The Hindu : Tamil Nadu / Chennai News : Is there appropriate care for the destitute?

Online edition of India's National Newspaper
Monday, Jun 29, 2009
ePaper | Mobile/PDA Version

Tamil Nadu

Tamil Nadu - Chennai

Is there appropriate care for the destitute?

Ramya Kannan

“Often people are unaware of what to do when they see a mentally ill person on the streets”

— Photo: V.GANESAN

NOWHERE TO GO? Apt medical, psycho-social intervention, if made available at the right time, could make a marked difference to the destitute.

CHENNAI: Recently a mentally ill woman was found wandering in the Chintadripet area. Concerned citizens called the women’s helpline 1091 and the police turned up. But they could not help either — the woman would have to be taken to the Institute for Mental Health only after being produced before a magistrate. At 10-30 p.m. there was little chance of that. Where would the woman go for the night?

Unfortunately, the above instance is merely one of many such incidents that occur regularly in Chennai today. Is it easy for one in a difficult circumstance or forced on to the road, to seek shelter even temporarily in a half-way home or shelter, run either by the government or NGOs? Is appropriate medical, psycho-social intervention available to him or her at short notice?

The answer is a chilling no. Except in the case of ChildLine, a phone outreach programme run by the State and voluntary organisations for children in distress, there are no social support structures for people on the streets, especially those with mental illness.

A system existed not very long ago in Chennai, when Banyan, an NGO taking care of mentally ill women, worked along with the police and the Institute of Mental Health (IMH) to rescue and rehabilitate mentally ill women on the streets. However, the Dial 100 Mental Health Helpline ceased to be effective, once the NGO pulled out after differences cropped up between it and the IMH.

“A few months ago, I found an almost naked mentally ill woman near Adyar. The helpline call was successful that time,” said Devika Anand, who has helped three such people.

“Last week when I tried to help another person wandering about near Alwarpet, I called the helpline but nobody came.”

While the issues are relevant for everyone who finds himself or herself temporarily at the mercy of the elements on the street, including women thrown out of homes by relatives, senior citizens, abused or trafficked women, it becomes even more complex with persons with mental illness prone to wandering. Apart from the fact that not everyone is trained to handle such people, it is also a fact that they need emergency psychiatric care.

The Mental Health Act of India places the responsibility of rescuing wandering mentally ill patients on the police. Every such person, taken into protection and detained under this section (23), shall be produced before the nearest Magistrate within 24 hours. After certification of mental illness by a medical officer, the Magistrate can then pass a reception order authorising his or her detention in a psychiatric hospital or nursing home.

“The question is whether the police should be the first point of contact for an individual who needs emergency psychiatric services,” says Vandana Gopikumar, founder-trustee, The Banyan. She suggests that perhaps an amendment of the law is in order.

As long as they were part of the Dial 100 helpline, she says, they had to treat the women for medical problems, including wounds, outside before taking her to the IMH. Every month, there was an average of 70-100 calls for help from members of the public. While roughly one third of them were admitted to the IMH with a reception order from the Commissioner of Police, a few others were admitted after being produced before a magistrate.

Short stay homes

Mohammed Rafi, who runs Anbaham, a home for mentally ill men, says the need of the hour is a short stay home within the city. In case of the destitute, who are seriously ill, he says he is unable to help them, for they might not survive the 25-km trip to the home. “They may not even survive the trip. I’ve been asking for a small corner in the GH or Stanley Hospital, where they can be taken care of for just the night with emergency medicare,” he adds.

Often people are even unaware of what to do when they see a mentally ill person on the streets, Commissioner of Police T. Rajendran says.

The easiest way is to still call ‘100’ to rescue those wandering on the streets with obvious mental illness. He says since the face-off between The Banyan and the IMH, the number of calls have also come down. However, interacting with the police and the legal system is sometimes intimidating for the public who might otherwise want to help a person in distress.

R.Satianathan, Director, IMH, says: “What we need to do is to organise an outpatient department on our campus with 10 beds and post-graduate students on shifts round the clock.

Three ambulances working 8 hours a day each can bring in patients to the hospital.” After this, co-ordination with the police can be initiated at the police outpost and necessary legal formalities undertaken.

“This is what we need; if this is possible then, the entire issue can be easily managed in the city at least.” He says.

He is also comfortable working with a ChildLine-like model, suggesting that the whole project be co-ordinated by the Commissioner for Rehabilitation with the involvement of NGOs. “We will be the facilitators, pitch in with the clinical work.”

(With inputs from Aloysius Xavier Lopez, R. Srikanth and Vidya Venkat)

Printer friendly page
Send this article to Friends by E-Mail

Tamil Nadu