No place like home for elderly


Ritwika Mitra

NEW DELHI : Sometimes she is Shanti, sometimes Savita. She asks to be sent home every time she sees a staff member or a new face.

The letters to the mailing addresses she has mentioned have been returned undelivered. With the elderly woman unable to recollect how she ended up in Delhi, there remains little hope now of her being reunited with her family.

She nervously paces up and down the corridor and tells the staff she will recollect the “correct address” this time.

But for now, her home is the old age home in Bindapur – one of the two Delhi government-run homes for the elderly in the city. She has been here for 11 months.

The home, run by the Department of Social Welfare, houses 47 women and 13 men. There is only one couple, who sought accommodation here after being cheated by a business partner.

Though the capacity of the home is 50, it has been stretched to accommodate more.
Most of them are destitute, a significant number of them with no recollection of how they ended up in Delhi.

The police bring such cases to the old age home. Court procedures follow. In some cases, the department manages to reunite them with their families.

The inmates also include elderly people with no pension, and nobody to support them. The department allows admission for them after verification, a process which at times, can take months.

The Delhi government has set up maintenance tribunals in 11 districts under the Maintenance and Welfare of Parents and Senior Citizens Act, 2007. The act allows senior citizens to seek maintenance from their children if they are not able to fend for themselves,

“When they seek admission in the old age home, we counsel them and make them aware that they can appeal to the tribunal in their district. If no other option works out, admission here is of course open,” says Bindapur superintendent M C Maurya.

Restoring the elderly who have lost their way in a big city to their families is an important aim, explains Maurya.

The other Delhi government old age home, in Lampur, is run in collaboration with the NGO Delhi Brotherhood Society. Currently, there are 25 inmates there. Unlike in Bindapur, only 50 per cent of the places there are available free of charge.

The New Delhi Municipal Council has two old age homes under it, but they do not cater to the destitute. The Municipal Corporation of Delhi runs recreational centres for the elderly but no old age homes.

Bindapur is reeling under shortage of staff. Currently, there are four caretakers – one female and three males – one part-time nurse and one part-time doctor. For emergency services, patients are mostly referred to the nearby Deen Dayal Upadhyay Hospital. With several inmates suffering from cardiac problems, the home must have a dedicated ambulance, feel staff members.

The ratio of one female caretaker to 47 inmates is poor. Also, the administration needs to depute one caretaker if a patient is admitted in a hospital for any reason. That depletes staff strength further.

Incontinence is a problem with the elderly, and it becomes difficult to maintain hygiene standards with this staff crunch. “There is a need for 12 caretakers who can attend to patients round the clock,” says Vineeta Sharma, link officer at Department of Social Welfare.

With only one part-time nurse on the 9 am-5 pm shift, there is no expert attendant for inmates at night. With a significant number of inmates suffering from psychiatric disorders, it is necessary that a nurse is present 24×7 in the campus, even if its to give them prescribed medicines on time.

“Around 30 per cent of the inmates are suffering from mental illnesses. These patients are undergoing treatment with IHBAS (Institute of Behaviourial and Allied Sciences),” says Dr Sushma Gill, the part-time doctor who visits the home thrice a week. In most of these cases, the patients are suffering from amnesia.

Though the rule book says those with communicable cases cannot be granted admission, in some cases inmates have contagious skin diseases which put others’ health at risk.

The medical room in the old age home is too basic, points out Dr Gill. There is a need to equip it with oxygen cylinders and suction machines.

H L Ghai, who spends most of his time reading newspaper, feels those suffering from mental illnesses should be in a separate wing.

“Otherwise, I am happy with my life here. My daughters visit me here once in a while,” says the 85-year-old who likes to watch the IPL cricket series and recite his self-composed shairi.

Though an assessment is made before allotting roommates so that there is parity in maintaining hygiene level in the room, it is unfair to segregate the mentally ill, says Sharma.

“Instead, we should focus more on coping techniques which help these individuals in being able to cope with the other inmates.”

But counselling has taken a back seat with the post of social welfare officer lying vacant at Bindapur home for over six months now.

Since the former welfare officer was promoted as superintendent, there has been no one to step into his shoes. “The role of a welfare officer is the most important in an old age home where intensive counseling is required,” says Sharma.

Ten sites have been identified in the city for new Delhi government-run old age homes.

“The projects are in various stages of gaining approval. According to the mandate, every district will have an old age home. Once the PWD (Public Works Department) gives the estimates and the funds are sanctioned, the construction is to be completed within two years,” says P R Meena, Director, Department of Social Welfare.

The identified sites are Kanti Nagar, Chittaranjan Park, Rohini Sector-4, Paschim Vihar, Chhatarpur, Wazirpur, Geeta Colony, Janakpuri, Sarita Vihar and Shakur Basti.

In the first three sites, the PWD has estimated the cost to be around Rs 5.78 crore, Rs 4.83 crore and Rs 12 crore respectively. Their capacities will vary from 50 to 100 inmates.

More sensitisation

“The staff at old age homes needs more sensitisation to deal with the elderly there. Work at the identified sites should be fast-tracked. The government should also consider running these old age homes on PPP (Public Private Partnership) basis for providing the best facilities,” said a senior administrative official in Department of Social Welfare.

The New Delhi Municipal Council runs two old age homes in the city – Sandhya in Netaji Nagar, and Aradhana on Bhagwan Das Road which house only female inmates.

At Sandhya, there are currently 52 inmates, including eight couples. There are 17 women there.

At the NDMC homes, the eligibility criteria for admission includes the inmates being physically and mentally fit. Inmates have to deposit a refundable amount of Rs 8,000 during admission. While the monthly charges for room on sharing basis is Rs 1,581, a single room goes for Rs 2,960.

“Most of the inmates here are retired government officials. Counselling and motivating these inmates is most important as it can control a lot of factors about their well-being,” said Pradeep Kumar Singh, the manager at Sandhya.

Here, the elderly can sign their attendance and go out on their will. It is also must for those seeking admission to have local guardians.

“In the majority of cases, their children or grandchildren come to meet them regularly,” says Singh.

The image of only the “abandoned” turning to old age homes should change, says Nimesh Kumar, who has been staying at Sandhya for 10 years now. A retired Indian Railways employee, he feels that old age homes should be the first preference of the elderly.

“Why wait to be a liability? Even the next generation should not be pushed to adjust with the elderly. After my wife’s death, I decided to come to the home. Children should be allowed to have their own lives,” says the 80-year-old dressed in a crisp striped kurta.

For 82-year-old Rani Kaul, whose three daughters have passed away, the place has been a home for the past 11 years. Beside the television serials, her daily dose of two strawberry ice creams is her source of happiness.

“One after lunch, the other after dinner,” chuckles Kaul as the attendant closed the door of her refrigerator. “Not to speak of the sneaked-in evening chicken kebabs,” she adds.

WAD, ECHO organises free medical camp


Imphal: Following the series of Awareness General Programme held in different part of Thoubal District and in continuation of continuous health camp under the project titled “Humanitarian Support to People Affected by Conflict in Manipur”, Women Action for Development (WAD) with the support of Actionaid and ECHO organized a one-day free medical camp on Sunday at Wangbal Gram Panchayet Ghar, Uyal under Thoubal District, Manipur.

A day before the health camp, volunteer of Uyal Oriental Club made an announcement through public address system about the health camp.

WAD was able to mobilize at least 204 patients including 126 women from Uyal village and adjourning.

A number of conflict affected persons who might have psychological problems were also screened by the train caregivers of WAD.

The health camp also provided general awareness about the psychosocial problems, mental illness and their treatments and methods of prevention to the villagers.

Counseling was also provided to more than 167 villagers including 110 women during the health camp.

A team of professionals including Dr M Jahangir Shah, Dr RK Surjit, Dr Annie Bichal Maisnam and Dr Y Jotshna from Primary Health Center, Wangjing along one staff nurse provided valuable professional contribution.

‘The Memory Of My 6- Year-Old Daughter Pa ined Me’ – My Story Of Living With Bipol ar Disorder


Punitha Suresh

CHENNAI : I am 45-year-old and have been living with Bipolar Disorder for the past 16 years. Twenty five years ago, my mother suffered from paranoid schizophrenia. We were children at that time, the four of us, and we did not know anything about mental illness. We couldn’t comprehend her sufferings and were baffled by her bizarre behaviour. She was taken to a psychiatrist but didn’t respond to the treatment. Then one day, she tried to commit suicide by immolating herself; she was admitted in the burns ward in a general hospital where she succumbed after three weeks of agony.

Mine was a love marriage; my husband Suresh was a drummer. When my daughter was one-year-old, one of my friends died in a road accident. This was when my husband’s late working hours and drinking habits made me panic that he will meet with an accident too. I started ruminating over this issue endlessly; it caused so much distress that sleep eluded me. Because of my delusions and hallucinations I was taken to the hospital where ECT (Electroconvulsive therapy) was administered. I was devastated when I learnt that I had mental illness like my mother and thought that I will end up like her.

On returning home after the trauma of the scary diagnosis, I faced stigma and discrimination. Both educated and uneducated people treated me with contempt. I was ashamed of my illness and the medicines were making me gain weight. After two years of treatment, my doctor informed that I had recovered and could stop the medication. My joy knew no bounds.

But after few months, I started becoming very argumentative and abusive. I fought with the TTR in a train once which made me feel that something was amiss. I got myself admitted voluntarily but refused to admit that I had had a relapse. I just kept on saying that I needed medicines to put me to sleep and when they started treating me instead, I got frustrated and went on a hunger strike. The doctor however said that he will go on with the treatment; I resisted and the ward boys manhandled me. I felt helpless and traumatised and ran away from the hospital to a church on a hill. My husband came and requested me to return. My running away infuriated the doctor further and he threatened that he will hand me over to the police. I was scared. After this I was discharged, but the doctor said that he was doing this against his wishes and advice.

Later on, my husband took me to many different doctors. I was put on different types of medication and had to go through their unpleasant side effects each time. Finally, there was one doctor who’s meds put me on right track. I started recovering but the hitch was that I wasn’t really a part of the treatment process. The doctor wouldn’t talk to me, so when I had marital issues, instead of going to my doctor I stopped my medicines and headed for a relapse. I was working in Avon Cosmetics and running a boutique at that time. I used to smash things in the house and be very abusive; I wandered to Chalukudy in Kerala once and was taken in police custody, my husband brought me back to Chennai. I refused to go for treatment. This time, I was administered ECT without my consent, and admitted in a rehabilitation home. I was paralysed with shock. The memory of my six-year-old daughter pained me and the fear of being locked and forgotten made me spiral deep down. It was then that I vowed that I will recover and come out. I also felt the need to be treated.

I came out of rehab as a totally different person. I started attending a day care attached to the rehab and after a few months I also took up a job. My interest in computers made me join an IT consultancy; I started as a recruiter and was promoted to the position of lead coordinator within a few months. I was happy with my work but deep down a fire was burning

“If I am not for myself who else is for me?
If I am only for myself what am I for?
If not now then when?”

I began my search for people like me and came across an NGO, the Banyan. Here I got a job as a supervisor of a day care and was promoted to be the Jr. Coordinator. I love the job in The Banyan. To think that I used to go to a day care myself and today I am managing one has made me stronger. People think that after ECT a person becomes like vegetable. But that is not true. Since my strength is advocacy, I took up “International diploma in mental health law and human rights”- a WHO initiative with Indian Law College, one of top ten law colleges in India, and passed in 2013.

My Vision: I want to see the world where people with mental illness are accepted in the society, get married, get employment, live with families in a world free from stigma and discrimination.

My Mission: I want to start a movement in India, be a change maker.

Convict ends life by jumping into prison well



2 jail officials suspended, charges issued against 2 others

VELLORE : Manikandan (29) of Chinnabargur in Krishnagiri district, a life convict in the Central Prison for Men, Vellore, who was undergoing treatment for mental illness in the Prison Hospital committed suicide by jumping into the well on the prison premises in the early hours of Friday.

He was undergoing life sentence in a murder case since April last year. Manikandan, who was a drug addict, had murdered his wife in his house in Chinnabargur in 2012. According to sources in the Bagayam police station, the prison authorities complained in the morning that Manikandan was missing. Later, his body was found in the prison well in the afternoon. While the well was kept closed, Manikandan had broken open the lock of the iron grill lid covering the well, bent the rusted rods and jumped into it.

V. Karuppannan, Superintendent of the Prison told The Hindu that Manikandan was mentally disturbed and was undergoing treatment in the Prison Hospital for the last one year. He had escaped from the hospital and took this extreme step.

Two prison officials — Neelakandan, Chief Head Warder and Thangamuthu, Grade-I Head Warder, who were directly in charge of the convict — have been placed under suspension for dereliction of duty. Charges under 17 (B) of the Prison Rules have been issued against Sardar Basha, Assistant Jailor and charges under 17-A of the Rules issued against Kalidas, Deputy Jailor, who were in charge of the area where the hospital and well were located.

Mentally Challenged HIV Positive Woman Rescued, Hospitalised


DINDIGUL: An HIV positive 25-year-old mentally challenged woman rescued by the health department officials from the streets of the pilgrim centre of Palani, was sent to the Institute of Mental health at Kilpauk in Chennai on Tuesday.

She was found in a corner of the temple town, before being handed over to the health officials.

Family members of the young woman on seeing a change in her activities took her to a local hospital in Palani where she underwent treatment for mental illness. However, she turned ferocious seven years ago. As the woman’s father and other members of the family had found it difficult to keep her at home, she started roaming on the streets without dress. She was preyed upon by anti-socials and was declared HIV positive a few months ago to the utter shock of the family, sources said.

Meanwhile, Ravikala, Joint Director of Dindigul government hospital, on inspection at Palani government hospital, was approached by the hapless woman’s father to save his daughter.

Upon Ravikala’s advice, the father lodged a complaint with the police, who then asked him bring the mentally ill woman home.

After a frenetic search, he found her in a corner of the town and pleaded with her to come home for lunch to which she agreed.

Woman constable, Renuga, waiting there took her to the Dindigul hospital in a van on Monday. Superintendent of Police Saravanan and DSP Vanitha extended assistance and the health officials admitted her in a private home that night. In the morning she was taken to Kilpauk in a van with police security.

List steps taken to improve state of mental hospitals: Bombay High Court to Maharashtra government


MUMBAI : The Bombay high court on Monday directed the state government to list out steps it is taking to improve care and hygiene conditions in four mental hospital in the state.

A division bench of justices Naresh Patil and VL Achliya said, “The authorities should generate awareness about mental illness and its symptoms among public so that people can approach psychiatrists in case they feel they have one or more symptoms.”

The bench made these observations after going through a report submitted by a judicial officer who made a surprise visit to four mental hospitals in Thane, Pune, Ratnagiri and Nagpur. The court noted that the hospitals’ conditions were deplorable, and there was a lack of psychiatrists and psychologists.The bench also suggested that the state may consider privatisation of government-run hospitals so that those admitted can be given better treatment/surroundings. The court has adjourned the hearing by two weeks.

The observations were made during the hearing of a PIL filed by Vrushali Kalal, who along with social workers had visited the mental hospital in Thane in 2009 and found that the diet provided to patients was deficient. Food samples were sent to a laboratory, which said in its report the food was adulterated and not fit for human consumption.

Further, it said the condition of the kitchen was the worst, as insects were found in the raw material for preparing food. The petition is seeking implementation of the provisions of Mental Health Act, 1987 in all the four hospitals.

HC suggests privatisation of state-run mental hospitals in Maharashtra


MUMBAI : Expressing concern over Maharashtra government’s apathy towards the condition in state-run mental hospitals, the Bombay High Court today sought to know what steps will be taken towards improving it and also suggested their privatisation.

A division bench of Justices N H Patil and V L Achliya was hearing a public interest litigation by social worker Vrushali Kalal who had raised the issue and sought a direction to the government to improve the condition of mental hospitals in Thane, Pune, Ratnagiri and Nagpur.

Apart from several other points, the petition is seeking implementation of the provisions of Mental Health Act in the four state-run mental hospitals.

The High Court had earlier asked judicial officers to conduct surprise checks at the hospitals and submit a report.

After perusing the report, the bench today said the condition at the hospitals were deplorable and no psychologist or psychiatrist was available at any of the hospitals and none of the hospitals has a rehabilitation programme.

“What steps has the government taken after perusal of the report? The government should consider privatisation of these hospitals,” the court said.

It also opined that the government should generate public awareness about mental illness and its symptoms so that people are not hesitant to approach psychologists to seek help.

It’s not just Deepik a Padukone who is ra ising awareness abou t mental health — Wh ite Swan story


Shradha Sharma

Manoj Chandran is a soft spoken guy but behind his unassuming demeanour, there is a determined entrepreneur wanting to make a difference.

A keynote address from Subroto Bagchi, Chairman of Mindtree at the Institute Day celebrations of the National Institute of Mental Health and Neuro Sciences (NIMHANS), got Manoj thinking about mental health issues seriously in 2013.Today with his non-profit venture in the mental health space, White Swan Foundation, he has demonstrated that you can realize a dream that you set out to achieve. In a country, where mental health is still a taboo and most issues pertaining to it brushed under the carpet, Manoj’s attempt deserves an applause from all of us. Read his story and join his quest to bring mental health the attention it deserves.

The reason behind starting up

In August 2013, after spending three years at Ashoka, the pioneering institution of social entrepreneurship, I was asking myself questions about my future career move. I went with the questions to Mindtree Chairman Subroto Bagchi, who has been my mentor for several years now. He asked me to explore the field of mental health and the opportunities that lay in the field to create and disseminate knowledge to the public.

Manoj Chandran, Founder, White Swan Foundation
For the next four months, I spent researching on the field, speaking with several mental healthcare experts, particularly reputed psychiatrists and psychologists at NIMHANS, and social entrepreneurs who have been working in the field of mental healthcare for several years. I learnt that for all the psychosocial problems that exist in mental healthcare, the underlying issue is the lack of access to the right information.

Based on the research, we developed a model for the creation of a not-for-profit organization that will develop and offer knowledge services to people on mental health. By end of March 2014, White Swan Foundation was born as a Section 25 not-for-profit organization, serving the knowledge needs of the people in the field of mental health.

We were also fortunate to have the early support of eminent business personalities such as Mindtree CEO and MD Krishnakumar Natarajan, Mindtree COO Parthasarathy NS, Nuvepro Technologies Chairman Janakiraman S, and Pulak Prasad of Nalanda Capital. They believed in the cause and our model of approaching the problem statement.

The strongest support to our idea came from NIMHANS and the renowned psychiatrists and other practitioners of the pioneering institution. Our strategy and approach got the much-needed ratification and boost from the members of our founding board of advisors, which consists of NIMHANS Director/Vice Chancellor Dr P. Satishchandra, NIMHANS Registrar Dr Ravi V, Former Join Secretary, Ministry of Health and Family Welfare Ms Sujaya Krishnan and Professor of Psychiatry, NIMHANS, Dr Prabha Chandra.

Motivations and objectives with the venture

There were three motivations for me to grab this opportunity:

– a chance to build an organization from scratch

– create a systemic change in a particular field

– once again, do what I love – create and disseminate content, leveraging innovative methods and cutting edge technologies.

Manoj’s journey with White Swan Foundation and what he enjoys doing

In the last one year of my work at White Swan Foundation, there are two things that I have thoroughly enjoyed – visioning and developing a strategy for the organization and creating and working with a wonderful team of people. One of my biggest learning in my current role has been that one drives the other.

The founding team that we put together during the first few months of our operations has played a crucial role in the development of the roadmap for the organization. Pavitra Jayaraman, Patrecia Preetham, Sanjay Patnaik and Ranjitha Jeurkar have helped establish a strong foundation for the organization.

Scope of such a venture

When we decided to address the gap in the mental healthcare sector, we consciously took a decision to start a not-for-profit organization. It was not difficult for us to see that the return we were looking for was deep down a revolutionary social impact. It was a systemic change in the mindset of the people that we were seeking, which could only be achieved through a sustainable social entrepreneurship model.

The so-called ‘market’ for us is as big as the population of the country. Let me illustrate using a few data. One in four of the Indian population will suffer from a mental health problem in his/her lifetime. That’s a huge number. Add to that the fact that for every person who suffers from a mental health problem, there are a few caregivers, whose life is impacted in the process of care giving. Thirdly, one cannot improve the quality of life of the patients and their caregivers unless the rest of the society changes its views on mental health and provides a supportive environment to them. The stigma, fear and the wrong knowledge on the subject is culturally and historically so deep rooted that we need to work with the common man in an engaged manner, for several years, before we begin to see positive results.

So, we have to speak with every Indian and get them to acquire the right knowledge about mental health. That requires us to have several White Swan Foundations in the country. We hope to create a model that will encourage several social entrepreneurs.

We are always aware of the fact that the team at White Swan Foundation does not have the expertise in psychiatry and allied subject. We bring in experience in communication and regularly seek advice from subject matter experts. In order to ensure the factual correctness of our content, each article is scrutinized by an expert.

White Swan Foundation portal and offerings

The White Swan Foundation portal at is our first offering to the public on mental health and wellbeing. It serves the knowledge and information needs of not only those who are suffering from mental health problems and their caregivers but also the public. Most importantly, the portal, through its rich trove of information and success stories, helps provide the much-needed confidence to people that mental health problems can be treated. By acquiring the right knowledge, one takes the first step forward to seek the help of a professional.

In the next few months, White Swan Foundation portal will be available in Kannada, Bengali and Hindi, making the rich content accessible to millions more across the country. We will also add new features to the portal that will help our readers access latest data on mental health service providers in the country.

The mental healthcare ecosystem and infrastructure in India

When someone finds himself struggling with a physiological health issue, it does not take him any time to reach out to an expert for diagnosis and possible treatment. However, if someone demonstrates symptoms of mental health issues, the road to seeking help is not an easy one to travel on.

He/she faces the extremely challenging phases of ignorance and self-denial, which, in turn, could be triggered by the possibility of being stigmatised. Such patients, and their caregivers, have to beat several odds to reach out to a professional and seek treatment. There are several reasons for this unfortunate reality.

The physical, services and social infrastructure of India’s mental healthcare sector are going through a lot of challenges. There aren’t enough mental health hospitals and practitioners. For a country of 1.2 billion people, there are only 4,500 psychiatrists, most of who are based out of Tier 1 and 2 cities.

There are only a few social entrepreneurs who are doing yeomen services in the field. However, we are yet to see their models being replicated to create a far-reaching impact. This is compounded by the existence of deep-rooted social stigma and other social issues attached to mental health. As a result, according to one study, only 50% of the serious mental health problems and 10% of the common mental health problems come up for treatment.

We hope that by acquiring right knowledge through access to repositories such as the White Swan Foundation portal, patients, their caregivers and the common man will begin to demand better services, which, in turn, will create greater supply of service infrastructure in the country. Simultaneously, if we change the mindset of the common man, we will be able to create a more supportive and inclusive social environment for those who suffer from mental health problems.