Chronic Mental Illness and Dumping Patients: A Concern towards Management

Chronic Mental Illness and Dumping Patients: A Concern towards Management

Jyoti Mishra Pandey (RINPAS, India), Preeti Mishra (Sri Mahant Indiresh Medical College, India), Shobit Garg (Sri Mahant Indiresh Medical College and Hospital, India) and Bholeshwar Parshad Mshra (DMC Ludhiana, India)
DOI: 10.4018/978-1-5225-0519-8.ch003


Patients with mental illness don't take care of themselves, are dependent not only for medicine intake but also for their day to day requirements including their personal hygiene. All these issues and many more put a heavy psychological burden on the families. When they become overburdened with these responsibilities and problems they find it easy to dump patients in the mental institutes. There are very few mental health institutes in India but the number of patients with chronic mental illness is very high. The common problems are poor social environment, hostile family environment, unaffordable prices of medicines Few efforts like proper psycho-education, frequent phonic follow-ups from the professionals, proper guidance, family therapy, supportive psychotherapy etc. can be done. The government should also take some steps to manage the chronically ill patients like following strict rules to avoid dumping patients in the mental health institutes. Proper vocational training and job perspective should be planned for these populations so that they can be less dependent on their families.
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The mentally ill people frighten and embarrass us...and so we marginalize the people who most need our acceptance. What mental health needs is more love, more affection and more unashamed conversation. (Anonymous)

Any kind of illness whether medical or psychological puts a lot of stress not only on the patient but also on people living with them like their families and care takers. Situation becomes all the more different and difficult when it comes to any psychiatric illness. The attitude and behaviour changes not only of the families and caretakers of the patient but also of the society towards them. It is known that a human is a social animal and without society it is difficult to survive. Therefore, any deviation from the social norms and standard is either changed or excluded from the society. Mental illness is one of those major social stigmas which have excluded many families of the persons who are suffering from mental illness from the society. Not only the social stigma but other social issues like economical condition, disturbed family environment, and chronicity of illness are the major issues which give rise to a very serious situation called “dumping”. Dumping patients in the mental institutes has become a very serious issue of our society. It has become a very easy way out for those families and caretakers who take these chronically ill mental patients as burden and because of this the institutions are becoming overloaded with dumped patients. Who is at fault for these dumping; the family or the society? The question is why this is happening? Why families or care takers are running away from their responsibilities? What problems are the caretakers facing with the chronically ill mental patients? Is it avoidable? What step or change is required to stop these patients dumping? The focus of the current topic would be to understand the seriousness of dumping and those factors that are leading to this dumping and what can be done to avoid this situation.



Mental health is psychological well-being of a person. There is no fixed definition of mental illness. As defined by WHO, “health is state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2006). At its Sixty-fifth session, held in May 2012, the World Health Assembly adopted a resolution calling on WHO to develop, in consultation with Member States, a comprehensive action plan that actively addresses not only the need for early identification and appropriate care for persons with mental disorders, but also assesses vulnerabilities and risks as a basis for developing the mental health plan (WHO, 2012). Chronicity of mental illness is very prolonged and severe in nature. It involves severe psychotic disorders like schizophrenia, mood disorders like mania and depression and other behavioural disorders etc. Prevalence of mental disorders as per World Health Report, 2001 is around 10% and it is predicted that burden of disorders is likely to increase by 15% by 2020 (Indian Council of Medical Research [ICMR], 2005). A study showed that about one in four United States [U.S.] adults (26.2%) age 18 and older, in any given year, has a mental disorder (e.g., mood disorder, anxiety disorder, impulse control disorder, or substance abuse disorder) (Kessler, Chiu, Demler., & Walters, 2005), meaning that mental disorders are common and can affect anyone. Many adults with common chronic medical conditions such as arthritis, cancer, diabetes, heart disease experience concurrent depression and anxiety—further complicating self-management of these disorders and adversely affecting quality of life (Chapman, Perry., & Strine, 2005; El-Gabalawy, Cox, Clara., & Mackenzie, 2010; IOM, 2012). In another study it was seen that the police officers frequently encounter people with mental illness—approximately 5 percent of U.S. residents have a serious mental illness, and 10 to 15 percent of jailed people have severe mental illness (Lamb, Weinberger., & Gross, 2004). The Lincoln (Nebraska) Police Department found that it handled over 1,500 mental health investigation cases in 2002, and that it spent more time on these cases than on injury traffic accidents, burglaries, or felony assaults (Lincoln Police Department, 2004). The New York City Police Department responds to about 150,000 “emotionally disturbed persons” calls per year (Waldman, 2004).

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