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Shelter for the stable: Halfway homes offer new hope for psychiatric patients

Delhi has made a start, with three homes; Rajasthan may be next. But many more homes are needed for the thousands of patients who have been declared well but have nowhere to go.

health Updated: Nov 25, 2017 22:19 IST
Mental health,Mental illness,Halfway house
Families often give fake names and addresses when admitting a psychiatric patient. When the person is ready for discharge, there is no one to call. (Ravi Choudhary / HT Photo)

Kumar* cuts a forlorn figure at the Psychiatric Centre, Jaipur, his home since May 2015. The 22-year-old from a Bhilwara farming family knows he doesn’t belong here. A few months of treatment was all he needed to be certified fit for discharge, but his family doesn’t want him back.

“My parents are dead, my brother has mental illness and my sister is married. The hospital has written to my relatives asking them to take me home, but no one responds,” he says. Kumar is one of 70 people here who have been treated but cannot leave because they have nowhere to go.

“We currently have 41 men and 29 women who are fit to be discharged,” said Dr Pradeep Sharma, superintendent of the centre. Rajasthan’s only other government-run psychiatric facility, in Jodhpur, has 11 people — eight men and three women — in the same predicament.

“We keep them busy by asking them to paint, sing, play musical instruments and participate in outdoor and indoor games,” said Dr GD Koolwal, superintendent of Psychiatric Centre, Jodhpur. The centre at Jaipur has also introduced yoga.

Across India, there are thousands of people who have completed their treatment courses, been declared fit for discharge and are still stuck in psychiatric facilities.

The Institute of Mental Health & Hospital in Agra has about a dozen people certified fit for discharge. Another of India’s leading mental health facilities, the Ranchi Institute of Neuro-Psychiatry and Allied Sciences, houses 50 such people.

Halfway home

In March, the Supreme Court observed that this was a “very, very sensitive issue” and asked the Centre to frame guidelines for the rehabilitation of such people. The Centre has accordingly asked all states and Union Territories to set up rehabilitation homes and file status reports before the Supreme Court by August 1, 2018.

Delhi already has a headstart, in the form of the country’s first halfway homes for people with psychiatric conditions.

The first, set up in February, is run by the Delhi-based Institute of Human Behaviour and Allied Sciences (IHBAS) and is home to 40. The Delhi government has meanwhile set up two other 30-bed homes in the city for people with mental illness and nowhere to go.

“My parents are dead, my brother has mental illness and my sister is married. The hospital has written to my relatives asking them to take me home, but no one responds.”

Shikha*, 50, had been living at IHBAS for five years before she was moved to their halfway home in February.

“I have been getting treatment for paranoid schizophrenia since 1990 in this hospital, but I used to go back home every time,” she says.

Then, in 2011, she attacked her mother with a knife. A year later, at the hospital, she tried to slit her own throat.

Doctors say she is now fit to return to the community as she is not violent and can look after herself. But her family is afraid to have her among them again.

“I don’t want to go home; I feel more comfortable here. It is definitely much better than the wards. We can go to the common room any time. I sometimes watch TV too,” she says.

How do you keep a stable but essentially homeless resident engaged? Psychiatric facilities say they use music, art and games. Some have also introduced yoga. (Ravi Choudhary / HT Photo)

Homeless after cure

Delhi alone needs at least 50 such homes, says Dr Nimesh Desai, director of IHBAS. An estimated 12,000 to 15,000 people in Delhi have a psychiatric condition and are living either in a hospital or on the street, found a technical committee set up on the directions of the Delhi high court in 2009.

In India, as of March 2017, an estimated 10,000 people treated for mental illnesses and fit to rejoin society continue to stay in institutions, according to the findings of a Supreme Court-mandated committee.

Rajasthan will likely be the next state to have psychiatric halfway homes.

“A daycare centre will be started in Jaipur by the end of this financial year, in a rented space. Later, a rehabilitation home will be constructed,” says JC Mohanty, additional chief secretary of the state’s social justice and empowerment department.

(* Names changed to protect identities)

First Published: Nov 25, 2017 22:19 IST