Deprived of care they deserve

Some 21 years after the Pabna Mental Hospital (PMH) -- the country's first specialised hospital for patients with mental disorders -- was upgraded to a 500-bed facility in 1997, it is still operating with the manpower of a 200-bed hospital.

It is under this reality of the current state of healthcare for people suffering from mental disorders, Bangladesh is observing World Mental Health Day today. This year's theme for the day is “Young People and Mental Health in a Changing World”; the World Health Organisation says half of all mental illnesses begin by the age of 14.

Of the 14 doctors at the hospital, two look into the administrative functions, and considering the casual leave absentee, the hospital is left with eight to 10 doctors on duty every day. Some four to six doctors treat outdoor patients from 8:30am to 2:30pm, leaving only a few to take care of 400-odd admitted patients during the period.

“We have submitted a proposal to the health ministry for 649-stong manpower, including 111 first-class specialised posts of doctors and experts. In the proposal, we have urged the appointment of chief consultants of adult psychiatric, geriatric psychiatric, child psychiatric, social psychiatric, neuro-psychiatric departments; senior consultants and junior consultants,” Dr Tonmoy Prokash Bishwas, director of PMH, told The Daily Star. But it is yet to get the concerned ministry's nod, he said.

At present, 435 patients admitted to the hospital are undergoing treatment, where nurses look after them with prescribed medicine and timely food in the wards.

“If any patient's condition deteriorates, we take them to doctors. Otherwise, the patients are given prescribed medicine, food and monitoring in ward,” Shefali Bishwas, a senior staff nurse of the PMH, told this reporter during a recent visit to the hospital.

The patients are served food four times a day. However, the daily allotment for each patient is Tk 125, which makes one wonder what the quality of the food is.

LACK OF FAMILY SUPPORT MAJOR OBSTACLE FOR RECOVERY

One of the patients at the hospital, a 50-year-old schizophrenia sufferer has been re-admitted to PMH 14 times over the past decade, as his family prefers to keep him in hospital although he does not exhibit violent tendencies and can live at home with proper care.

“When I go home, nobody takes care of me and I become ill again. Then they [family members] send me to hospital. I have been admitted here 14 times. This is my home now. I am feeling better and am ready to go home, but nobody comes to take me back,” he said.

Like him, at least 20 out of the 40 admitted patients at Ward-3 of PMH are re-admitted patients, says nurse Shefali.

Most of them have been admitted several times, as they do not get proper care at home and are neglected by society.

Some 150-180 of the patients currently admitted have returned after their release due to carelessness of their families, said Dr Shushanto Kumar, superintendent of PMH.

“Medicine is not enough for patients with mental disorders. Community and family support are essential for their recovery, but people in our country often depend on doctors instead of community support,” Dr Shushanto added.

When visiting PMH and talking to patients and hospital authorities, it was learnt that many patients who are released after having recovered, return in poor mental state.

Sometimes things at home go beyond neglect, as is the case of a patient, aged 55.

“When he was admitted a couple of months ago, he was wounded and too weak to stand, because his family often tortured him. He was often locked inside the bathroom without food because of his mental disorder. After getting treatment, he is now doing better, but is still traumatised,” Halima Khatun, senior staff nurse of PMH said about the patient.

Shefali said: “We always monitor timely feeding, proper medicine and shower of the patients. That is how they recover. If we are able to monitor 40 patients with four to five staff, then why don't family members take responsibility of one patient?”

A total of 13,293 patients were admitted to PMH between 2009 and 2017, and of them 13,136 were released after recovery, said Angshu Poti Bishwas, statistics officer of PMH. However, the official couldn't provide exact numbers of how many of those “recovered” patients eventually returned.