hear them less often,” says Raagini, who is under regular psychiatric treatment for her schizophrenia at Anbalayam since 2011.

Raagini is not alone: there are approximately 10 lakh wandering mentally ill persons on Indian roads today according to recent statistics from the National Institute of Mental Health and Neuro Sciences, Bangalore.

“We can neither prevent mental illness nor completely stem a fresh wave of mentally ill from wandering into the streets after the existing ones have been rehabilitated,” says T.K.S.Senthil Kumar, founder president, Anbalayam. With a steady flow of such affected persons forming the backdrop, he feels the onus is on families and the government to ensure their early identification and rehabilitation.

“Most families expect mentally ill persons to take their own medicines because they seem capable of other routine activities- however, they don't know that patient cleverly toss their medicines away,” he says. With the medicine's controlling effect absent, they often leave home under the influence of hallucinations or paranoia and end up at foreign places that further compound their social isolation.

“When someone is diagnosed with mental illness, families should devise ways in which the person can be actively engaged in simple, repetitive tasks that can keep in check their tendency to wander away.”

With a significant chunk of mentally ill arriving at alien places on trains, there is an urgent need to integrate identification mechanisms at all the major railway stations, feels Senthil.

“Social workers and the Railway Protection Force must work in tandem to identify such people at railway stations so that their migration to places very far from home can be curbed,” says Senthil, who feels that the increase in distance is inversely proportional to their rehabilitation chances.

Anbalayam has created a website, www.wanderingmentallyill.in, to hasten the process: “Anybody who spots such people can log on to our portal, and fill in basic details about their present whereabouts along with a picture if possible,” says Senthil, who adds that the details can be used by the Police department to locate persons reported missing by their families.

But the process of rehabilitation is not just about compassion says Dr.K.Ramakrishnan, Executive Secretary, Shanthivanam, a Karur-based NGO that also works with wandering mentally ill. A psychiatrist who runs his own hospital, Dr.Ramakrishnan is aware of the legal tangles involved in caring for destitute mentally ill persons.

“According to the Mental Health Act, 1987, such persons can be admitted to an asylum only after an FIR is filed at the local police station and a person in the category of a judicial magistrate has signed a retention certificate,” he says. Also, they must be given acute medical care before being instituted at a rehabilitation home.

However, there is complete lack of awareness about such specifications amidst the authorities because of which Dr. Ramakrishnan is often refused an FIR. “The police sometimes offer to give me a letter, which will not stand in a court of law, in case the mentally ill person dies under my care,” he says.

With Anbalayam and Shanthivanam occupied to capacity, the NGOs are looking towards their respective district administrations to provide them with supplementary spaces. Jayashree Muralidharan, District Collector, Tiruchi, felt there were enough places in the city that could be converted into dedicated homes for the wandering mentally ill: “Though the two existing night shelters in Tiruchi were created for roadside dwellers, they remain under-utilised and it I think at least one of them can be handed over to Anbalayam on a pilot basis.”

Keywords: mental illness