Karnataka's mental health hospitals see second most re-admissions: Survey

Re-admissions to the state’s mental health hospitals among long-stay patients was found to be the second highest in the country with Karnataka having a re-admission rate of 49.3%, at the National Institute of Mental Health and Neurosciences (Nimhans) and Dimhans, Dharwad, only behind strife-torn Jammu & Kashmir (61.1%), according to a survey report.

All the 43 government-run mental health hospitals in the country were studied for the survey. The rate of readmission in the state is higher than the national average, which is less than 15%. This is probably because it is the country’s largest tertiary mental health hospital and patients from different states get treated here. Interestingly, Nimhans was also part of the task force which did the pan-India study.

After studying patients who have been in the facility for more than one year, Hans Foundation along with a task force comprising members from the Ministry of Health and Family Welfare, Ministry of Social Justice and Empowerment, Nimhans, Tata Institute of Social Sciences and other civil society organisations rolled out a ‘National Strategy for Inclusive and Community-Based Living for Persons with Mental Health Issues’.

A total of 4,935 people were identified with one or more years of stay in state mental hospitals across 24 states. In Karnataka, out of the 570 surveyed, 69 were long-stay patients.

So, 12.10% had stayed for more than a year.

In Karnataka, more women than men have been confined in state mental health hospitals.

Among the 69, 28 were men and 41 were women. So, around 60% were women. Around 45% of the patients were admitted by their own families, 16% by police and 31% by others.

Also, a very minuscule percentage of patients have occupied open wards (1.4%). Around 98.6% of patients are occupying closed wards.

At 44.9%, Karnataka is among the three states with more than 40% of long-stay users classified with severe disability, again probably because of the presence of the country’s largest tertiary mental health hospital in the state.

With respect to the best possible placement for long-stay patients, 18.8% were recommended for placements in nursing homes or to continue at the hospital. Dr B N Gangadhar, director, Nimhans, was in Africa at the time of writing this report and unavailable for comment when DH reached out to him.

Information for the study was collected over a period of seven months from August 2018 to February 2019.

Reintegrating patients

Dr T Sivakumar, Additional Professor, Psychiatric Rehabilitation services, Department of Psychiatry, Nimhans, one of the investigators in the study, told DH that the high rate of readmissions should be seen as a sign of the hospital's effort to reintegrate its patients with its community. "Had the hospital not admitted patients when they see a relapse or when their families reject them in cases of severe disability, the rate of readmission wouldn't be high in both Nimhans and Dimhans," said Sivakumar.