“One of the greatest diseases is to be nobody to anybody” – Mother Teresa.
1. There are about 500,000 homeless wandering mentally ill patients in India.
2. They are mainly found wandering on the streets near bus stands, street corners,
pilgrim centres and railway stations in poor physical state in urban areas.
3. They are treated mainly by the government run mental health hospitals.
4. They require psychosocial rehabilitation with treatment.
5. 15% suffer from severe mental illness and are homeless.
6. Homelessness is a serious problem and the wandering mental ill mainly belong to
economically, socially backward families.
7. All have diagnosable, treatable mental disorders.
8. 80% have significant co-morbid physical health problems, mainly injuries infected with maggots.
9. In India, 80% of our districts do not have a psychiatrist in public service. Hence, India needs a massive mental movement to take care of homeless wandering mental ill patients.
10. The World has focused on the wandering mental ill and they are unique as a group. 11. They require someone to pick them up from the streets to the hospital.
12. Diagnosis, treatment without history, poor communication, language barriers, identity determination, such as name, age, address is a big task to the psychiatrist.
13. Psychiatry- Liaison, referring the homeless mental ill patients to various other medical departments for his co-morbid physical conditions is another big task to the psychiatrist.
14. Finally they need rehabilitation either to their families or shelter homes.
15. About 90% of this special population do not have any identity issued by the government authorities, such as Aadhar card, Voters card, Ration card, etc and even it is impossible to get the same as they do not have an address, hence they are not eligible to get many of the government welfare schemes.
16. The huge 15% homeless mental ill patients needs special attention by the government to bring them to the hospital for treatment and rehabilitation, unfortunately, the Honourable Chief Minister Sir, did not come across this special group during his “Pada Yatra”. This clearly shows that the Honourable Chief Minister Sir must personally intervene for the welfare of the special group of patients.
17. They are a distinct psychiatric inpatient population requiring special attention, mostly admitted to the hospital as “Unknown”.
18. Unfortunately and sadly in the state of Andhra Pradesh, the Government Hospital for Mental Care, Visakhapatnam is the one and only teriatary care exclusive hospital catering to the needs of the homeless mental ill patients.
19. The fortunate thing is that after treatment more than 80% of the patients are reintegrated into their families. Families happily, willing to accept and support them.
20. Untreated, inadequately treated mental illness is the most common reason for homelessness.
21. Schizophrenia is most highly prevalent in the age group of 31-40 years, who are admitted with reception orders as “Unknown”.
22. This most vulnerable group of the society are to be treated in India is a big emerging problem which requires immediate and effective intervention.
23. The rehabilitation of these persons requires effective liaison with social welfare department, the police and the Judiciary. We should be able to go in the right direction, then everyone can be rehabilitated into the society and can contribute to the society in a very useful way.
24. Homeless persons with mental disorders in India end up living on the streets, jails, begging, or in mental hospitals. The role of the Mental Health Establishment is to provide treatment as well as rehabilitation.
25. As per the Mental Health Care Act, 2017 which came to force on the 07th April, 2017, rests major responsibilities on the police department. The Station House Officer of the concerned police station under his or her jurisdiction should bring the homeless mental ill patients to the mental health establishment for admission, assessment and treatment.
26. MHCA, 2017, Chapter XIII, section 100 clearly states the responsibilities of the police station or the SHO, the duties of the police officers in respect of persons with mental illness wandering on the streets.
27. Every officer-in-charge of a police station shall have a duty—-
(a) to take under protection any person found wandering at large within the limits of the
police station whom the officer has reason to believe has mental illness and is
incapable of taking care of himself; or
(b) to take under protection any person within the limits of the police station whom the
officer has a reason to believe to be a risk to himself or others by reason of mental illness.