RAWALPINDI, Dec 19: The Mental Health Ordinance 2001 has brought little change to the lives and suffering of mentally impaired persons in Rawalpindi.
The mentally ill are often seen wandering in the busy markets of the city by day and in the open cold of the main roads by night, although the Ordinance was supposed to have brought significant changes to the law relating to such persons with respect to their treatment and care.
Few hospitals have a psychiatric unit, most notable being the Institute of Psychiatry at the Benazir Bhutto Hospital. But there is no state-run psychiatric facility in the city which can serve the long-term special needs of this neglected segment of society.
Mentally-retarded persons usually survive on alms and help — often in the form of food and clothes — given to them by people in the markets but they remain malnourished and filthy, says Mohammad Hussain, a shopkeeper on the busy Bank Road in Saddar, referring to a mentally-ill man eating rice outside his shop.
Although the Mental Health Ordinance 2001 provides for the establishment of psychiatric facilities by the federal and provincial governments, the nearest rehabilitation centre for the mentally-retarded in the twin cities is the Psychiatric Hospital in Lahore.
The above shopkeeper, who has been observing the behaviour of the mentally-impaired, says, “The general public are often afraid of them and avoid them, taking no notice of their presence and pass by them. They need food for survival but they often cannot even express themselves that they are hungry and want food”.
He adds, one usually only realises that a mentally-retarded person is hungry when he starts chewing or eating whatever that is given to him.
Under the Mental Health Ordinance 2001, persons who are believed to be suffering from mental disorder found in a place which the public have access, may be removed to a government-run health facility or a government-run psychiatric facility for treatment or care.
According to the Rescue Police and Rescue 1122, calls about persons who are mentally ill mostly come from the residential areas. They are usually informed by residents whenever such a patient wanders into their locality.
A Rescue 1122 personnel says that people in the busy markets often ignore them as they neither feel threatened by them nor do they take serious notice of their presence. Shopkeepers often give them food or guide them to sit under the shade.
According to Dr Asad Tamizuddin Nizami of the Institute of Psychiatry, Benazir Bhutto Hospital, “A good number of such patients are drug addicts and are mentally disturbed when they fail to get their usual dose. Others who have disorganised thoughts and are unable to control their movements usually suffer from schizophrenia”.
The psychiatry expert says that such patients cannot take care of themselves and face many perils when left unattended because there is no psychiatric facility in Rawalpindi for long-term rehabilitation of mentally-impaired patients.
Although these patients usually recover within months, they need continuous and prolonged care and medication to keep them going, he adds.
Dr Nizami relates, “Some time back the police brought to us an old woman from the Pirwadhai area. She had multiple injuries and was suffering from schizophrenia. We treated her injuries and provided her mental care. A few days later when no one came to claim her, she was taken away to an Edhi home”.
There is a dire need for a facility in Rawalpindi run by the social welfare department where medical experts can treat and rehabilitate the mentally disordered, Dr Nizami opines.
But District Officer Social Welfare Aslam Mehta says that the welfare of these people does not come under the purview of his department.
According to the Mental Health Ordinance 2001, the federal and provincial governments can establish and maintain psychiatric facilities “for the assessment, admission, treatment, rehabilitation, care and after care of mentally-ill patients”.
At the same time, community-based care for the mentally impaired is also encouraged by the Ordinance.
The Ordinance specifically provides for “community-based mental health services” to be set up to provide “mentally-disordered persons, their families and others involved in their care with guidance, education, rehabilitation, after care and preventive measures and other support services on an informal basis”.