E-ISSN: 2984-7435, P-ISSN:
2984-7427
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Exploring the Current Status of the Rehabilitation and Welfare Programs
for Women with Severe Mental Illness
Yatheesh
Bharadwaj H S, Sateesh R Koujalgi
Dharwad Institute of Mental
Health and Neurosciences, Dharwad, India
Email: [email protected], [email protected]
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Abstract This study examines the multifaceted challenges faced
by mentally ill women in developing countries, with a particular focus on
India. Drawing on research from various sources, including studies conducted
in India, the paper highlights several critical issues affecting mentally ill
women, such as societal misconceptions about mental illness, legal
vulnerabilities, caregiving burdens, and the absence of state-supported
programs. The study underscores the urgent need for comprehensive government
interventions to address these challenges, including legal protections,
access to healthcare and support services, efforts to combat stigma, and
targeted interventions for vulnerable populations, such as homeless
individuals with mental illness. Despite ongoing efforts, gaps in the
availability and utilization of rehabilitation services persist, especially
for women. The paper calls for continued advocacy, policy reform, and
community support to address gender disparities and improve the effectiveness
of rehabilitation services, ultimately striving for a future where mental
health is prioritized and all individuals have the opportunity to thrive. Keywords: Rehabilitation, Welfare Programs,
Women, Mental Illness. |
INTRODUCTION
Mental illness poses
a significant public health challenge, affecting approximately one in four
people globally at some point in their lives. (World
Health Organization, 2004). Mental health
disorders contribute substantially to the global burden of disease, impacting
not only individuals but also their families, communities, and societies at
large (Bond et al., 2001).
Within the realm of mental
health, the unique challenges faced by women deserve particular attention.
Gender disparities in mental health manifest across various life stages and
circumstances, influenced by societal norms, cultural expectations, and
biological factors. Women experience higher rates of conditions like depression
and anxiety, often compounded by factors such as caregiving responsibilities,
socioeconomic status, and access to healthcare. Addressing women's mental
health necessitates tailored interventions that consider the intersectionality
of gender with other social determinants. In light of
these complexities, it is imperative to adopt a comprehensive approach to
mental health that addresses the diverse needs of individuals, promotes gender
equity, and enhances support systems for rehabilitation and recovery. By
prioritizing mental health literacy, reducing stigma, and integrating
gender-responsive strategies into policies and programs, we can strive towards
a future where mental health is prioritized, and all individuals have the opportunity to thrive.
A study conducted in
India brings attention to the significant challenges faced by mentally ill
women in developing countries, shedding light on several critical issues. One
prominent issue highlighted in the research is the widespread misunderstanding
surrounding mental illness and its consequences. This misunderstanding often
leads to the erroneous belief that marriage can remedy all problems, resulting
in mentally ill women being married off without disclosing their condition to
their prospective husbands and their families. This lack of awareness
perpetuates harmful practices and denies women the opportunity for informed
consent in their marital relationships.
Furthermore, the
research underscores the legal vulnerabilities faced by mentally ill women, who
often lack adequate legal protection, particularly regarding maintenance after
separation or divorce. This leaves them economically dependent on their families,
exacerbating their vulnerability and hindering their ability to access
essential support services.
Another significant
aspect illuminated by the study is the burden of care disproportionately
falling on aging parents. With aging parents shouldering the responsibility of
caring for mentally ill daughters, often while grappling with their own health
issues, the situation presents significant challenges for both the women and
their families.
Moreover, the absence
of state-managed support programs further compounds the challenges faced by
mentally ill women, limiting their access to crucial services such as
healthcare, financial assistance, and protection from exploitation. This
absence underscores the need for comprehensive government interventions to
address the intersecting needs of mentally ill women in developing countries.
Additionally, the
research highlights the pervasive stigmatization and negative attitudes
surrounding mental illness, which contribute to the isolation and
marginalization of affected women. Negative attitudes from spouses, their
families, and broader society often hasten separations or desertions, further
exacerbating the challenges faced by mentally ill women.
Moving beyond the
specific focus on mentally ill women, the study also delves into the
intersection of mental health and homelessness, particularly among women.
Homelessness presents a complex societal issue intertwined with mental health
concerns, with a significant proportion of homeless individuals, particularly
women, grappling with mental health disorders. Recognizing this correlation,
initiatives such as the National Mental Health Program emphasize the importance
of improving access to mental health services for marginalized communities,
including the homeless population.
Furthermore, research
conducted in South India provides valuable insights into the clinical outcomes
and rehabilitation efforts for homeless individuals with mental illness. This
research underscores the multifaceted nature of their needs and the importance
of tailored interventions to address their mental health and social support
requirements.
The research
underscores the urgent need for comprehensive government-sponsored welfare and
rehabilitation programs aimed at addressing the intersecting challenges faced
by mentally ill women, particularly in regions like Karnataka. Such initiatives
should encompass legal protection, access to healthcare and support services,
efforts to combat stigma, and targeted interventions for vulnerable populations
such as homeless individuals with mental illness.
METHODS
The proposed research method will employ a
mixed-method approach to investigate the multifaceted challenges encountered by
mentally ill women in developing countries, with a focus on India. Quantitative
analysis will be conducted utilizing data on rehabilitation/halfway homes,
intake capacity, occupancy rates, and the proportion of individuals in mental
health institutions compared to those accessing rehabilitation services.
Utilization rates and vacancy statistics will be computed to assess the efficiency
and availability of rehabilitation services. Additionally, qualitative methods
such as interviews and focus groups will be employed to explore the lived
experiences of mentally ill women, caregivers, and stakeholders, elucidating
perceptions, barriers, and gaps in support systems. The study will also analyze government policies and welfare programs aimed at
addressing mental health issues and empowering women, evaluating their
effectiveness and identifying implementation challenges. By triangulating
quantitative and qualitative data, the research aims to provide comprehensive
insights into the complex dynamics of mental health challenges faced by women
in India and propose recommendations for policy reform and community-based
interventions to enhance support systems and promote gender equity in mental
health care.
RESULTS AND DISCUSSION
The escalating concern surrounding mental
illness has highlighted the specific hurdles encountered by women, particularly
the heightened risk of homelessness compounded by inadequate rehabilitation
services. Without sufficient support, mentally ill women face increased
vulnerability, potentially leading to homelessness. However, societal backing
can play a pivotal role in their rehabilitation.
The media spotlight on a former famous ramp
model found in distress on the streets of New Delhi, suffering from psychosis
and substance abuse, spurred government action to address the needs of mentally
ill women. Following media coverage, a Delhi University student filed a Public
Interest Litigation, prompting the Delhi High Court to direct the establishment
of specialized wards for mentally ill homeless women within state-run shelter
homes. These wards, staffed with psychiatrists and medical personnel, aimed to
facilitate their rehabilitation. (Chatterjee et al, 2020). This incident catalyzed a significant shift in governmental approach,
leading to collaborative efforts with NGOs to establish Rehabilitation Homes
and halfway houses nationwide. These initiatives offer crucial support and
services, marking a pivotal moment in recognizing and addressing the unique
needs of mentally ill women, ensuring they receive the care and assistance they
require.
Programs for persons with mental
illness
Manasadhara: "Manasadhara"
(Day Care) Centers was announced in the budget in the year 2013-14. Manasadhara is a Community Mental Health Day care programme, funded by the state government. Presently, these
centers are functional in 15 districts (Bangalore Rural, Bangalore Urban, Dakshina Kannada, Kodagu, Udupi, Tumkur,
Hassan, Dharwad, Gadag, Mandya,
Chitradurga, Chamarajnagar,
Haveri, Chikkaballapur and Belgaum). Efforts to
initiate these centers in all the districts (1 for each district) are in
progress. Enhancing the mental health of adolescents is a component of Rashtriya Kishor Swasthya Karyakram (RKSK) and is included as an activity under the Manasadhara Programme.
Half way/long stay homes
According to MANOASHRAYA, the
Dashboard on Rehabilitation Homes(RH)/ Halfway
Homes(HH) in the country provides State/UT-wise details of RH/HH, including the
number of homes, intake capacity, occupancy, and number of persons languishing
in Mental Health Institutions.
|
Category |
Total |
|
Total
number of Rehabilitation/Halfway homes |
355 |
|
Total
Intake capacity in these RH/HH |
|
|
-
Male |
11,597 |
|
-
Female |
11,963 |
|
Total
Occupancy in RH/HH |
|
|
-
Male |
8,774 |
|
-
Female |
9,426 |
|
Total
No. of persons languishing in Mental Health Institutions |
1733 |
|
-
Male |
831 |
|
-
Female |
902 |
There are 355 rehabilitation/halfway
homes in total. These facilities serve as essential resources for individuals
requiring support and assistance in overcoming challenges such as addiction,
homelessness, and mental health issues.
Total Intake Capacity:
The intake capacity
refers to the total number of individuals that these rehabilitation/halfway
homes can accommodate. The total intake capacity for males is 11,597, while for
females, it is 11,963. This indicates the maximum capacity of these facilities
to provide support and services.
Total Occupancy:
The total occupancy
reflects the actual number of individuals currently residing in these
rehabilitation/halfway homes. For males, the total occupancy is 8,774, and for
females, it is 9,426. This indicates the current utilization of these
facilities.
Total Number of Persons
Languishing in Mental Health Institutions:
1,733 individuals are
languishing in mental health institutions in total. Among them, 831 are male,
and 902 are female. This highlights the prevalence of mental health issues and
the need for comprehensive support and intervention.
Utilization Rate:
The utilization rate
can be calculated by dividing the total occupancy by the total intake capacity
and multiplying by 100. This provides insights into how efficiently these
facilities are being utilized.For
males, 75.7% and females, 78.8%. These utilization rates indicate that a
significant portion of the capacity is being utilized, suggesting a demand for
rehabilitation services.
Vacancy:
Vacancy refers to the
difference between the total intake capacity and the total occupancy. This
represents the available capacity for additional individuals seeking
rehabilitation services.
For males: 11,597 - 8,774 = 2,823
For females: 11,963 - 9,426 =
2,537
These vacancies
suggest that there is room for more individuals to be accommodated in these
facilities.
Proportion in Mental Health
Institutions Compared to RH/HH Occupancy:
This comparison
provides insights into the prevalence of mental health issues among individuals
accessing rehabilitation services. It can be calculated by dividing the number
of individuals in mental health institutions by the total occupancy of rehabilitation/halfway
homes and multiplying by 100.
For males: (831 / 8,774) * 100 ≈
9.5%
For females: (902 / 9,426) * 100
≈ 9.6%
These proportions
suggest that a significant portion of individuals accessing rehabilitation
services may also require mental health support. Overall, the data highlights
the importance of rehabilitation/halfway homes and the prevalence of mental
health issues among individuals seeking support. It underscores the need for
comprehensive and integrated approaches to address the diverse needs of
individuals in rehabilitation settings.
According to
Government Order No: MME: 145: PHP: 2006(3), Bengaluru, dated 17-08-2007, Manasa Kendras (short stay and
permanent stay) are being implemented in Bengaluru, Belgaum, Bellary, Raichur,
and Shimoga. However, only Bengaluru and Belgaum Manasakendra are functioning, and the remaining are not yet
fully functioning.
Disability Certificate: Issued by competent authorities to assess the
level of disability, enabling individuals to avail welfare benefits.
Free Transportation Facility: Persons with mental illness (PwMI) can avail of travel concessions such as concessional
bus passes and rail concessions. Additionally,any
women, including women with mental illness, can travel in non-AC buses across
the state free of cost under the Sthri Shakthi
project. This will help her to come to the hospital, get treatment regularly,
and avoid relapses.
Disability Pension: PwMI with 75% and
above disability receive a pension of Rs. 1,400 per month, while those with 40%
to 74% disability receive Rs. 800 per month.
Job Reservations: The government of Karnataka has identified
posts for persons with mental illness in Group C and Group D categories. The
Right to Persons with Disability Bill proposes 1% reservation for persons with
mental retardation, mental illness, and autism.
Pension Transfer: Government employees/pensioners/family
pensioners can transfer a pension to a disabled dependent in the family.
Udhyogini Scheme: Encourages women to take loans from banks for
income-generating activities, providing assistance in
the form of subsidies to avoid reliance on private money lenders.
These benefits and schemes aim to
support persons with mental illness in Karnataka by providing financial
assistance, job opportunities, and access to transportation and loans for
economic empowerment.
CONCLUSION
Addressing mental health issues, especially
among women, requires a comprehensive approach considering the
intersectionality of gender with other social determinants. Challenges faced by
mentally ill women in developing countries like India include misconceptions,
legal vulnerabilities, stigma, and lack of support programs, exacerbated by
homelessness. While government and NGOs collaborate to establish rehabilitation
homes and specialized wards, there are gaps in service availability,
particularly for women. Welfare programs aim to provide support, including
financial aid and employment opportunities, but obstacles remain in
implementation and equitable access. Addressing gender disparities and
improving rehabilitation services demand sustained advocacy, policy reform, and
community support, alongside efforts to prioritize mental health literacy and
reduce stigma.
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Copyright holder: Yatheesh Bharadwaj H S, Sateesh R Koujalgi (2024) |
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First publication right: Journal Transnational
Universal Studies (JTUS) |
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