Gaurav Singh1, Nilima Shah2, Ritambhara Mehta3. 1. Assistant Professor, Department of Psychiatry, KD Medical College Hospital and Research Centre , Mathura, Uttar Pradesh, India . 2. Associate Professor, Department of Psychiatry, SMT NHL Municipal Medical College and VS Hospital , Ahmedabad, Gujrat, India . 3. Professor and Head, Department of Psychiatry, Government Medical College , Surat, Gujrat, India .
Abstract
INTRODUCTION: There are estimated 400,000 wandering mentally ill persons in India, found in poor physical state wandering on streets and railway stations; mainly treated either by government run Hospitals for Mental Health (HMH) or Psychiatry units of a Government Medical College (GMC). They require psychosocial rehabilitation along with treatment. AIM: To study the presentation, clinical profile and rehabilitative outcome of wandering mentally ill admitted in government psychiatric care facilities. The objective was to establish them as a distinct psychiatric inpatient population requiring special attention. MATERIALS AND METHODS: The study was a chart review of all wandering mentally ill patients institutionalized during a period of two years in two distinct government facilities. Additionally, clinical staff was interviewed for cross checking the data and for eliciting problems faced in management. The discharged patients were contacted to assess the present status. RESULTS: Forty seven patients in HMH and 35 patients in GMC were studied. Wandering mentally ill patients were brought to mental health facility by helping person (30) and police (23). Majority of them (61) were picked up from streets and railway station. Most of them (56) belonged to <40 years age group and communication with them was difficult due to language barrier in 51. Diagnosed as Psychosis NOS (45) initially, they presented with poor physical condition, with positive viral markers (25) and pregnancy in females (4). Most common final diagnosis was schizophrenia (45) along with prominent negative symptoms and poor cognitive abilities. Forty three of them showed good improvement on treatment. Forty five gave their address; Relatives were found in 39 through police, post cards and social workers and were rehabilitated back to family. CONCLUSION: Wandering mentally ill constitutes a unique patient population with specific challenges different from other inpatients in management and rehabilitation. Provisions to take care of this most vulnerable group of the society and mechanisms to watch for their continuous implementation are required.
INTRODUCTION: There are estimated 400,000 wandering mentally ill persons in India, found in poor physical state wandering on streets and railway stations; mainly treated either by government run Hospitals for Mental Health (HMH) or Psychiatry units of a Government Medical College (GMC). They require psychosocial rehabilitation along with treatment. AIM: To study the presentation, clinical profile and rehabilitative outcome of wandering mentally ill admitted in government psychiatric care facilities. The objective was to establish them as a distinct psychiatric inpatient population requiring special attention. MATERIALS AND METHODS: The study was a chart review of all wandering mentally ill patients institutionalized during a period of two years in two distinct government facilities. Additionally, clinical staff was interviewed for cross checking the data and for eliciting problems faced in management. The discharged patients were contacted to assess the present status. RESULTS: Forty seven patients in HMH and 35 patients in GMC were studied. Wandering mentally ill patients were brought to mental health facility by helping person (30) and police (23). Majority of them (61) were picked up from streets and railway station. Most of them (56) belonged to <40 years age group and communication with them was difficult due to language barrier in 51. Diagnosed as Psychosis NOS (45) initially, they presented with poor physical condition, with positive viral markers (25) and pregnancy in females (4). Most common final diagnosis was schizophrenia (45) along with prominent negative symptoms and poor cognitive abilities. Forty three of them showed good improvement on treatment. Forty five gave their address; Relatives were found in 39 through police, post cards and social workers and were rehabilitated back to family. CONCLUSION: Wandering mentally ill constitutes a unique patient population with specific challenges different from other inpatients in management and rehabilitation. Provisions to take care of this most vulnerable group of the society and mechanisms to watch for their continuous implementation are required.
Authors: David P Folsom; William Hawthorne; Laurie Lindamer; Todd Gilmer; Anne Bailey; Shahrokh Golshan; Piedad Garcia; Jürgen Unützer; Richard Hough; Dilip V Jeste Journal: Am J Psychiatry Date: 2005-02 Impact factor: 18.112
Authors: Karishma R Kulkarni; R P S Shyam; Virupakshappa Irappa Bagewadi; Guru S Gowda; B R Manjunatha; Harihara N Shashidhara; Vinay Basavaraju; Narayana Manjunatha; Sydney Moirangthem; Channaveerachari Naveen Kumar; Suresh Bada Math Journal: Indian J Med Res Date: 2020-10 Impact factor: 2.375