Ambika, 34, loves to read poetry but it makes her sad sometimes. She tries to be happy most of the time but, at times, tears well up unbidden at the thought of the daughter she left behind at home and whom she has not seen in ages.

“She is 13 years now and must have grown up so much since I left her nine years ago, when the Mental Health Centre (MHC) became my home. I am so thankful to my younger sister for taking care of her that I have promised never to trouble them,” says Ambika.

She has a big family back home, parents, four sisters, and a brother, who she does not visit either. Her husband divorced her when she had to be hospitalised after she was found to be suffering from Bipolar Mood Disorder, a psychiatric illness characterised by extreme mood swings. “The doctors say that I can lead a normal life, even though I have to be on medication all life. I do yearn to be home but when I think about the future of my daughter I think that it is better that I stay away. I do not blame my family, they did try their best,” she says.

Unwanted by their own families and rendered helpless by a society which is apathetic to their plight, hundreds of patients at MHC are resigned to spending the rest of their lives within its four walls even though they are well enough to go back to their homes.

“On an average, we have about 15 admissions daily. But the number of new admissions is never more than three; the rest are all patients who had been discharged earlier. They are sent back home to be with their families after completing the treatment of the acute phase of their illness. Sadly, they either come back to us on their own or the family is only too eager to bring them back, often barely days after discharge,” says Sunilkumar G., MHC Superintendent.

The MHC has at least 200 such patients, who are ready to be discharged and should be rightfully home with their loved ones, leading normal lives.

“These patients go back home to families, where they are not exactly welcome and where they continue to be treated like they are still mentally ill. What they need is a loving family atmosphere which will give them back their lost self confidence and sense of well being. In their vulnerable state of mind, it is easy for the family or others to harass them into reacting violently,” says Nanda, a psychiatric social worker at MHC.

One family member has to take responsibility for the patient and ensure that he or she takes the medicines regularly. But after the first few days, none takes care to ensure this and the medicines become irregular. As for the patient, the feeling of being dependent, lack of social acceptance and having no worthwhile vocation or earning pushes him towards alcohol.

The stories are no different. The families are happy and relieved to bring them back to MHC.

MHC has a separate rehabilitation ward also, where there are about 13 persons who are fully cured and are completely self-sufficient. They are allowed to walk free on the campus, get a small daily earning from the bread- or furniture-making unit inside MHC and generally help out the MHC staff.

“Many of them have been here for years now. They have no parents or spouses and no immediate family who are willing to take them back. We cannot turn them out because they have no where to go,” says Akhila, a psychiatric social worker.

Anyone looking at the genial middle-aged man, dressed in a smart-collared and tucked-in T-shirt and trouser, would take him to be a staff member at the MHC. Joby has been in the rehabilitation ward for over nine years now. He has three daughters and a son. He was first brought to MHC in 2000 for treatment of schizhophrenia.

“I did go back home after I was discharged but I knew that I was not welcome, so I came back here. In these past nine years, my wife passed away, all my children got married but I was never informed. Now, this hospital is my home,” he says. A farming enthusiast, he is the happiest potting around in the garden.

“The effort should be to rehabilitate them within the community, as a productive, earning, and self-sufficient individual member. Taking them out of the MHC and confining them in some shelter is not the answer. It is important that they feel their self-worth,” Dr. Sunil says.

(The names of patients have been changed to protect their identity).