Challenges faced by state and society in providing care to homeless mentally Ill Patients: Know the unknown project

Abstract

Background: Homeless mentally ill (HMI) patients pose a major problem in our society. There are no specific, focused studies to understand the complex needs and the challenges faced by state and society in providing care of HMI patients in India. Objectives: This study was planned to understand the challenges faced by state and society in providing care to HMI. Materials and Methods: We performed a retrospective chart review of “HMI” patients from January 1, 2002, to December 31, 2015, who were admitted to the Department of Psychiatry at National Institute of Mental Health and Neuro Sciences, Bengaluru, India. Pathway to care and reintegration outcome characteristics were analyzed using descriptive statistics. Results: In our study, among 78 HMI patients admitted, police 32 (41%), public 32 (41%), and nongovernmental organizations (NGOs) 14 (18%) were the first contacts who found HMI patients. In the 15 weeks of mean duration of inpatient care, 40 (51.3%) were reintegrated into the family through a multidisciplinary approach. However public, NGO, Clinicians had multiple challenges in admission, treatment services, rehabilitation, and aftercare of HMI patients. Conclusion: Holistic care and services for HMI patients are challenging and have multiple hurdles with the existing infrastructure in India. Better care might be possible with collaborative, multidisciplinary approach with NGOs, Rehabilitation centers, local police, judiciary, and psychiatric facilities. Mental Health Care Act 2017 has addressed above few challenges making admission procedure simpler, administering free treatment, involving police officers in the identification of HMI, admission to hospital, tracing HMI, and reintegration with the family.