Dr. Abhiruchi Chatterjee, Consultant Psychiatrist, MHF Kolkata, speaks on Schizophrenia, the illness that is often not recognized or treated, leaving many homeless
It was a morning in month of August, 2012, a man unkempt, untidy, was lying near garbage in the Khiddepore area of Kolkata: preoccupied, muttering to self.
Nobody cared to know, who he is…or from where he came…..for everybody he had only one name ‘MAD or pagol’….he had no language, religion or even nationality. Most of the pedestrians were avoiding that particular footpath. The footpath took a deserted look during the busy hour of the day.
Suddenly a NGO social worker offered him some food and water to drink, and asked him to follow him….to a nearby place….where they were conducting a street side medical camp. In the camp, he was examined by the psychiatrist, provisionally diagnosed to have a serious mental illness termed Schizophrenia. Medicines which are given to persons with Schizophrenia, was prescribed and the concerned social worker started providing him food and medication. In a few days the person showed improvement. His self-care was gradually improving. His long, dirty, filthy hair and beard were gone. He started choosing more clean and comfortable place to sleep at night. This change became news in the local community. A few started believing that some care can result into wonders.
Mr. Bilal Khan (name changed) who is an owner of a local grocery shop started helping the social worker for his care. Gradually he became that ‘madman’s local care giver. The mad man got a name…local people including Bilal started calling him ‘Arif’ (name changed). He started showing further improvement within a month, his self-care got much better, and he started communicating in Hindi with Mr. Bilal. He started helping Mr. Bilal for running the shop, and developed a deep bonding with him.
After around 7 months , suddenly one day he told that his name is Mahesh Kamble (name changed) a Hindu from Maharashtra….professionally he was a radiographer at a famous hospital in Mumbai. He already got improved significantly, but when his journey back to Mumbai was planned….he refused to go. To him ‘Bilal’ is his brother and this is his new birth. A Hindu x-ray technician became a Muslim grocery shop helper. But he is happy with this identity.
The local community evidenced the change of a ‘madman’ to a ‘responsible citizen’ – a new learning for them, which was beyond their imagination…some sort of ‘evidence based’ awareness generated that it is not an alien phenomena but the person was suffering from a treatable illness, called ‘Schizhophrenia’….which needs prompt diagnosis, medication and a little compassion.
Homelessness and mental illness:
A homeless person is one who has been deprived of a home and family, who has lost these through some circumstance or other, and has suffered from this loss and deprivation. The overlap between homelessness and presence of mental illness or mental health related problems in individual is well recognized. The first documented case was in 1906 by Karl Williams. (Bhugra,2007)
In studies done in the USA, it has been estimated that roughly 20-25% of homeless people, compared with only 6% of the non-homeless, have one or more major mental illness. (National Coalition for Homeless,2009)
Homeless mentally ill are more prone to abuse and physical illnesses. The homeless population with mental illness is twice handicapped and twice marginalised sector of the society.
Indian perspectives and provision in Mental Health Acts:
India has high burden of homelessness and mental illness. We do not have accurate data on this area. There is a an excellent organisation in Kolkata which does excellent work in rehabilitation of homeless mentally ill.
Mental Health Legislation in India has not taken a proactive role in protecting the interest of homeless mentally ill. It remains to be seen whether the new Mental Health Care Bill, 2017 when implemented is more effective or not.