By H H Mohrmen & Niwanka Shylla
Initially, we thought that this would be an article best suited to publish on World Mental Health Day which is observed across the globe. The write-up is a classic case of the plight of mentally ill patients across the world. But on second thoughts we asked ourselves how long can a person wait for freedom? How long can she wait for an opportunity to reunite with her near and dear ones? She is entitled to her rights, but when and how can she enjoy her basic human rights? Or does she lose all her rights just because she is on the wrong side of the divide?
Rights of People
with Mental Illness
On the wall at the entrance to Meghalaya Institute of Mental Health and Neurological Science (MIMHANS), there is a big board with the Rights of the Mentally Ill Persons engraved on it. The rights are as follows: 1. The fundamental rights as their fellow citizens, including the right to a decent life, as normal and full as possible. 2. Legal Safeguards against abuse, 3. Right to appeal, 4. Right to necessary treatment in the least restrictive setup and as far as possible to be treated and cared for in the community. 5. Right to rehabilitation, right to personal autonomy, privacy, freedom of communication, 6. Right to education, 7. Right to training, 8. Right to economic and social security, 9. Right to family and community life, 10. Right to employment, 11. Right to protection against exploitation and discriminatory, abusive, or degrading treatment, 12. Right for assistance, including legal, for protecting their rights. The question for the general public is, are we even aware of these rights that people with mental illness are entitled to?
Freedom from what?
On the eve of India’s 78th Independence Day, when people across the country celebrated the day, there were citizens of this great nation who were suffering at mental institutions or were shifted to Halfway Homes. Some proud citizens took selfies with the Tri-colour and the chakra, yet some went on to do some good work and others attended the parade to commemorate the occasion while others spent time working with this vulnerable section of the population.
Society for Urban and Rural Empowerment (SURE) supported by the Office of the Director of Social Welfare Department is embarking on a new venture to run a Halfway Home for mentally ill persons who have been treated at different institutions and were found to be fit for rehabilitation in society. These patients who have languished in the MIMHANS are now transferred to The Halfway Home at Sabah Muswang, Jowai. They are now under the Society’s (SURE) care and the setting of the place where inmates are sheltered has changed from a mental institution to a homely environment. Even if the transfer had happened in the last few days, one can see the transformation that happened in the lives of the mentally ill.
Does Independence
mean freedom?
Perhaps for many of the inmates, the last Independence Day was the first meaningful Independence Day that they had ever taken part in. They had the opportunity to be part of the flag hoisting ceremony at the Home and some were seen to even softly sing the national anthem. But the big question that remains is – What does Independence Day mean for them? Since in most cases they were brought by the police to the Institution, some of them do not even have an identity. They don’t know who they are when the police brought them to the Institution. In many cases their identity was created by an official at the Institution just for the sake of creating a case summary for them. Few have a good memory of their loved ones and their homes; some do not have any inkling at all where they came from. Yet most of them long to go back to their homes and unite with their loved ones once again, but most of them don’t remember where their homes are.
Now that they are no longer in the Mental Institution, we can say that they are partially free, but they will ultimately attain freedom only when they are once again united with their loved ones. Sadly for most of them, this is going to be an impossible goal to achieve.
The case of a patient straying across the border
There are many cases of people with or without mental illness who happened to accidentally or purposely stray across the border from the neighbouring country. Many of them languish in jails in different parts of the state, but a particular case worth mentioning is that of Salini (name changed to protect the identity of the individual). According to her summary report from MIMHANS Hospital, it mentioned that the police found her loitering somewhere on the Shillong-Dawki road on January 29, 2016, and the police report said that the patient seemed to be mentally ill and was referred to MIMHANS. Her case summary from MIMHANS also said on further examination it was found that she was not a citizen of this country and had perhaps strayed across the border. She has not only told them her name but was able to provide them with her full address in her country of origin and even provided the staff with her husband’s and her father’s name.
The patient was shifted to SURE Halfway Home Rehabilitation of Persons living with mental illness at Sahbah Muswang Jowai from MIMHANS Shillong on August 11, 2023 and on the very next day, the NGO was able to request a friend who could communicate in the neighbouring country’s language to talk with the patient. In the conversation the patient shared the same address of her place of residence which she had mentioned earlier when she was at MIMHANS which only proves the consistency of her statement. She had also shared with the staff nurse of the home, her younger brother’s name and his mobile number. On receiving the number with the help of people who can speak the country’s language, they called the number and talked to the person who also confirmed that he was her brother and said that he did not know where she is at present.
It was observed that now the patient is mentally stable but becomes unruly only because she desperately wants to go home. She said she wants to see her children. At one point she even mentioned the name of the border town on the Indian side of the border. The patient’s condition was stable but sadly, after three days of her stay, the inmate became homesick due to which she is not interested in any activities. She is adamant about trying to escape and her non-cooperative behaviour creates disturbances for other patients at the Home. The staff were not able to control her as she refused to eat the whole day, and the Organisation had no other option but to re-transfer her on August 17 to MIMHANS. The patient does not belong to the Institution as she is a fit case for rehabilitation, but sadly there is nothing one can do as she is not a citizen of this country and due process has to be followed to deport her.
The System has failed her
It has been more than one year since this case was taken up by the Government of Meghalaya Home (Political) Department with the Ministry of External Affairs for deporting the patient to her country of origin, but sadly nothing has moved and the inmate has to languish in the Institution for no fault of her. Her only fault is that she was perhaps mentally ill when she crossed the border and now she has to suffer for that. What is a border to a mentally ill person anyway? Does the border have any meaning to them? When she crossed the border which is as porous as everybody knows, did she realise that she was in another country? Do these imaginary lines that we draw have any meaning to them? Now this same system is preventing her from going back home and meeting her family.
The country has failed her, and the system and even humanity have failed her too. When we tried to persuade her to get in the car to take her to MIMHANS, we were able to convince her to travel only by telling her that we were taking her back to her home. After we had dropped her at MIMHANS when we reached the home and told the staff about her reaction when she realized that she had again returned to the mental institute, one of the staff nurses asked if she would ever trust humanity again.
(Niwanka Shylla has a Master’s degree in Medical & Psychiatric Social Work and she is the Project Coordinator of Halfway Home, Sabah Muswang, WJH).