Mental Health Crisis in India

More than 50 million people in India suffer from a mental illness.  In 2011, India recorded the highest rate of major depression in the world at 36 per cent.  According to doctors, roughly 10 per cent of India’s population suffers from depression – MGMH

 

Women with mental illness are treated as less than human.  They are dumped, abandoned and abused.  If there are any signs of mental illness, a woman is put in a mental hospital with no chance of getting out.  Men can go back home while women are there for life.  In the following video, we meet a woman whose husband had her institutionalized although she had no history of mental illness.  Here’s a story of a mentally ill woman whose husband built a case against her so that he could get custody of their children after divorcing her.

It is not surprising that women suffer from depression at higher rates than men.  They have to deal with gender inequality, violence, lack of paid employment, lack of education, excessive spousal alcohol use and poverty.  Mothers are blamed for the birth of a female child and many face pressure to have male children.  Women are diagnosed with schizophrenia later in life, oftentimes, following the birth of their children.  The children are often removed from the ill mother’s care and this results in further distress for her. Indian women have higher rates of suicide than women in most developed countries and a higher rate of suicide compared to men in India.  Depression is one of the most common reasons for suicide among Indian women.

Mental health in India carries with it a stigma, especially if the person suffering from mental illness is a woman.  According to MGMH (Movement for Global Mental Health), in rural India, it is common to see people taking their children to temples and faith-healers instead of hospitals and doctors, especially in cases of mental health.  Mental health was something that was talked about in hushed tones.  Thankfully, it is no longer being swept under the rug.  People are coming forward.  Deepika Padukone stunned her fans last year when she admitted that she suffered from anxiety and depression.

At the time the news broke, she was one of the most sought after actresses in Bollywood. It took tremendous courage for her to disclose her illness, especially since people diagnosed with mental illness face discrimination.  Deepika has since launched the Live Love Laugh Foundation to raise awareness about mental health issues and as a result many celebrities were inspired to come out in the open and address the need to talk about mental health.  Varun Dhawan admitted that he was depressed during the making of Badlapur and Honey Singh revealed that he has been undergoing therapy for bipolar disorder.

Sadly, those living with mental illness are victims of a cruel fate.  They are often locked away and stripped of their basic human rights in state-run institutions that are under-staffed. In an article, titled Mentally Ill Suffer a Horrible Fate in India posted on the site for Deutsche Welle (DW), most state run mental hospitals are in deplorable conditions. The National Human Rights Commission (NHRC) reported that out of the 43 government mental hospitals in India, less than half a dozen are in a “livable” condition”.

There are doctors in charge of these hospitals who have no business being there.  “These doctors don’t understand the intricacies of a psychiatric illnesses and the comprehensive care the patients require,” said a psychiatrist working in a state-run mental hospital in Uttar Pradesh.

And in the midst of the crisis of hospitals not providing the conditions and care the patients need, are quack healers who are profiting from this.  According to a study by Dr. Shiv Gautam, former superintendent of Jaipur Mental Hospital, 68 per cent of the mentally ill are taken to faith healers before a psychiatrist.  “The reason, besides superstition, is that most general medicine doctors fail to diagnose psychiatric illness,” Gautam said. “A mentally ill patient displays symptoms which superstitious people believe are paranormal,” he added. “Such patients are tortured, chained and used for extracting money from their families.”  Hema, who was suffering from Schizophrenia was believed to have an evil spirit.  Her family took her to Datar Sharif Dargah where she spent a year locked up.  It wasn’t until her condition deteriorated that she was brought to Dr. Gautam.  In 15 days, she began to improve and a month later she was normal.

In other cases, the mentally ill are subjected to one of these horrific ordeals:  whipping, caning, inhaling burnt chili smoke, having their eyes smeared with chili paste or having their eyes branded with red, hot coins.  There are laws banning this practice, however, many dargahs and temples keep the patients chained.  Some of them spend the rest of their lives like this.  In 2001, 26 patients perished in a fire at a dargah in a coastal village because they couldn’t escape the blaze since they were chained.  What a horrific and senseless tragedy.

Families of mentally ill people opt for dumping them.  This means that they are dumped into an asylum where the conditions are not fit for a human.  When an illegal asylum was raided, they found thirty-five men and six boys living in inhuman conditions.  The stench from their unwashed bodies and the excrement drove neighbors to alert the health department.  Naked and chained inmates were discovered, dumped there by their families after they paid the asylum owner.  Some of these poor souls were found crawling in their excrement, some even consuming it.  On their bodies were marks of torture.  Some had surgical scars on their backs, leading to allegations that the asylum had links to kidney theft.  78 patients had entered the asylum but only 41 were found during the raid.

Other patients are dumped in jungles or forests ranges.  Their families pay lorry drivers to drop them.  Women and children are among these victims and in some cases, the females are raped by the drivers before being dumped.  Social activist Murugan S. who has rescued countless mentally ill people from the streets, cautions us not to judge the families by calling them cruel.  Instead we are to examine what forced them to take such extreme measures.  He believes that system needs to change.

Part of the solution is raising awareness.  The suffering of the mentally ill has been brought to our attention. It is out in the open.  The next thing that needs to be done is to show the superstitious and fearful society that mental illness is nothing to run away from or to be ashamed of.  The person suffering from mental illness needs love, support and most importantly, proper care so that he or she can live a normal life.

The government needs to put something place to ensure that patients are placed in reputable, sanitary facilities that will provide the care that they need and to ban the operation of illegal asylums and the practice of dumping.  Quack healers should be banned from profiting from other people’s suffering.  Husbands should not be allowed to institutionalize their wives if there is no record that they have mental illness.

No one wants to be mentally ill but it is a reality for many people and what they need is to know that they have a platform where they can talk about what is happening with them. Here in Canada, we have Bell Let’s Talk, a wide-reaching, multi-year program designed to break the silence around mental illness and support mental health all across the country. It has done so much to fight the stigma of mental illness and encourage people to get involved in educating themselves and others.

It is my sincere hope and prayer that something will be put in place in India so that attitudes toward mental illness would change and those suffering from it will have a platform where they would not be judged, dumped, abandoned or discriminated but supported and be treated with dignity and open minds.  In the meantime, let’s keep talking and raising awareness.

Talking is the best way to start breaking down the barriers associated with mental illness – Bell, Let’s Talk

 

Sources:  Vice News; Movement of Global Mental Health; Wikipedia; Deutsche Welle

Administering Medication to Parkinson Patients on Time

Lately, *Wendy is plagued with the fear of losing her mother.  Granted her mother *Marian had lived a long and happy life but Wendy was not ready to lose her.  Marian was in her seventies.  She celebrated her 75th birthday a couple of months ago.  Wendy and her sister *Lauren had taken her out for lunch to celebrate.  In the past, Marian celebrated birthdays, Christmases and every Mother’s Day at her home or at one of her daughter’s home.  However, everything changed when she was diagnosed with Parkinson’s.  She couldn’t remain in her home after she fell.  She was a widow and had been living on her own.  She had to sell her home and move into a nursing home.  It took time for her to adjust to living in a room and having to depend on nurses to change and bathe her and do the things she used to do for herself.  It was hard to give up her independence.

She was still able to go and spend time with her children and grandchildren but lately, it was becoming increasingly difficult for her to move around without the wheelchair.  She had gone from using a cane to a walker and now to a wheelchair.  She had fallen several times.  Once Wendy went to visit her and was horrified to see the ugly bruises on her arms.  Marian fell because she tried to do things on her own when she should have called for help.  The nurse would go into her room and find her on the floor.  Thankfully, she hadn’t had any serious falls but Wendy worried about her.  She had heard stories of elderly women breaking their hips and suffering other serious injuries from falls.

Just recently, Wendy received distressing news.  Her sister Lauren informed her that their mother was not responding well because she hadn’t been given her medication that morning.  The last dosage was the night before so she was supposed to get the next one around 7 in the morning but the nurse hadn’t given her.  When Marian’s regular nurse found out two hours later, she decided to wait until 11 to give her her medication.  Lauren was livid.  She demanded to know why the nurse waited instead of giving her mother the medication right away.  As Wendy listened to her sister, she felt sick in the stomach.  Their mother had been without her medication for 15 hours.  She was lying in her bed, with her eyes closed.  She was aware that her nurse was in the room and was responsive but she couldn’t do anything except lie there.  Her nurse kept checking on her to make sure she was okay.  She was relieved when Marian woke up.  Marian’s doctor told the nurse to try to get the medication into Marian which she kept trying to do until she succeeded. The doctor said that it could take 24 hours for Marian to recover as a result of not getting her first dosage that morning.

The Administration at the nursing home acknowledged that two gross mistakes had been made.  The first nurse should have given Marian her 7:00 a.m. meds and her regular nurse should have immediately given her the meds at 9:00 when she realized that she hadn’t been given her first set of meds instead of simply waiting for the next set.  The director assured Lauren that they were taking measures to make sure that this never happened again.  They plan to follow up with the first nurse who neglected to give Marian her morning medication.

Wendy was thankful to God for watching over her mother who is okay.  Tears came to her eyes as she imagined her mother lying there with her eyes closed, unable to do much else and how it could have been much worse…

How many other Parkinson’s patients like Marian do not receive their medication on time?  According to an article written on the National Parkinson Foundation website, hospitals can be danger zones for people with Parkinson’s.

Hospitals are usually a safe haven for people with serious illnesses, but for people with Parkinson’s disease (PD) going to the emergency room or being hospitalized can be a nightmare, because their condition is more likely to deteriorate due to inappropriate care and the anxiety of being in an unfamiliar environment.

Parkinson’s patients are often afraid to challenge a hospital’s medical staff, because they assume that they know what they are doing, but many may have little or no knowledge about how to care for someone with Parkinson’s, said Dr. John Morgan, assistant professor at Georgia Health Sciences University.

Three out of four people with Parkinson’s do not get their medication on time when they go to the hospital, which can cause serious complications even death, said NPF’s National Medical Director Dr. Michael Okun. Even more alarming is that research shows that the majority of hospital staff do not know which drugs are unsafe for Parkinson’s patients, and they do not understand Parkinson’s disease.

People with Parkinson’s must take their medication on time, especially those with moderate and advanced Parkinson’s who are taking frequent doses of levodopa, a common Parkinson’s medication, Dr. Morgan said. “If medication is not taken on time, they can become stiff, rigid, tremulous and unable to move and prone to falls, etc. Even one hour off of a scheduled time can make a big difference,” Dr. Morgan explained.

There is no cure for Parkinson’s, but medication helps control symptoms by increasing the levels of dopamine in the brain. Dr. Morgan emphasized that medications should be taken 30 minutes to an hour before meals or an hour or more after meals, because the protein in food can inhibit the absorption of the medication into the body. If a person eats too close to their scheduled medication time, Dr. Morgan said it is better to eat a low-protein meal rather than delay taking medication.

The article mentions that one hour off of a scheduled time can make a big difference.  Wendy’s mother had been 15 hours off her scheduled time.  Another article states, “Medications must be administered on time to promote consistent therapeutic blood levels and prevent disabling symptoms. A delay of even 5 minutes can cause the patient to suddenly lose the ability to move, walk, and speak^.”  If Wendy and Lauren wanted to, they could sue the nursing home for gross negligence and failing to administer the proper help.  Marian should not have gone through what she did.  She was in a facility that was supposed to take care of her.  Their negligence could have cost Marian her life.  For now, Wendy and Lauren are hoping that this doesn’t happen again.

Want to get involved in raising awareness for Parkinson’s?  Here’s how.

*These are not their real names.

Source:  http://www.parkinson.org/About-Us/Press-Room/NPF-In-The-News/2012/November/Hospitals-can-be-a-danger-zone-for-people-with-Par; http://journals.lww.com/nursing/Fulltext/2011/03000/Administering_medications_for_Parkinson_disease_on.24.aspx