"She says we have brought her to a mental asylum. I ask her to tell me what she means by a mental asylum? People have different types of ailments and come here to be cured. We do not know what a mental asylum is," says Mr Narain.
Barely 100 meters from her ward, on the same campus, is the genesis of horror stories. This derelict building, with its isolation cells, is a reminder of how patients with mental illness were shackled and locked up 25 years ago. Caged like prisoners in cells with toilets, the patients were given food through the bars. The old ward was part of the former Shahdara mental hospital, which ceased to exist 24 years ago, following a public interest litigation. The old hospital was converted into IHBAS, a model facility.
The infamous Shahdara mental hospital, also referred to as the Shahdara pagalkhana, is now the nerve center of positive mental health activities. Over the next decade, significant changes were brought into mental health care. "There are a lot of training activities. There is research, policy advocacy, and the most important part is that you overcome the stigma of mental hospital or mental health institutions," says Dr Nimesh Desai, a senior Professor, Psychiatry and director, IHBAS.
Playwright Vinod Verma was among those who sought treatment for bipolar disorder from the new IBHAS. "I was in Mumbai for work when I realised that I cannot remember the dialogues. I forget three lines also. I was shocked. Then I moved back to Delhi and went to IHBAS," he says.
At the emergency services, like in any hospital, cards are made for the patients. Except the cards are assigned codes. "A patient having a suicide risk is marked with a 'red' code. If the patient is violent, we give a 'yellow' code. We give 'green' code to settled patient and make them sit in waiting room," says Bharti Dhingra, a senior Nurse in Emergency Services and Observation facility.
Once in two or three months, padded rooms without furniture are used to keep patients in supervised care if they exhibit violent or homicidal behaviour. Even with medicines, it can take 15 minutes to an hour for a patient to stabilisze. A nurse keeps watch through a CCTV camera and every 15 minutes or so the patient’s blood pressure is monitored.
Some of these patients were disowned by their families. In the absence of halfway homes or long stay homes, they end up as the homeless, mentally-ill on the streets.
Like IHBAS, which is run by the Delhi Government, all custodial based centers across the country need to be reformed. Of the 43 government mental health hospitals, few have reached the level of reform that centers in Bangalore, Ranchi, Agra and Delhi have reached. Nearly 30 are still in the custodial or long stay mode.
Reforms are slow despite the directions of the Supreme Court and the National Human Rights Commission.
The Union health ministry says it is trying to improve the resources support to the government institutes so that they can deliver better.