Not every patient wants to return to loved ones: Institute of Mental Health

CHENNAI: Not every homeless patient who has been treated and rehabilitated wants to be reunited with their families, as they fear stigma and societal alienation, opined experts at the Institute of Mental Health (IMH), Chennai.

There are about 30 people who have recovered significantly but don’t want to leave the IMH as the fear of stigma and lack of family support is real. So, they request to stay at half-way homes or as wards at the hospital.

“We don’t force them to leave. They help us take care of other patients with basic tasks and management,” said Dr M Malaiappan, director, IMH.

As many as 788 homeless and wandering mentally-ill persons, rescued by the police and NGOs, who have been treated at the government-run Emergency Care and Recovery Centres (ECRC), were reunited with their families in 2023-2024. A total of 1,032 patients have been admitted to the ECRCs in 2023-24.

There are many NGOs and social workers who also admit patients to ECRC centres. Around 252 patients were admitted to NGO-run ECRCs, of which 149 were discharged in 2023-24.

“We collaborate with NGOs to reunite patients with their families across the country. Even our healthcare workers travel with them to drop them off in their hometown,” he stated. “But follow-up care is difficult. More needs to be done to ensure that they are taken care of even after discharge.”

For patients who struggle with memory loss and have no ID, the IMH collaborates with social workers and volunteers to gain documentation and other details to be able to reunite them with the family. A senior professor at the IMH explained, “The biggest challenge in treating them is not the language but communication. Not all mentally-ill patients are violent, but many don’t have the motivation to talk, or have the natural drive to even take care of themselves. Such patients need to be assisted with everything.”

Those who display violent behaviour can be treated and managed with medications. But if they are not violent, and withdraw into themselves, they have, what the experts call, ‘negative symptoms’ such as the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.

“We don’t have active medicines to treat negative symptoms. Patients with negative symptoms require a lot of support and reassurance. We have patients who have been staying with us for five years. Most of them have chronic mental illness and intellectual disability. We cannot send them to self-help homes or other places for rehabilitation because those places cannot take care of them,” he elaborated.

The only way a mental health institution can trace the family of patients, who fail to communicate or remember their address or name, is through Aadhaar. However, the already-registered patients cannot obtain a new one if they do not have the old details.

“We cannot find the credentials even if the biometrics registration says that the patient has an Aadhaar card. We’ve requested the government to help us retrieve Aadhaar without the OTP sent to the mobile number as patients do not have any phones. This will help us to trace their families. The UIDAI has accepted the request but we’re awaiting implementation,” pointed out a senior IMH official.