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Mental Health Month: The Crisis Continues in 2014

May is Mental Health Month: The Crisis Continues

The world and US keeps on inching towards progress in provision of mental health services to 450 million (World Health Report Geneva October 4 Report) estimated to be afflicted with a disability which makes others run away from it. In this month we need to remind ourselves of the barriers and problems to the treatment and justice  for those who are afflicted with highly debilitating and the most misunderstood disease in the world. We need to do that to offer hope to mentally ill and assuage people like me who are always angry with the injustice done to this population which generally lives in shadows. Some highlights are:

·         Stigma, misinformation, discrimination and neglect continue to prevent treatment of mentally ill.

·         Tradition ridden and ignorant segments of society continue to equate mental health problems to personal failure. This dogmatic belief is the most important impediment to treat mentally ill.

·         The policy makers all over the world are scared of cost of treatment of mentally ill, while ignoring the cost of this disability to the society which is much greater. It is one of the top disabilities over the world.

·         This continues to be a belief in society that mentally sick persons cannot lead productive lives. This is a myth propagated by ignorant or those interested in perpetuating the currently broken system. It is well known in medical community that with proper medical and psycho therapeutic care , 80% of schizophrenics and 60 % of those afflicted with depression  can lead productive lives. (WHO Report).  

·         As a result of this callousness to 450 million persons in the world, 40% of countries of the world have no mental health treatment. 25% do not have the basic drugs to treat mental health. On average there is 1 Psychiatrist per 100,000 people all over the world.

·         The prevalence of mental health over such a large scale perpetuates the cycle of poverty. Some mental ailments may emanate from the stresses and strains of being poor and homeless.

Nearer home in USA one does not find the situation any better. Our hospitals overmedicate routinely after a brief examination. The hospitals have no beds and no safety net for mentally ill once diagnosed and sometimes misdiagnosed. The deinstitutionalization with all the good intentions to award rights of mentally ill the right to live in a free society was botched in a big way. E Fuller Torrey a known mental health advocate has stated that the number of beds per 100000 persons in US is too low. Currently it is 14. He estimates that that it would suffice to make it 50. Joe Nocera, a NY Times columnist has summed it up well “What happened to the patients who left the hospitals after deinstitutionalization was horrendous. State mental hospitals would release patients with little idea where were they going. They often ended up on the streets, or in prison, which have become today's de facto mental hospitals".

In last 6 months we witnessed a rerun of this terrible movie in my hometown of Las Vegas in Nevada. They were dumping patients to California with 3 days of medications.

I have been associated with mental health for last 25 years and had hard time in containing my anger over this dismal state of mental health in our country. I am also the last person to lose hope over this. Here are some of the steps those members of society who can devote time to goodwill of disabled and those associated with mental health can take:

·         Make advocacy a part of your daily regimen. Take it up with legislatures, legislators, state and federal governments and utilize all legitimate forums for this purpose.

·         Assist your neighbors and communities by educating them about treatments, stigma and help wherever needed.  

·         Speak out when you notice homeless and use all available forums to highlight the callousness of the society.

·         Educate your friends and family members on mental health.

·         Emergency rooms at the hospitals make mentally sick persons wait for very long times. If you come across such a situation, advocate for them and get them help.

·         Never forget the election time. Force our representatives to spend more time and energy on mental health issues.

·         And last but not the least display your outrage on your sleeve and yell if you need to seek justice for the mentally ill.

My friend BS Bedi wrote a beautiful piece on Khushwant Singh who died today at 99. Here it is:

Bishan Singh Bedi on Khushwant Singh--

I'm not sure if I'm equipped to do an obit of the mighty S Khushwant Singh 'cos he was senior by more than three decades. Nor was he a 'friend' in the real sense. But I had loads of reverence for the 99 year old institution called Sardar Khushwant Singh, which fell today in normal course!

I'd like to think we had a lot in common--national pride was certainly one. Also,our love for scotch & humour, vulgarity was no taboo at all! I'd often get a post card from him, "Pl come and have a drink only if your dirty jokes are aplenty and fresh!".

Aparently,he was doing crossword today just before leaving his abode in Sujaan Singh Park. What a lovely way to go just one short of a ton! Once I told him a story of a rich man expressing a weird last wish of serving two large of deluxe scotch to all before and after the funeral, the wish was granted but not before he hit the bucket, the dying man asked for his four!! 

S Khushwant Singh was in peels. I was very tempted to ask his son Rahul if his Sire had any such wish! Only to be told that doctors were removing his eyes to be donated as per the will of the master writer/author/historian!!

On another occasion in Bombay in mid seventies, I was going into the steam/sauna of good old Taj and S Khuswant S was coming out. "What is the latest Bedi saab?". Luckily, I had a good one up my sleeve and let him have it! He just couldn't stop laughing!After about an hour, S Khushwant S walked into the sauna, all dressed up for a formal moment, "please tell me the gist of the story again Bedi saab!"!! I repeated the joke saying he can carry it in his editorial of the Illustrated Weekly if he so desired! And lo behold, he accepted the challenge and carried the joke with relevant alteration! "The original is unprintable and was told to me by none other than the captain of Indian cricket!" he wrote. I was very impressed with his bravado and became an unadultrated fan of S Khushwant Singh.

He was an authority on Maharaja Ranjit Singh.There was a do at Vigyan Bhavan in honour of the great Punjab ruler. Atul Behari Vajpayee, the then PM too was there whence prominent leaders from Lahore were also present. Maharaja Ranjit Singh was an  illiterate ruler from all accounts. But he was blessed with meaningful intuition to handle the French and British staff in his Darbar. And once the Punjab ruler was convinced of all deliberations he would then go ahead and scribble 'sahi' in urdu, which meant the treaty was as good as signed.

Now, while explaining all this to a very interested audience (house full!) at Vigyan Bhavan, S Khushwant turned towards Atal Behari Vajpayee and asked "Mr Prime Minister, when are you going to learn to write the word 'sahi'?!". The whole house came down I vividly remember. 

My early introduction to the great literary Sardar was through his widely appreciated book on partition "A Train to Pakistan". As a young impressionable Punjabi, I quite enjoyed the interpretation of some the choicest Punjabi swearing by S Khushwant Singh, not as in the Parliament these days, but very authentic all the same, to convey to the Lahoris in right earnest!!!

Once I got the feel of the Khushwant factor, it was easy to read/listen to him in all forums and enjoy his subtle and at times, not so subtle obsevations on matters of sex, booze and anything closely nearby! 

I reckon S Khushwant Singh derived huge vicarious pleasure from snubbing the clergy of all faiths and beliefs. He would claim to be an agnostic and yet did a great job of 'History of the Sikhs'! He would detest all sorts of religious movements on roads. Alas, not many in the Parliament would agree with him publically! That's when he would tear into his opponents ruthlessly!!

S Khushwant Singh was the only sikh writer to puncture the collective anti national designs in the Punjab in 70's and 80's, only to earn the sobrequet 'controversial' by the petty minded.

I was there at the release of his last book when he was 92 and in a wheel chair. The hall at the Le Meridien was bursting at the seams, with more than 70 percent of the audience from the feminine gender! It was an awesome sight when a youngish lass kissed him on his lips, only to confirm my belief that S Khushwant Singh was loveable/hateable, but never ignoreable!!

We'll not see the like of S Khushwant Singh in a jiffy simple because honesty is at such a premium these days. Also, the personal discipline of the Sardar in a glorified bulb was absolutely stunning--sleeping early and getting up very early for almost 80 of 99 years was not at all mythical, it was real!

Well, he may have left the world, but I doubt if he'll ever leave our thoughts and book shelves. We, as a nation need to celebrate the life of a man who was a constant reminder of Indianism at its best. RIP.