Retaliatory aggression on psychiatric patients and the issue of closed wards

Abstract

Byline: Roy. Kallivayalil This reply is in response to issues raised by Kumar on retaliatory aggression on psychiatric patients[sup][1]. Psychiatry should articulate science and humanism in its practice [sup][1] and psychiatrists should be the torch bearers for this noble ideal. reports of assaults on the poor and helpless patients from various parts of the country is very disturbing. conditions prevailing in some of the mental hospitals or mental health centres in India are appealing. We the members of Indian Psychiatric Society must not only be care taker's and physicians, but also protectors and guardians of the persons with mental illness. In the first week of August 2012, Satnam Singh Mann, a 24 year old man died at the Mental Health Centre Trivandrum, in tragic circumstances. Indian Psychiatric Society had enquired into this incident. were lapses in several places. At the very outset, the poor and hapless mentally ill person Satnam Singh was charged with attempt to murder by the police. This led to his admission in the Forensic (or criminal ward) at the Trivandrum hospital, where more than 82 patients were kept in 24 This points to severe infrastructural deficiency. Having more than one excited patient in a single closed room often leads to fights among them and is dangerous. In Satnam's case, the clash apparently had started with his fellow patient. Others who intervened have apparently brutually assaulted him. Let the ongoing police investigation bring out the truth and the guilty must be given exemplary punishment. Varghese P Punnoose, Secretary, IPS Kerala branch who had enquired into the matter has written, [sup][2] There is a big media and public out cry over this incident. So the government is under great pressure to take'some' action to calm down the situation. They have to find scape goats. real problem lies with deficiencies in providing acute care in GMHC trivandrum, infrastructural and man power deficiencies in government hospitals and lack of training for paramedical staff. Doctors have to bear the brunt of all these deficiencies. Everyone is eager to believe that the attack happened inside the hospital. Superintendent of the hospital (a non- psychiatrist doctor) readily admitted to the media that the assault has happened inside the hospital!. Following the incident, many public spirited persons too had written to Indian Psychiatric Society. Nirmala Srinivasan of Action for Mental Illness (ACMI), a Bangalore based NGO wrote, [sup][3] The greatest contribution IPS can do is to evaluate the clinical merits and demerits of Closed wards and Cells. If it really helps the user/patients, then it should have an evidence base for the same, just as for de-merits. above initiative is critical in view of the fact that neither the MHA 1987 nor the proposed MHC Bill 2010 provide a legal justification for Closed wards and cells. …