Empirical Study on the Challenges to Community Reintegration under Mental Healthcare: An Analysis With Reference to SDG 2030

Abstract

Background: Mental healthcare today has extended beyond treatment at mental hospitals to include community reintegration and rehabilitation. However, beyond the protective walls of institutional care lie neglect, stigma, poverty and lack of resources which often leaves mentally ill patients in a vicious cycle of relapse, re-admissions and discharge from hospitals. This is just tip of the iceberg when it comes to the pitiful plight of mentally ill persons and mental healthcare across the world especially in developing and under-developed economies. 

Aim: This empirical study was designed to collect data of both quantitative and qualitative nature on the socio-economic background of patients admitted in two state mental health institutions in Maharashtra, India though a review of patient case files. The study also adopted a method of co-operative inquiry and assimilated opinions from psychiatrists and psychiatric social workers to comprehend the challenges to community reintegration of patients and possible solutions.        

Methods and Materials: Data collection was carried out at Thane and Yerwada Regional Mental Hospitals. 30 case files of discharged or discharge eligible patients were referred for background information on type of illness, instances of relapse, occupation and activities during admission. The sample was picked through random stratified sampling method. The second set of data was collected through questionnaires with open and closed ended questions to seek opinion of psychiatrists and psychiatric social workers on the situation of mental healthcare at the state mental health institution and possible suggestions.        

Findings: The data collected from the patient case files indicate certain socio-economic patterns and nature of illness as possible barriers to receipt of quality mental healthcare and community reintegration.

The data collected from the psychiatrists and psychiatric social workers corroborate the challenges indicated in data collected from patients as they also highlight the issues of socio-economic background of the patients, lack of sufficient counseling due to unavailability of family members, stigma, causes for frequency of relapse among the patients, giving fake address and information by family of the patient, refusal of family to take the patient home post discharge and lack of awareness. The data also suggested introduction of family wards in mental hospitals to improve treatment and process of community reintegration of mentally ill patients.

Conclusion: Mental health is a priority under Sustainable Development Goals of 2030 and to achieve it there is imminent need for significant contribution in terms of funds and expertise. Community living for the disabled including mentally ill persons is a right under UNCRPD as well as Mental Healthcare Act of 2017 and therefore it is the responsibility of the state to formulate and enforce measures for adequate treatment and community reintegration of the mentally ill.