No succour for women mental health patients: Survey

Seema Kaul

Tribune News Service

New Delhi, July 18

Women patients at 10 mental health institutes across the country are usually unable to go home because of social stigma, abandonment, rejection by their families and legal and judicial issues which do not pressurise families to take their responsibility. 

A joint survey by the National Commission for Women (NCW) and NIMHANS, Bangalore, was conducted in 2015-2016 to assess the living conditions of women inmates and identify clinical, social and familial reasons for their long stay and lack of rehabilitation. 

The onsite survey was conducted across 10 mental health institutes (both government and private) in Amritsar, Pune, Kozhikode, Thane, Goa, Calcutta, Murshidabad, Ranchi, Agra and Bareilly.

The biggest concern for patients and staff at the Institute of Mental Health in Amritsar is discharging patients who need not stay in the hospital.  

Social stigma and insufficient qualified mental health professionals are the roadblocks for proper rehabilitation or return of inmates to their homes.

The Amritsar facility gets a lot of support from Pingalwara (NGO working in mental health). However, there are three psychiatric social workers whose services are not used appropriately. There is no provision for a vehicle to make home visits and they are not allowed to do detailed checkup in the outpatient department either.

The Institute of Mental Health (Government Mental Hospital) is spread over 60 acres and caters to mental health patients from Punjab, Haryana and Chandigarh.

There are also patients from faraway states like Tamil Nadu, Karnataka and West Bengal. 

The report recommends improving awareness regarding mental illness and its treatment. Long term patients in these hospitals should get identity documents like Adhaar card to avail benefits like insurance or pension.

Long stay must be discouraged by increasing family and open wards and voluntary admissions. 

“A routine legal aid must be carried out for each woman who is admitted involuntarily or is not discharged within three months of hospitalisation. Such a facility may be set up by the State Legal Services Authority and emergent issues discussed with the hospital committee and other monitoring committees,” the report recommended.

The report also recommends supervised halfway home facilities or rehabilitation, including treatment for addiction. The homes should have income generation possibilities within the community. There should be shelters with daycare facilities and link-ups with vocational centres to ensure equal opportunities for women with mental health issues.

A rehabilitation plan is most critical. As of now there is no critical assessment of existing rehabilitation models so a white paper needs to be formulated with effective models of rehabilitation. 

The NCW will adopt 10 psychiatric institutions for monitoring and assistance in improving facilities for women. The commission can explore whether the Nirbhaya or Swaadhar funds can be used to improve living conditions. Incentives for families have also been recommended and may include free or subsidised treatment, travel concessions, disability assessment and pension and access to insurance schemes.