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A beautiful mind
Dr
Sharda Menon, an internationally-known psychiatrist, led by a group of dedicated philanthropists and mental health professionals, formulated SCARF as a centre of repute in rehabilitation, being the first of its kind in India. This non-governmental, non-profit organisation has since then rendered itself to the care and research of the mentally ill. It is ironical that in India, mental illnesses have assumed the lowest priority among physical diseases despite their significant impact on the mortality rate. Nearly one-third of all disabilities are due to mental disorders. The human mind, as we are aware, is considered to be the most intricate and perplexing form of matter present. It is so complex in nature that at a given point of time it can make you the king or the queen of the universe or at times put you in variance with yourself. An example of this kind of malady of the mind is known as schizophrenia. It is the scientific term used to describe the state of mind wherein the individual loses his ability to think, feel or behave in a normal way. He perceives a distorted reality and suffers from delusions which are based on false beliefs. He begins to act on them usually - unaware of the fact that he is ill. For example, he believes that he is being conspired against or that some external force is controlling his thoughts. During the acute phase of the illness, the patient often hears voices and begins responding to them.
Schizophrenia starts in the most productive years of life, i.e. between 15-45 years. A schizophrenic patient loses interest in his work, family and friends. The illness is usually accompanied by disturbed sleep patterns and loss of appetite. The exact cause of the disease has continued to puzzle scientists and the scientific community. However, research has emerged to give biological and psych-social aspects of the disease. The other causes are related to the bio-chemical irregularities in the brain. The family and social pressure can also work on a vulnerable individual. A great deal of this illness can be attributed to the present scenario of life that exists, wherein coping with the demands of progress and productivity can be quite stressful for an individual. Today’s world is defined as the age of survival - The age of speed, which can spread fantasy with such velocity that a human in pursuit to escape would ultimately destroy himself or herself. The greatest ambition of SCARF for building a comprehensive mental health centre was fulfilled in 1998 with the completion of the construction of the building with a total area of 10,800 sq ft on the land donated by the then (and now) chief minister of Tamil Nadu, J Jayalalithaa. The creamy white building of SCARF stands for its purity and cause that it has dedicated itself to. As I headed for the reception, a woman welcomed me with her bright smile. I told her that I had to meet the deputy director of SCARF. She dialed the intercom as I stood their waiting for the response. Across the other side of the room I could hear the rolling of dices and the striking of carom coins and the laughter of some patients while others were seen moving freely in and around the room. There seemed to be no restrictions on their movement. Meanwhile, the woman at the reception pointed towards the spiral staircase on my right and I made my way to meet Lata Rani, the deputy director of SCARF. I had known Lata Rani since my childhood. She had always had a soft voice and her bright smile never missed to leave an impression on others. I saw her sitting at her desk with the same calmness and poise and she looked beautiful as ever. We got down with a cup of coffee in our hands, and started talking about SCARF. Lata started talking about the initial struggle of SCARF - a time when mental illness was considered a taboo, a stigmatising disease with all the societal consequences of personal shame and family burden. Lata spoke of the mentally ill who were simply thrown in dark rooms known as ‘snake pits’. The lack of clinical support made them dreadful and they were locked away, chained and totally cut off from the outside world. She mentioned about the horrifying incident that took place in an unauthorised asylum at Erwadi, Ramanathapuram - where 27 mentally ill individuals died in a most tragic way. As fate would have it, a fire broke out and the staff and others ran to safety but not a soul thought about the mentally ill who were locked in the dark and clumsy corner of the room struggling to get out of their iron manacles. SCARF was founded as a result of the inadequate clinical and rehabilitation support and facilities provided by the hospitals for the mentally ill. Since the government hospitals have a limited number of rehabilitation facilities, it resulted in relapse in patients every time they were sent back.
“When we started, the only tools we had was a questioning mind and a cooperative group of patients and families. Mental health is not a priority area for many funding agencies and our own limitations in having to confine ourselves to chronic mental illness narrowed down the opportunities even more.” She smiled at the fact that, when the government officials/Health Ministry officials would come to inspect the patients, they found them perfectly normal - since most of them would discuss politics and other current issues with them. After this they were not ready to believe that these people were mentally unsound. It took a long time to convince them about their condition. She further added that: “All of us dream, aspire and hope to express our inherent goodness but there are only some who are able to translate it into reality. That was really what SCARF was, a dream in the minds of a few.” SCARF offers a comprehensive, totally free treatment package. It organises for various activities for men and women. The women are mostly involved in handicrafts, basket-weaving, making of puppets and stuffed toys, whereas the men are involved with screen printing and making paper bags, covers and folders. An incentive of Rs 100 to 150 per month is given to the patients in appreciation of the work they have done. It is to boost their spirit and tell them that they are still useful and not useless as some make them believe. SCARF also provides free transport facility for the patients to come to its day-care centre to make sure that the patient completes his course of treatment. There are some families who consider it inappropriate to waste time, money and energy on the mentally ill and this could quite easily lead to relapse in the patient. Hence, free transport facilities are provided to the patients to come to SCARF. SCARF also has an placement cell, which seeks jobs for the recovering patients who deserve self-respect and dignity like others. It provides outpatient consultation for the public and provides free medication for those who cannot afford it. It supports the education of the children of mentally unsound who have lost their ability to work and support their families. There is also a provision for family education programmes known as the ‘FEP’, which lays emphasis on the family. Organised by the family cell, it provides to support, counsel and involve the family in the treatment programmes of the patients. The rehabilitation programme consists of occupational therapy, group therapy, social skill training and cognitive training. The present team, led by Dr Thara, is composed of a psychiatrist, psychologists, social workers, rehabilitation personnel, administrative and support staff. At present there are two centres of SCARF. The first one is at Tiruverkadu, which was built in 1991; it houses nearly 55 mentally disabled women. The second centre is outside the town of Mamallapuram, which houses 20 men, an additional floor in the centre at Mamallapuram will accommodate 15 more residents. SCARF has also been equally active in the field of awareness and education. Due to the stigma associated with the mental illness, there seemed to be a growing need to educate people. SCARF has been exploding the myths and misconceptions abounding in understanding the mental illness leading to the delay in seeking treatment. It was believed that if a schizophrenic was married, he would become normal, given the responsibility of marriage. But, it can give a totally negative result. SCARF believes that schizophrenia is not an illness without hope. There is a possibility of a considerable social recovery. It can be definitely difficult at times when they would need a lot of help and support from the families. Give them a sense of responsibility that they are needed. Don’t dispose them off as ‘useless vegetables’. They are also humans with the same feelings and emotions, the same heart that beats, laughs and cries. If they do things strangely sometimes, it’s because they don’t know what they are doing but that doesn’t mean that they are mad. They understand the language of love. They just need time and space to - GROW. There are families who have not given up and hope for a better future for their mentally ill family member: “We hope we can make some kind of life for ourselves and the rest of our families. With hope and hard work there is a future for all of us and some day, and let us hope soon, a cause and a cure will be found.” I sincerely hope there will come a time, when the attitude would change, for our brothers and sisters who have been afflicted with this disease. I hope we can all join some day and lend them our helping hands - to the faceless and the voiceless - as they have always been. I hope we will understand that they wish to be heard and seen. I hope for a better tomorrow for them. In recognition of the outstanding services for the welfare of the handicapped, SCARF received the national award for outstanding employer in 1995 from the then president of India, Dr Shankar Dayal Sharma. Schizophrenia Research Foundation (India), Natasha Gariyali
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My visit to
It has been said of famous Danish painter Van Gogh that he cut his ear under the influence of delusions. The researchers now believe that he might have been suffering from
SCARF, that started with five patients and three staff members, Lata being one of them, today boosts of about 80 patients in its day care center alone. According to her:
