Attitude problem or mental disorder' Awareness groups are striving to make the distinction clear. But work has only just begun, reports Nisha Lahiri
Man1: “Does your nephew get angry a lot' Does he get violent enough to hit out'”
Woman 1: “No. He’s usually very calm. He came home after his exams one day, and decided he would not go to school again. He wants to study at home.”
Man1: “Hmmm… Watch out. Eta peke gele, aro kharap hobe. (It will only get worse). This is just the beginning. But with the right treatment, he will get better. My son is a grown man, and he still runs out into the street sometimes, naked. People are telling me to get him married off. That might cure him. But how can I'”
Man2: “If something happens to the girl, the family will come after you for getting her married to your ‘mad’ son.”
Man3: “Mental disease is a very bad thing. It’s on the rise now. I don’t know why this is happening or what the answer is…”
this scene in a doctor’s waiting room mirrors the attitudes and understanding of people towards mental health problems. While more Calcuttans are coming forward and doctors here are also more informed now, the situation still remains very much in the twilight zone.
There is a very thin line between a child with a mental disease and a child with an attitude problem. Parents and teachers have to tread it carefully at every step. What makes it harder is that information is scarce, the subject is still taboo, and admitting that your child might actually have ‘a problem’ and is not just going through ‘a phase’ is never easy.
Schizophrenia, Autism and Attention Deficit Hyperactive Disorder (ADHD), to name just a few, are some of the more obscure diseases, that even till a decade ago were not really heard of, especially in India. But things are changing, say doctors, parents and professionals. The reason: awareness campaigns by concerned groups.
Information is the only answer to the question and the most important weapon in the arsenal to fight the diseases, feels Indrani Basu Mallick, a clinical psychologist at Revive, on CIT Road. “Most people still haven’t even heard of the word autism. How will parents know their child has a problem if they don’t even know the symptoms' Things are changing though, because the number of children coming to me for diagnosis has definitely increased. Almost five in every 10 cases I get are children. In a way it is good, because it means that parents and paediatricians recognise the signs, since early intervention is usually the key to rehabilitation, particularly in autism. However, it might also mean that mental health diseases are on the rise,” she explains.
One of Mallick’s patients is a three-year-and-eight-month-old boy, whom she diagnosed with autism. His mother says they first suspected something was wrong when at two, he wasn’t talking or responding to verbal commands. “We could see that he couldn’t understand what we were saying. So, we took him to a paediatrician. For the next six months, it was like riding a merry-go-round. Three paediatricians, one neurologist, one psychiatrist, and then a psychologist, Dr Mallick, who finally got it right. The worst part was being told by every doctor that our son was a late developer and nothing was wrong with him,” she recounts.
Now, a year later, after help from individuals and the right intervention, the boy has started understanding and responding to language. He has even picked up words like ‘biscuit’. It has been a long road, and the way ahead is hard, too, but his mother feels she’s going in the right direction. “One step at a time” is her philosophy.
One problem area, feel doctors and parents, is that the government seems reluctant to take even the first step towards understanding and then addressing such disorders. There are no state-backed rehabilitation programmes or centres, no provision in law for autism, no awareness campaigns, no government-approved training schools for professionals and no schools for kids with autism.
So, a group of parents recently got together and started Autism Society – West Bengal. At the inaugural workshop, the members were delighted with the number of professionals, including doctors, teachers and social workers, who attended. “I have been to a lot of such workshops before, and the number of professionals attending them has increased,” observes Indrani Basu, joint secretary of the Society. “They now understand that all mental health disorders cannot be grouped under one label and treated in the same way. This is one of the most significant improvements.”
Together with the secretary of the Society, also Indrani Basu, she conducts special classes with autistic children, recently started at Manovikas Kendra. “The teachers at the Kendra are receptive to our training. What they recognise is that autism is not the same as, say for example cerebral palsy, because there aren’t the usual obvious signs. The main hurdle is that autistic children are more often than not good in school. Because they are quiet and a little withdrawn, no one realises they have a problem,” says Indrani. The Kendra workshop has 10 kids, with plans to push the number up to 15.
Srikumar Mukherjee, another city-based psychologist, points out that the biggest improvement is in the form of support groups formed by parents and family members of victims, especially in the case of schizophrenia. “It is very difficult, emotionally and physically, to live with a patient of schizophrenia. These support groups help them to share their problems, spread awareness and rehabilitate the patient in little ways. The most important factor in dealing with a patient of schizophrenia is the home environment. If the family has help, it is automatically in a better position to provide the same for the victim.”
Ishita Sanyal runs a centre for schizophrenia patients, Turning Point, where they are rehabilitated, “by bringing them back in touch with reality” through vocational courses and group discussions and games. She also started sessions for children with attention disorders at Disha. Sanyal feels people still know too little about schizophrenia, and there is still a stigma attached to it. Education is the key, she stresses.
One particular schizophrenia patient has been visiting Turning Point for the past few years. When she first started attending, she wouldn’t talk, was “deeply paranoid” and had severe hallucinations. Through simple acts, like watching the news and listening to others with similar problems, she has managed to gain a degree of self-confidence. At the vocational training classes, she discovered a liking for sewing. She now earns a salary through this and values her independence.
A few good private clinics have come up, but it’s definitely not enough. As Mallick observes: “In the case of physical diseases, there has been some aggressive awareness tactics. We need the same for mental health disorders so that the next step can be taken before it is too late.”