- Mukul Goswami
I was discussing 'Mental Health' with
a group of people at Lakhimpur in the far North East corner
of Assam, when one of them informed me that a young boy
who was affected by a mental illness, is being kept chained
by his father. Proud of my role as an activist fighting
for the 'rights of persons with mental illness', I rushed
to this village some 30kms away and confronted this 'father'
who could be so cruel towards his own son.
The father who had a learned look despite
being weighed down by poverty, replied calmly "I know
my son is affected with a mental disorder, and needs proper
medical treatment. But do you know, that for treatment I
must take my son in this volatile condition to Tezpur Mental
hospital, over 200 Kms away. You can also see that I cannot
take him by bus, and hiring a Taxi is obviously beyond my
capacity. Also, I chain him to protect him from many of
my neighbors - not to torture him. Do you know that when
he is free, he wanders from house to house in the village
talking nonsense - for that he is harassed and beaten up
- no one understands that he is behaving abnormally because
of an illness - not affecting the body but the mind"
No one can refute the logic of the father,
as both the Government and Civil society have not yet succeeded
in providing any major relief to the abject helplessness
of the mentally ill and their families in any comprehensive
manner. The 'father' would have to cross two District Head
quarters, Dhemaji and North Lakhimpur (meaning two Civil
Hospitals) without available Psychiatrists to reach LGB
Regional Institute for Mental Health, Tezpur. The father's
problems would not end by reaching Tezpur. His son's condition
would in all probability require indoor treatment. But the
Mental Hospital at Tezpur , being the only such facility
in the north east and so catering to patients from all over
the region has only 318 beds. In this context, the Medical
College at Dibrugarh has around 40 beds in the Psychiatric
ward, Guwahati Medical College has 64 beds and Silchar Medical
College has 20. With less than 500 available beds for Psychiatric
patients, it would certainly be not easy to get a vacancy.
Finally to break the chains of the 'son',
the neighbors must also be made aware of the nature and
symptoms of mental disorders. In this context, it must be
said that, NGOs have played a major role in creating awareness
on many issues, but unfortunately this has not happened
in any substantial way in the area of mental health in the
State of Assam. As far as my knowledge goes, Ashadeep in
the Brahmaputra Valley and Deshabandhu Club in the Barak
Valley are the only two civil society organizations working
in the field of mental health.
Now, I am in a dilemma. Who is to be reprimanded?
The 'Father,' the Government or the Civil society for the
definitely inhumane act of chaining a human being. Let us
try to find out by analyzing the problem.
| Chaining
of boy |
Family |
-
Lack of knowledge of mental illness
- No access to Psychiatric care
- No access to crisis management
- Services
|
| Access
to Psychiatric care and treatment |
Primary
Health Centre (PHC) |
-
PHC's not functioning, abandoned, occupied by
armed forces
- No Manpower, Para Medicos and General Practitioners
not trained in Mental health
- Medicines not available
|
| Mental
Illness |
Civil Hospital
Psychiatrist
Mental Health Professionals |
| |
| |
| |
| |
| LGB Regional Institute
of Mental Health |
| |
| |
| |
| |
| |
| Medicines |
|
| - Only 8 districts have
psychiatrists |
| - Indoor facilities unavailable
for |
| persons with mental
illness in CH or small hospitals |
| - Psychiatric Wards only
in three hospitals |
| |
| - Only Mental Health
hospital in the North-East - |
| - Understaffed, Only
318 beds catering to a population of over
2.5 Lakh |
| - Outdoor services overcrowded |
| - No emergency admission |
| |
| - Not available in most
areas |
| - Long term requirement |
| - Very expensive |
|
| Crisis
Management |
| Health Workers |
| |
| |
| |
| Police |
| |
| Ambulance Services |
| |
|
| - Not oriented to mental
health issues |
| - National Rural Health
Mission, Asha |
| etc. does not cover Mental
Health |
| |
| Not sensitized |
| |
| Public Health ambulance
service at PHC |
| level non functional
|
|
| Awareness
and sensitization of community on Mental Health |
| Health Department |
| |
| |
| Government Publicity |
| |
| NGO working on Mental
Health |
|
| Except in three districts
of Assam, no |
| awareness programmes
|
| |
| Nil |
| |
| 1 NGO only |
|
|
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