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Support, not abandon, the mentally disabled

ht view Updated: Dec 14, 2014 23:27 IST
Intellectually disabled

“Ten male and female cops surrounded me. They started kicking me against my shin with their boots, laughing as they pushed me into the police van,” Deepali, a 45-year-old mother of four, told me in Delhi. The police did not tell her why she was being picked up. They took her to a mental hospital. Deepali later learned that her father had convinced her husband to sign the papers committing her to an institution, claiming that she had a psychosocial disability (a mental health condition) following a panic attack.

Deepali (name changed) was subsequently institutionalised by her family despite having her medical file and a letter from her psychiatrist stating she did not have bipolar disorder nor did she need to be on medication or hospitalised.

Under the law, women can be admitted to institutions by family members or guardians without their consent. Widespread stigma and a severe shortage of state-sponsored community-based services and support often result in families abandoning people with psychosocial or intellectual disabilities.

“Relatives just dump patients at the hospital and think that’s it,” a nurse in one of India’s largest mental hospitals in Pune told me. “They put fake addresses and phone numbers on the registration forms so we cannot contact them again.”

So what makes families do this?

For one, the dearth of services is striking. For more than 70 million people with psychosocial disabilities — mental health conditions such as schizophrenia or depression — who live in India, access to mental health services is poor, with only 43 state-run mental hospitals across the country, three psychiatrists and 0.47 psychologists per million people. The few voluntary community-based services that do exist are short-staffed and lack resources.

Similarly, for people with intellectual disabilities — cognitive impairments such as Down syndrome — not only are support services limited but the few existing services are under-utilised. A 2012 survey by Parivaar, a national confederation of over 230 parents’ associations and NGOs working to empower persons with intellectual disabilities and their families, found that 40% of people interviewed in 58 districts across 10 states did not benefit from any services at all.

Once in institutions, women with psychosocial or intellectual disabilities are vulnerable to abuse and they have little say in what happens to them. To add to that, state institutions are often overcrowded, the sanitation and hygiene dismal, access to treatment and counselling poor, and rehabilitation efforts non-existent.

Under Indian laws, they can be denied their legal capacity — the right to make their own decisions — whether in healthcare or even choosing where to live.

Although India was among the first to ratify the UN Convention on the Rights of Persons with Disabilities in 2007, it still has a long way to go in ensuring that the rights of this population are respected and they have access to services on an equal basis with others.

As the world recently celebrated International Day of Persons with Disabilities, India should commit to initiating a roadmap to end an abusive system that locks up women and girls with psychosocial or intellectual disabilities in institutions and instead provide support and services in the community.

India should commit to initiating a roadmap to end an abusive system that locks up women and girls with psychosocial or intellectual disabilities in institutions and instead provide support and services in the community.

Kriti Sharma is researcher at Human Rights Watch
The views expressed by the author are personal