Change approach to mental illness

Recently, the National Health Mission and Greater Chennai Corporation joined forces to ‘rescue’ homeless persons with mental illness in the city with the aim of treating and rehabilitating them. News of the plan immediately raised concerns among activists as the civic body had embarked on a similar drive during the previous DMK regime in 2010. At the time, over 150 people who appeared homeless were rounded up and taken to a state hospital, screened for mental illness and allegedly forcibly detained. This time, the rescue efforts initiated showed that institutions had evolved somewhat. Mental health professionals were part of the process and the consent of the individuals was respected—to an extent. However, one-off attempts of this sort are problematic given that the needs of this vulnerable population are complex. Mental illness in itself cannot be seen purely from a medical perspective—environmental, economical and sociological factors all play a role. States cannot adopt a one-size-fits-all approach. Tamil Nadu acknowledges this and runs, in partnership with NGOs, Emergency Rescue and Crisis Centres at the district level. The understanding is that if interventions were widely available, a person with mental illness might be less likely to end up on the streets.

However, alongside that, sustained effort and engagement is required to reach out to people already on the streets rather than having them moved into institutions, temporary or otherwise. For this, the state must change its paternalistic view of persons with mental illness and adopt a rights-based approach as envisaged by the Mental Health Act of 2017. It stresses the need for informed consent and says that treatment must be provided in a setting that least infringes on a person’s rights.

In 2008, after a similar drive in Kanniyakumari resulted in a French national (with no mental illness) being certified and detained in the Institute of Mental Health, the Madras High Court said: “The police should not ‘round up’ people as if they were stray cattle and deal with them as such. Each individual should be dealt with as a separate case, he/she shall be treated as a human being with all constitutional rights.” About 13 years later, there is clearly a long way to go.