The National Health Mission, Tamil Nadu, is setting up five emergency care and recovery centres for the mentally ill and homeless people across the State — in Vellore, Tiruppur, Tiruvannamalai, Theni and Villupuram.
The ₹335-lakh project is being implemented along with NGO The Banyan, which works in the field of mental health and poverty.
“Mental health cannot be dealt with in institutions alone. It needs a community approach,” said NHM, TN Mission director Darez Ahamed.
At present, there is only the Institute of Mental Health in Chennai that looks after the needs of the homeless mentally ill who need treatment and shelter. “These five centres will strengthen services for them and will be able to take in patients directly as well as by referral,” Mr. Ahamed said.
This is in line with The Mental Healthcare Act, 2017, which states that persons with mental illness living below the poverty line who are homeless are entitled to treatment and services free of cost at establishments run or funded by the government.
Each centre will have 50 beds, and aim to cover at least 10% of the total homeless people with mental illnesses in the State. Five of the beds will be dedicated to patients who opt to stay in voluntarily along with their caregivers. The centres will each have a team, including a psychiatrist, psychologist, social worker and nurses to provide medical and social care.
There are an estimated 150 million people with mental disorders living in India but less than 10% of people with common mental disorders and only about half of all those with schizophrenia are estimated to be accessing any form of care.
“Homeless mentally ill persons are a statement of gross societal negligence and injustice. They experience discrimination, starvation, poor health, high rates of mortality and are susceptible to violence including rape,” said Vandana Gopikumar, co-founder, The Banyan.
The centres, she said, will focus on building approaches around person-centred care and social role valourisation. “We will use standardised measures to evaluate outcomes on quality of life and participation parity to understand the impact of our interventions across sites. We hope that our goal of social mixing will challenge stereotypes associated with mental illness and help foster a culture that respects every individual’s dignity and right to a full life,” she said.
Access to basic amenities and livelihood options as well as family and social life is part of the protocol developed by The Banyan, which the NHM, State and other parterres will collaboratively implement, she said.
The centres will also provide vocational training and equip patients will skills such as baking, cooking and tailoring among others.
Back home after 17 years
After 17 years away, Pavithra* finally went home in June this year. Her story is like something out of a film — at an institution in Kerala for 17 years, Pavithra, who was diagnosed with a mood disorder was brought into a ‘Home Again’ programme by The Banyan, under which, she, with a few other women lived independently in a home near the Calicut airport in Malappuram district.
At first, The Banyan had no details about her address or family, but one day, she told NGO personnel that she wanted to go to her village in Thalavadi in Erode district. A journey began involving a bus and a jeep, a driver and a local resident that took the group across remote stretches before finally getting to her village. “She didn’t recognise her village as so many years had passed,” said Salih P.M. of The Banyan, Kerala. But then, an elderly woman from nearby approached.
“The woman and Pavithra gazed at each other and recognition clicked in,” he said. A celebration began, as Pavithra’s husband, a daughter-in-law she had never met and later, her two sons all came by and took her home. She had been unwell and left their home 18 years ago, her husband said. He had thought she had gone to her parents, as she normally did, but she had never made it there. Now, three months on, Pavithra is still at home with her family, while her medication is sent to her every month and the team keeps in touch with her daughter-in-law.
“The initiation of these five centres with smaller bed strengths, will decrease the burden on IMH, Chennai, and contribute to a reduction of those with long-term care needs,” said Kamala Easwaran, assistant director (partnerships), The Banyan.
*Name changed
