Mental hospitals around the country usually hit the headlines for all the wrong reasons, but this one is a rare exception. Dhobi Ghar, an automated laundry that was launched in Kolkata’s Pavlov Mental Hospital on July 1, is turning out to be a path-breaker. About two dozen inmates who are cured and have nowhere to go have started earning, and if everything goes right, they may well get separate quarters to start living with minimal assistance and supervision that they should have ideally received at home.
“I have found a sense of self-worth… that we can do things by ourselves and earn as well,” said Bijan Roy Nandi (name changed) who is living in the hospital since 2006. He is one of the 138 patients who are living in the hospital for more than five years.
The Belgharia resident’s mother and younger brother have shown no interest in taking him back home.
Another member of Roy Nandi’s group is Ashok Ghosh, a resident of Lake Town, living at the hospital since 2004. He had lost hope of ever getting out of the hospital but feels optimistic now.
Feeling optimistic, according to experts, is crucial to recovery.
Of about five dozen inmates who are cured, 20 are presently handling the imported, industrial laundry machines in five groups. Each group of four works on three-hour shifts on rotational basis and gets paid at Rs 350/ 8 hrs. Each member earns between Rs 390 and Rs 525 a week. The laundry helps 518 inmates at the hospital get cleaned and ironed clothes and bed sheets once a week.
The project is being run by mental health NGO Anjali, which has Sparsh Foundation as technical partner. A team from Nagpur mental hospital, which has 170 patients living for more than five years and 236 destitute patients, recently paid a visit to Pavlov to examine the pros and cons of the Dhobi Ghar model.
In Pavlov, four female inmates run a tea stall as well, named Cha Ghar. They prepare tea and snacks for the visitors , doctors and employees of the hospital.
“A majority of those abandoned by their families are from low income groups. Even after they are cured their families consider them as financial liabilities, and refuse to take them back” said Suman Bhowmik of Sparsh Foundation.
The laundry project has significant implication. Even as psychiatrists around the world are trying to determine whether creative talent is directly linked with mental illness, several hundred inmates in mental hospitals across India are forced into a suffocating life, deprived of dream and hope.
While a three-member division bench of the Supreme Court, led by the chief justice of India, is hearing a petition seeking release and rehabilitation for the recovered inmates, a handful of hospitals in different parts of the country have stated addressing the issue. The Pavlov experiment has to be judged against this background.
According to a report prepared by a committee constituted by National Human Rights Commission (NHRC) and released in June this year, 386 inmates in the five state-run mental hospitals in West Bengal are in hospital for more than five years. The all-India figure is 3,025 patients in 47 state-run hospitals.
“Long stays in hospitals for recovered patients can cause them irreparable mental damage,” said lawyer Gourav Bansal, who filed the petition in the apex court seeking release and rehabilitation of recovered patients.
The NHRC report, however, cautioned that “addressing the issues of long-stay should not become an exercise to ‘get rid’ of them because they occupy hospital beds”. It said, “The longer a person with mental illness is untreated and the longer a person remains in hospital without any attempt at rehabilitation and reintegration, the chances of independent living are likely to diminish (the more). Thus early intervention, early rehabilitation and appropriate medication whenever necessary are all very important factors in reducing chronicity and disability.”
In West Bengal, inmates at mental hospitals are not allowed to leave voluntarily. Mental health activist Ratnaboli Ray, who heads the NGO Anjali, recalled that only one patient was allowed to leave on his own, only after Anjali approached court seeking his release.
“The person, an Assam resident, was allowed to move out after doctors certified him fit and on the condition that Anjali will keep in touch with him. He has been doing fine over the past five years in running his business,” Ray told HT. Dhobi Ghar, she says, is the first step towards helping the recovered inmates regain the sense of self-worth and build on self-confidence.
Most of those recovered and recovering patients need regular medical supervision and access to medical facilities in times of relapse. That is why, such eminent mental health experts as Dr Alok Sarin say, releasing them without proper support mechanism in place is not advisable.
“They need to be made accustomed to independent living by helping them with the necessary assistance. Rehabilitation and reintegration in the society also requires a holistic and person-centric approach,” Sarin, a psychiatrist at Sitaram Bhartia Institute of Science and Research, New Delhi, told HT.
Among hospitals in other states, the mental hospitals in Yerawada and Nagpur in Maharashtra and Tezpur in Assam have taken initiatives to help long-stay inmates get back to normal life.
In December 2014, a 40-bed rehabilitation ward was set up for the recovered patients at the Yerawada mental hospital. The centre, run by psychiatrist Hamid Davolkar (son of slain anti-superstition activist Narendra Davolkar), has helped several inmates reunite with their families. The INCENSE programme of the Parivartan Trust is also arranging for training in making paper and clay products and imitation jewelry, besides gardening and farming.
According to Vandana Gopikumar, co-founder of the Chennai-based NGO, Banyan, and a professor at School of Social Work, Tata Institute of Social Sciences, “People with mental illness who do not have a place to call home are among the most vulnerable people. They are in utmost need of care to help them live with dignity. Among people we have worked with, examples of rejection by family members are many but the rehabilitation programmes have also resulted in some fairy tale-like reunions.”
The Institute of Mental Health, Chennai, has the highest number of long-stay inmates – 551 persons are living for more than five years.
West Bengal has more institutions treating mental patients than many other states. Apart from the five state-run mental hospitals, all 13 government-run medical colleges have psychiatry departments. But, the NHRC report noted, it is among the states that “have not kept pace with the other states in developing these facilities within the psychiatric institutions.”
Most mental hospitals in Bengal suffer from overcrowding of patients and shortage of human resources. Barely two months ago, Berhampore mental hospital hit the headlines for its inhumane treatment of the patients, most of whom were forced to live without clothes.
Whether Dhobi Ghar will succeed will determine whether experiments to empower cured mental patients who have nowhere to go will get a fillip or not.