More Families Abandon Mentally ill – News Article
Lack of Support System , Insurance Cover Pushes Kin to the Edge ; Clinics Verify backgrounds before admitting Patients
CHENNAI: Surya’s wizened face peeped out of the tiny opening in the iron gates that led to ward 3 at the Institute of Mental Health. “Take me home,” he rasped, wiggling his finger through the opening.
The 42-year-old, for whom IMH has been home for more than 20 years, is among hundreds of mentally-ill patients who have been abandoned by their families and forced into institutions that are hard pressed for beds and staff. Psychiatrists say there has been a substantial rise in the number of families seeking admission for mentally-ill kin, but they have to turn many away owing to lack of space.
“We don’t have sufficient hospitals for the mentally ill in the city. Many hospitals find it difficult to return patients to their homes as most families don’t want to take them back,” said Dr R Thara, director of SCARF, which has around 140 beds.
Dr Thara attributed the surge in people seeking admission to the decrease in the number of caregivers. “As long as parents of the mentally-ill person are alive, he or she is taken care of. Later, relatives see him or her as a burden since medication is expensive and periodic monitoring is required. Under such circumstances, families look for a place to admit the patient and never look back,” she said.
Many institutes have stepped up measures to verify the backgrounds of kin. “We ask for at least three references and check the mobile numbers. Even then, when we send them home, they are often greeted with locked doors,” said an official at IMH.
Mental health experts say families are under a lot of pressure. “We don’t have a support system. Mental health is not covered by insurance . When a patient becomes violent, families don’t know where to go,” said Dr Thara.
Doctors say a family environment is more conducive for recovery. “When a patient comes out of a disorder, the chances of a relapse are higher if he or she sees strange faces, instead of family. It confuses them,” said Dr Saradha Menon, who was IMH superintendent for 17 years.
Some institutes like The Banyan are experimenting with alternate housing for patients abandoned by families. The institute has categorised patients into three groups. The first comprises people in remission and it helps them rent a house and find work and provide medical help, if necessary . “The second group needs help. They live in cottages and either work or come to us for vocational training,” said Vandana Gopikumar, co-founder of The Banyan. The third group has people with disabilities and they motivate one another. “The only way to tackle the problem is to experiment with different approaches,” she said.
Source:Times of India
Shortage of psychiatrists hits treatment
With the focus firmly on combating noncommunicable and lifestyle diseases, mental health is neglected in India. The subject has always received little attention as mental illness is a cause for stigma, and as a result the country has a severe shortage of mental health professionals.
For students too, clinical psychology is the last option since patients are fewer. Director of medical education Dr V Kanagasabai said, “There are very few seats for psychology and they get filled last. The burden of mental health issues like anxiety, lack of tolerance and stress is increasing rapidly among the urban and rural population.”
The country needs 11,500 psychiatrists but has just 3,500, according to the Union ministry of health and family welfare. The entire mental health workforce, comprising clinical psychiatrists, psychologists, psychiatric social workers and psychiatric nurses stands at 7,000, while the actual requirement is 54,750.
The situation is similar in Tamil Nadu where there are just 350 psychiatrists for a population of 7.2 crore. Less than 25 psychiatrists qualify every year. Though the state has a better healthcare index than many others, it lacks adequate manpower and infrastructure for mental health programmes. As for hospitals, TN has the 1,800-bed Institute of Mental Health, a few hundred beds in medical college hospitals and district headquarters hospitals, and about 1,500 beds in private sector.
“The number of psychology seats should be increased to bridge the gap between demand and supply,” said Kanagasabai.
Merely increasing seats would not make a difference as it takes more than five years to become an expert in the field of psychiatry, said Dr C Anbudurai, who works at a mental health clinic in Loyola College. “These days, anyone with a good command over the language claims to be a psychologist. To prevent this, integrated community workers should be brought into the picture,” he said. Community workers could help with early detection and rehabilitation, he said.
He said that people didn’t approach mental health experts for fear of being stigmatized. Another reason is the time it takes to recover; it is not the same as going to a doctor and popping a pill to heal. “Patients are not open to consulting a psychiatrist as the results are not immediate. It is more like a classroom set-up where you learn something from your doctor and you have to work with him over time to get better,” he said.
The sheer number of mentally ill people abandoned by their families speaks of a brewing social crisis that may assume tremendous proportions. It’s often impossible to reconcile such people with their relatives; at the same time, it’s cruel to lock them up in institutions. Government could instead plan halfway homes which can provide shelter, jobs and a social network aimed at rehabilitating the countless who are battling internal demons. NGOs, self-help groups, village panchayats may be able to help provide supervision, create a protective environment and develop skill sets needed to ensure that this section of the population continues to lead productive lives.
Source:Times of India