The court has asked the state to put a mechanism in place within five weeks, but the problem involves many things – the first is sensitivity
The state health department has no data on the mentally handicapped – neither on the road nor at home.
The Madras Supreme Court’s June 28 decision to vaccinate the mentally ill has raised questions about the challenges associated with the vaccination campaign.
At the hearing of a petition filed by CHEER, a Chennai-based NGO, the court said that just like the special measures taken by the state to protect people with disabilities, a similar measure should be taken for the mentally ill who may be home shackled , or are unaware of the need to protect themselves.
“The policy that mobile teams travel to people with disabilities instead of bringing such disadvantaged people to the centers can be applied to mentally ill patients,” the court said.
It ordered not only the home-bound insane to be vaccinated, but the wandering insane as well.
“There are a lot of people who are abandoned by their families and run around on the streets. They should be looked after at the local level. Communities, businesses and panchayats should ensure that such individuals are given shelter and priority vaccination, ”the court said. All of this should be done in five weeks and a status report from the health department should be submitted, according to the court order.
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The federal government spoke to some mental health professionals and activists to learn about the challenges of running the vaccination campaign.
“No data on the mentally ill”
S. Namburajan, secretary of the Tamil Nadu Association for the Rights of All Types of Differently Bled and Caregivers (TARATDAC), said at a time when the state health department has no data on the mentally disabled – neither wandering nor at home – this is difficult to carry out the vaccination campaign.
“First of all, we need to know where they will be vaccinated. How are they identified? Would they be tested for Covid? Where would they be kept if they tested positive? These are some of the questions that need to be answered, ”he said.
It should be noted that due to the public interest litigation filed by TARATDAC, all inmates at the Institute of Mental Health (IMH), the state’s only state hospital treating the mentally ill, were tested for Covid last July.
There are different challenges when vaccinating mentally ill people at home, says Namburajan.
“The first requirement for vaccination is proof of identity. In most districts of the country, the Disability Office has not issued certificates for the mentally handicapped. It is therefore feared that many mentally ill people at home would miss the vaccination campaign, ”he said.
Dr. Kishore, director of Banyan, an NGO, said vaccinating the mentally ill is only part of the overall treatment process. “The first concern to be resolved is: Where will the rescued mentally ill be housed? They must be administered twice within three months. So what are you going to do until then? There should be meaningful engagement. They need to be provided with food and work. It needs the cooperation of different departments like police, urban development and others, ”he said.
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It is not possible for mentally ill people who are house-bound to identify them and bring them into the vaccination campaign unless the state government conducts a house-to-house survey. The nominated representative of the mentally ill should also be informed about vaccinations, said Kishore.
“Vaccination already available”
A state psychiatrist from the Pudukkottai district says that, like other patients, the Covid vaccination for the mentally ill is underway.
“The IMH has already been vaccinated. Likewise, in other parts of the state, vaccinations are administered to patients in institutional care through the district psychiatric departments. But such a drive has not been published much. So there is a general perception that the mentally ill are excluded from the vaccination campaign, ”he said.
However, there is a problem in the case of the mentally ill who are home confined, he said.
“The case of vaccinating the disabled is different. If a person has a physical disability, no one will take care of the person. But mentally ill people are also stigmatized. Just because you’ve home tied the mentally ill person simply doesn’t mean you can vaccinate them. This is a rights-based problem. So it should be treated with some sensitivity, ”he said.
Another government doctor from the Chengalpattu district said, on condition of anonymity, that in the first wave of the pandemic, no one cared for the migratory sick.
“Now the court has ordered her to be vaccinated. Although it looks good at first, a proper test could be done before they are vaccinated. Doctors need to assess what kind of mental health problems they have, whether they also have physical problems. Doctors should know if they have the authority to make decisions, ”he said.
State Health Minister J Radhakrishnan said they will take action after consulting the Commission for Differently Abled.
“We cannot say that we will not follow the court orders. But it would take time. After we have received data and other details from the Disability Commission, we will support them in any way we can, ”he said.
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