‘Within the designated enclosures at IHBAS, patients are free to sit, roam around or play music, but are never tied down or chained’.
The Institute of Human Behaviour and Applied Sciences (IHBAS) looks like an average government hospital until one visits its open wards. The patients at IHBAS are different and in its open wards, most of the people are waiting to find their families or be found by them.
Sarita spends most of her time with her face dug in a pillow which she carries around with her all the time. She continues to stay crouched in a corner of the courtyard while The Sunday Guardian takes a look at the semi-open ward for the mentally ill at IHBAS. Constantly monitored by guards, these female patients in the semi-open ward are destitute women who were rescued from streets and brought to IHBAS for treatment.
Dr Nimesh G. Desai, director of IHBAS, explains, “The police and the court send them here. They are either lost and reported to the police by public or the court found them fit to be kept in a facility. So we try to improve their condition at the earliest possible and let them go. Most of them are not violent, but we take precaution. We practice restrictive care, not custodian care.”
On an annual basis, IHBAS receives close to 100-120 patients out of which a majority are rehabilitated and reunited with their families. “This is crucial for de-congesting our wards.”
Dr Desai said, “There is a huge difference between restrictive and custodian care. Here in the open and semi-open wards, there is a restriction on how much freedom we can give to our patients. So within the designated enclosure, they are free to sit, roam around or play music, but are never tied down or chained.”
Explaining the presence of security guards across the hospital, Desai said, “There are so many security offices because we are neither keeping our patients chained nor locking them up. We have given them freedom to go about under supervision. You must understand that this is not a mental hospital. Mental hospitals are under police custody. Here our purpose is to cure these people so that they can go back to their families.”
The Intensive Care Unit (ICU) at IHBAS also has two “Protected Supervised care” rooms. “If a patient gets violent, we do not beat them or tie them; instead, we use chemical restraints in the form of medicines. But chemicals take time to work which is why it takes time for a patient to calm down again. Meanwhile, in order to keep them out of harm’s way, we keep in separate Protected Supervised care rooms. These rooms are sound-proof and are equipped with CCTV which is monitored by a doctor sitting outside the room.
Dr Desai said, “When we decided to make these rooms, we were not sure how often we will need these. But we hardly have to use them twice a month. The reason is that modern drugs are efficient and have replaced the need of old physical bondage under which the mentally ill were kept. It is a myth that all mentally ill patients will be necessarily violent.”
He further added, “People need treatment, but family members hesitate thinking that the hospital will forcibly get the patient admitted. However, advanced scale of research has made it possible for 90% of the cases to be treated at OPD itself. The admission rate of severe cases is 1% only.”