Plan to integrate long-stay patients in mental hospitals

NIMHANS is coordinating the Health Ministry’s project in 14 hospitals.  

A 53-year-old chronic schizophrenia patient was brought by his family members to NIMHANS in December 2016.

When his family requested his admission on the grounds that he could not be managed at home, doctors admitted him for three months initially after due evaluation.

Subsequently, despite the patient having recovered from his psychotic symptoms, including delusion, hallucination, aggressiveness and impairment in brain functioning, his family disowned him. It became inevitable for doctors to periodically extend his stay in hospital. Now, after two years, doctors are trying in vain to integrate him in a larger open-space community.

This is not a lone case. There are several such patients abandoned by their families and have been staying for long in mental hospitals in the country. Although their condition has improved and they can be integrated in the community, they have no opportunities. To identify such long-stay patients abandoned by their families in mental hospitals, and explore the possibility of rehabilitating them, the Union Health Ministry is working on a project titled ‘National strategy for inclusive and community-based living for persons with mental health issues.’

While this will ensure that beds in mental hospitals are not blocked by long-stay patients, it will also help in mainstreaming persons with mental illness who no longer require hospital care.

The project, which is being carried out with funds from the HANS Foundation, will involve all the 42 mental hospitals in the country. NIMHANS is coordinating the project in 14 hospitals, NIMHANS Director B.N. Gangadhar told The Hindu.

Growing awareness

According to the National Mental Health Survey of India 2015–2016, mental disorders contribute to a significant load of morbidity and disability, even though a few conditions account for an increasing mortality. This is probably owing to the growing awareness in society, improved recognition, variations in disease patterns, changing lifestyles, and biological vulnerabilities.

“Mental disorders, such as depression, anxiety, alcohol use, suicidal behaviour, and drug use, apart from several others, are on the increase. However, with advancements in medicine and better healthcare services, patients improve after treatment for some period and can be integrated into the community,” said NIMHANS Registrar K. Sekar.

“In the past, there were asylums where patients were put up for long. But now that concept no longer exists. The project is essential as most of the nearly 20,000 beds in the 42 mental health hospitals in the country are occupied by long-stay patients,” he added.

Need for corporate involvement

The impact of chronic mental problems lasts for a protracted period, gradually resulting in a poor quality of life for such individuals and their families. From a cultural perspective, mental disorders are associated with a considerable amount of stigma in Indian society, leading to neglect and marginalisation.

Such individuals and their families face numerous challenges in daily life, both for managing the condition as well as for making them productive. It is probably due to this, some families abandon persons with mental illness.

Doctors in NIMHANS have now taken the lead in exploring various opportunities to facilitate community integration for patients who no longer require hospital care. “In the absence of government-run facilities to rehabilitate such patients, there is a need for involvement of private institutions and NGOs as well as corporate sector to fund such community level rehabilitation efforts,” said John P. John, professor of Psychiatry at NIMHANS.

“We in fact contacted some corporates seeking their help to rehabilitate a few patients. But unfortunately none responded positively,” he said.

Pointing out that the corporate sector needs to be sensitised about the need, he said such rehabilitation initiatives could be taken up under CSR funds. As several such patients in NIMHANS require community level integration, interested companies can contact Dr. John on jpj@nimhans.ac.in.

This article is closed for comments.
Please Email the Editor

Printable version | Nov 17, 2020 7:47:57 PM | https://www.thehindu.com/news/national/karnataka/plan-to-integrate-long-stay-patients-in-mental-hospitals/article24782339.ece

Next Story