No funds allocated for improving facilities

The mental healthcare community, which had, in the wake of the alleged murder of the Bihar youth Satnam Singh at the Thiruvananthapuram government mental health centre, hoped for a budget announcement for improving the woeful condition of the mental healthcare facilities in the State, is disappointed.

While the budget has proposed a mental health programme and a rehabilitation scheme, it has allocated no funds for improving the existing mental healthcare facilities. Finance Minister K.M. Mani earmarked Rs.20 crore for a new ‘comprehensive mental health programme’ to be executed by NGOs and schools. He also proposed opening care homes for mentally challenged children in every district in partnership with NGOs and allocated Rs.10.5 crore. It is another matter that last year’s budget proposal to open psychiatric wards in all district hospitals is yet to take off.

Satnam’s death

Satnam Singh’s death had highlighted the pitiable conditions in the three government mental health centres — in Thiruvananthapuram, Thrissur, and Kozhikode. The fact that Satnam, who had shown mental disturbances at the Amritanandamayi Ashram at Vallikkavu before being sent to the Thiruvnanthapuram mental health centre, had to lick dirty water off the toilet floor to quench his thirst before death, was a tragic indicator of the condition of the centre. A couple of months after Satnam’s death, another inmate had died at the same centre in similar circumstances.

Following public outrage over Satnam’s death, the Estimates Committee of the Assembly investigated the condition of the mental health centres and made recommendations to the government in December 2012. The committee, headed by V.D. Satheesan, found that the three centres had heavy shortage of psychiatrists, clinical psychologists, social workers, and security staff and that their buildings were dirty and dilapidated. It had asked the government to formulate a master plan for infrastructure development for the centres and allot funds from the budget

Mr. Satheesan told The Hindu that he was disappointed that there was no allocation in the budget for the centres.

C.J. John, a senior psychiatrist and a functionary of the Indian Psychiatric Society, said he was shocked that there was no budget allocation for strengthening the mental healthcare facilities.

Dr. John, however, appreciated the announcement of a new ‘comprehensive programme.’ He said the NGO, Maithri, had recently launched such a programme in the Kizhakkambalam panchayat with the participation of the panchayat, schools, and social organisations. He said the Kizhakkambalam model could be adopted for the programme and the Rs.20-crore allotted for it could be used for the initiative in about 300 panchayats.

Policy needed

Litto Palathinkal, president of ‘Kanivu,’ a collective of mental health rehabilitation and care homes, said clear policy statement for the mental health sector was urgently needed. “There should be visions for both treatment and rehabilitation,” he said. One major reason for the current mess was the lack of coordination among the four departments— Health, Police, Social Welfare and Local Self-Government.

He said that the district mental health programme was handicapped by the shortage of mental health staff. There were very few psychiatrists, and most were based in the cities. For a population of 33 million, hardly 1,700 beds were available in the government sector. Upgrading of facilities at the government mental health centres has been overdue for decades.

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