THE OLD BALD MAN FROM CHENGANNUR

 

An old bald man from Chengannur,

Married a young pretty lass from Trivandrum. 

He didn't have MI.

He sang tuneless sa-ri-ga-ma slapping his fat thigh.

At night he slinked into the maid-servant's room.

His daughter saw, had a breakdown.

He didn't care a hoot.

This old bald man from Chengannur.

 

Some say mental illness runs in families 

While offering homilies.

Little do they know that incest runs in some 

bloodlines.

Skips a generation maybe. But runs it does.

And how.

 

 

 

 

Families impacted by serious mental illness in India are vulnerable...

...to indifference, harassment, harshness, predators, easy targets for very rude patronising behavior… Unsolicited advice is available in plenty, concrete support little. 

To preserve the person hood of a family member with serious mental illness is critical. It comes with the knowledge of knowing the person. It cannot be taught.


Giving care on a daily basis to a family member with serious mental illness takes most of a 24 hour day. The quantum of provision of care varies. Periods of intense supportive care are needed to be provided during psychosis, life threatening self-neglect, attempts at suicide …which are acute emergencies till a period of stability is reached.

Most people in India, even the educated and the aware, do not have easy access to inpatient beds in hospitals so crisis is managed at home with OPD visits to a psychiatrist the frequency of which increase during a crisis and relapse.

If one is fortunate to have sufficient financial resources, making appointments, visits to a dentist and other medical practitioners are helpful as a loved one grows older with a serious mental illness.

Medication management, easing the side effects, has to be ensured sensitively which is not easy with a lot of prowling predators discouraging treatments and offering all sorts of cures. The absence of IEC (Information Communication Education) campaigns which was one of the objectives of the National Mental Health Programme launched in India decades ago has been very favourable for *the growth of these predators*.

When a family has more than one family member with mental illness in India, to sustain the daily living activities without helpful support is very difficult. Tragedy follows and left behind is just the...remains. 

It happened recently with a family in Thiruvananthapuram in Kerala.

A print media report is given below
28 May 2015:
When Prasannakumaran paid scant heed to policemen who advised him to take his mentally ill son to a doctor, little did he know that the boy's actions would claim his wife's life. In a tragic incident, a 48-year-old woman died at Alamcode near Attingal, allegedly after her teenage son bludgeoned her using a traditional lamp (nila vilakku) in the early hours of Wednesday. Police identified the deceased as Ushakumari of Pallimukku near Alamcode under Attingal police station. Police have arrested her 19-year-old son, Akhil alias Vishnu, in connection with the incident. The murder took place when his father Prasannakumaran and sister Aparna were sleeping over at relative's house nearby.

Attingal circle inspector M Anil Kumar said Vishnu, who had been mentally unstable for the past three years, had been in a violent mood since Tuesday morning and the tragedy could have been averted had the family taken him to a hospital. "Yesterday morning, he stabbed his father's hand using a knife in a violent fit of rage," Anil Kumar said. In the evening, he went to Alamcode Junction and created a ruckus, following which local residents summoned the police. Cops arrived on the spot and took him into custody. When his relatives approached police and sought his release, the cops advised them to take him to a hospital, but in vain. Above all, the family left Ushakumari who was also under treatment for mental illness with her violent son in the house.

"After he was stabbed in the morning, Prasannakumaran did not have the courage to return home. He also asked his 22-year-old daughter Aparna to accompany him to the relative's house," the inspector said. On Wednesday morning, Prasannakumaran visited the hospital to tend to his injury and then returned to his house. Upon reaching home, he saw Vishnu sitting in front of the house, his body drenched in blood. Terrified, he summoned a few local residents and entered the house through the back door to find his wife lying in a pool of blood in the living room. The room had blood all over, including on the walls and ceiling. "It is suspected that the boy may have struck her down with the lamp and then clubbed her repeatedly on the head, causing the blood to spray out," police said.

The accused was produced before court and remanded in judicial custody. The magistrate has forwarded a letter to the Attingal sub-jail superintendent to subject the accused to a medical test to ascertain whether he was indeed mentally ill as claimed by the family. A copy of the letter has been forwarded to the district medical officer too. Vishnu, had dropped his studies after Class X owing to his mental illness. He often turned violent when he was denied money to eat food from outside. Prasannakumaran is a former NRI, who is currently into real estate business. Ushakumari was a homemaker.

Responses: 
1. A mother with mental illness who needed to be given supportive care died and her son with mental illness who should have been taken for emergency treatment has entered the criminal justice system.

2. Where is the assistance offered to the smallest social unit in society when a family member has mental illness? 

3. Where is the protection offered to the smallest social unit in society when a family member has mental illness? 

4. India has ratified many treaties which clearly state that assistance and protection should be given to preserve the family the smallest social unit in society which is not happening. 

5. 'The Kerala Joint Hindu Family System (Abolition) Act, 1975 has already stripped many families of the traditional rights, support, comfort and protection of Joint families.

References:
1. The UN Convention Rights of Persons with Disabilities
2. The International Covenant on Economic, Social and Cultural Rights
3. The Kerala Joint Hindu Family System (Abolition) Act, 1975
4. The Universal Declaration of Human Rights.
5.  The Hindu
6. The Times of India 

The genesis of blaming families impacted by mental illness in India

...through a tome which lay in the website of the Ministry of Health and Family Welfare, Government of India for several years . One could access this tome when one clicked on a link titled 'National Mental Health Programme'

The cover of the tome bore the title,‘Mental Health An Indian Perspective 1946-2003 ‘ by Directorate General of Health Services Ministry of Health and Family Welfare New Delhi.

This tome has a Chapter I ‘Mental Health 2003: The Indian Scene’

Beginning rather theatrically with a quote from A Tale of Two Cities by Charles Dickens ‘It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the seasons of light, it was the seasons of darkness, it was the spring of hope, it was the winter of despair,...’

This quote was followed by the writ,'It all began with a fire…’

Referring to the fire that broke out at a private centre, in a place called Erawady where several people with mental illness who were chained, were charred to death. The writers use the word ‘asylum' for a private centre as if the Indian Lunacy ACT 1912 was still in existence at the time of the fire when it was not.

One of the reasons stated by the writers for impacted families leaving their family members in the private centre at Erawady was that ‘stigma and superstitions associated with mental disorders coupled with unwillingness or inability of families to care for their mentally ill relatives appear to be the main contributory factors.’

What was left out (as if the writers were unaware) was that ‘Public mental health education’ was not taking place when it was one of the Plans of action in the National Mental Health Programme. 

For many in India, reading this chapter whilst giving supportive care to their loved ones with mental illness trying their best to keep despair out of their lives its ...a Chapter I ...of incredulous excuses. 


Reference:‘Mental Health An Indian Perspective 1946-2003'  by Directorate General of Health Services. Ministry of Health and Family Welfare New Delhi.