Public Health Information On Mental Illness not being disseminated in India

And laying all the blame at the door of the families.

Stigma the new doctrine of the influential and the powerful, is being parroted as a universal cause for individuals and families not seeking treatment for mental illness in India a country with diverse cultures. And all the blame is being laid at the door of families. When incomes are lost, education is disrupted; buckling down with serious mental illness and being blamed is a knock-out punch when all the chips are down.

But then does the Government of India really care? ‘Care’ cannot be found in the Mental Health Care Bill, as tabled in the Rajya Sabha with no reference point of ‘Care’, definition of ‘Care’  or ‘Right to Therapeutic Care’ which would adversely impact more than 65 million Indians living with serious Mental Illness in India.

The economically poor dwelling in the villages who are being attributed today to as having no common sense or wisdom were seeking treatment in the 38 Mental Hospitals in India from 1947-1969. The Government of India’s first report on the Statistics of Mental Health in independent India issued in 1970 titled ‘Mental Health in India’ by S K Sen Gupta and D R Chawla stated, “Mental Illness is common among the poorest – 89 percent of the inpatients belonged to the income group of Re 1 to Rs. 100 per month. The incidence of Mental Illness is said to 2 per 1000 of population.”

Unrestrained misinformation, misconceptions and myths on mental illness abound which are increasing by the day are fuelling only fear and ignorance of mental illness. 

Fear of ridicule resulting to sequester oneself and ignorance which is being exploited by the unscrupulous are strangely not being countered by any ‘Public Education Campaigns’ on Mental Health one of the objectives of the National Mental Health Programme and several Five-year Plans.

Answers are never sought as to why such posters as the ones given below specifically made for 'public health dissemination' by the Government of India are not being released in malls, cinema halls, shopping centres, market places or in schools, colleges, universities, libraries, hostels, youth camps....
 

Stigma thrives in an environment of ignorance which is being perpetuated by the Government of India by withholding public health information campaigns on mental illness.

References:
1. Mental Health in India by S K Sen Gupta and D R Chawla issued in 1970 by the Central Bureau of Health Intelligence (CBHI), Ministry of Health and Family Welfare, Government of India
2. National Mental Health Programme, Ministry of Health and Family Welfare, Government of India

Mental Health Care Bill India - Serious Mental Illness - Chains - Mothers - Punishment

Establishment -> Evidence-based treatments?
Therapeutic Care? Data!

Not many miles away from where the First Northern Regional Consultation Meeting on the Mental Health Act-1987 was held, lives/or lived a mother Simarjit Kaur with her children, two with serious mental illness. Kuldeep Mann had written about the family in a newspaper on 29 December 2003. How Simarjit Kaur’s husband Amar Singh was shot dead in front of their children and she was beaten up.

Four months later Baljit Kaur, a daughter died by suicide by consuming pesticide. Kuldeep Mann had written what the mother had said, “I spend all my energy taking care of Gursahib and Kuldip who try to run away when they are not being watched.” Her children Gursahib Singh and Kuldeep Kaur are kept chained.

Ten years later, the children appeared recently in a piece titled ‘India fights old myths on mental disorders’ with the picture titled ‘Shackled! -Accompanied by a write- up link of which is given below -

http://www.stuff.co.nz/world/asia/8892701/India-fights-old-myths-on-mental-disorders 

...with portraits of people living in the villages of India as having no common sense or wisdom.

More than 65 million Indians living with serious mental illness are not mentioned.

The invisibility of ‘Public Health Education' campaigns on Mental Illness’ one of the objectives of the National Mental Health Programme which was launched in the last century with much hoopla are also not mentioned. 
 
If the current text of the Mental Health Care Bill, as Introduced in the Rajya Sabha Bill No. LIV of 2013, prevails, Simarjit Kaur, would be punished for keeping her children in chains, the children would be taken to the 'Mental Health Establishment' which has no provisions for Serious Mental Illness and no surety for evidence-based treatments and therapeutic care.

Reference: Kids tied to a nightmare's chains Kuldeep Mann, 29 December 2003, Amritsar, Hindustan Times New Delhi

Mental Health Care Bill - Right to CONFIDENTIALITY OF DATA WITHHELD ?

.....And an audience to SEE your ‘care’ for FREE?


Once Individuals with serious mental illness enter the portals of the care centres defined as 'mental health establishments' in the Mental health Care Bill - which won’t be easy after all the legal documentation -> one would be offered a platter of treatments.
The Bill is silent on the kinds of treatments which would be offered. Also silent on a prescribed fundamental standard of care to meet the varying degrees of cognitive impairments and complex medical needs of individuals with serious mental illness.

Strange when the constitution of India one of the few constitutions in the world spells out ‘scientific temper.’
Most of the print and electronic media in India short of slobbering and falling at the Government of India’s feet has been hailing the Bill as a ‘revolution’ after constantly publishing photographs of bewildered individuals with mental illness foraging garbage, peeping through windows complacently from one of the forty Government Mental Hospitals in India or chained by their families and claiming that all the families in India who have a family member with Mental illness are ‘dumped’ in Tiger Reserves or out to get their property and this much before the Land Acquisition Bill was passed by our Parliament. Most of the print media have gone on to say that our government is benevolent and compassionate for being so generous to bestow our family members with serious mental illness ‘rights’. 

Somewhere it was missed out that yet another crucial right has been withheld. ->the Right to Confidentiality Data. So the case history, a source of great vulnerability for individuals with serious mental illness would be *poached*.

The Mental Health Care Bill –No Priority Right to Care for individuals with serious mental illness but priority...

cartels -mental health establishments with NO prescribed fundamental standard of Care...?

The Wayand district of Kerala where the Kabini river originates, is rich in biodiversity. The tribal population living in this district is surrounded by medicinal plants and they possess the traditional knowledge of their properties.

It stands to reason that the intense, overwhelming feelings of despair and hopelessness, precursors to dying by suicide would be averted if these plants had those properties to chase away those thoughts. If plucking leaves from medicinal plants and eating them was a remedy, most of the tribals would be alive today which is not what is happening; deaths by suicides are only increasing.

As reported in the print media which appeared in 
- The New Indian Express dated 08 September 2012 which is given below -
Tribal suicide rates escalate in Wayanad
Tribal suicides are increasing in Wayanad, thanks to the burgeoning economic distress among tribals. A majority of the tribals here are agricultural workers. In the 2011 survey, it was found that there was a dramatic decline in the total number of working days available in the agrarian sector. Out of the 43,428 men who got work, only 31.02 percent got work for more than 180 days. The number for women is a mere 10.55 percent. The drastic decline in paddy cultivation, the total area for which shrank from 30,000 hectare in 1980 to 7,000 by 2001, seems to have taken a heavy toll on the livelihood of these women. It is said that even the MNREGS could not attract many tribals. “The delay in the payment of wages made the tribals indifferent to the Centre’s flagship employment guarantee scheme,” an official said. “For many years, small scale farmers haven’t been able to do cultivation in a sustainable way. The tribal workers who depended on these farmers started migrating to neighbouring states in search of work. Migration may alter the tribal social fabric in myriad ways,” said E G Joseph, former joint director of the department of ST Development.

The Mental Health Care Bill which is in the website of the Rajya Sabha in CHAPTER I PRELIMINARY Defiinitions states that -

(o) “mental health establishment” means any health establishment, including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy establishment, by whatever name called, either wholly or partly, meant for the care of persons with mental illness, established, owned, controlled or maintained by the appropriate Government, local authority, trust, whether private or public, corporation, co-operative society, organisation or any other entity or person, where persons with mental illness are admitted and reside at, or kept in, for care, treatment, convalescence and rehabilitation, either temporarily or otherwise; and includes any general hospital or general nursing home established or maintained by the appropriate Government, local authority, trust, whether private or public, corporation, co-operative society, organisation or any other entity or person; but does not include a family residential place where a person with mental illness resides with his relatives or friends;
It is relevant to note that- 
1. That no fundamental standard of care with the essential skills for giving care are prescribed for these establishments which is vital for the ongoing care of the vast majority of individuals with serious mental illness in India who are living with varying degrees of cognitive impairments and complex medical needs.

2. With powers being vested on all kinds of establishments through legislation, cartels of mental health establishments using the taxpayers’ money would be administering ‘herbal’ remedies through pills, teas, potions etc. before offering any empirical evidence and  peer review of their bioavailability, efficacy and safety.

3. This despite the fact that these remedies are not saving the lives of the tribal population of Wayanad in Kerala who are living amidst the rich flora and fauna of medicinal plants with traditional knowledge yet dying by suicide.
Links to –
1. Article in the New Indian Express
http://newindianexpress.com/states/kerala/Tribal-suicide-rates-escalate-in-Wayanad/2013/09/08/article1773911.ece
2.The Mental Health Care Bill as introduced in Rajya Sabha http://164.100.24.219/BillsTexts/RSBillTexts/asintroduced/Mentlcare-E%20I.pdf