People living with schizophrenia can also lead a 'normal' life
False assumptions lead to discrimination, exclusion and infringement of the rights of people living with mental illnesses.
Ramit is a 36-years-old male, and he works at the billing counter of an art gallery. He has been working here for six years and loves his work, as he is surrounded by art. After office hours, he teaches martial arts to kids. This not only allows him to pursue his interest in martial arts but helps him earn extra money.
Ramit was diagnosed as suffering from schizophrenia at the age of 21 when he was pursuing a professional degree, which he could never complete. Now, he lives with his parents and has a few friends whom he met through his psychiatrist and they share experiences similar to Ramit.
To you or me, Ramit looks like a person living an ordinary life who likes to do the work that he enjoys and likes the company of people that can understand him. And he isn't alone, many people living with schizophrenia have a similar story to share.
When we think of schizophrenia, often the images that we conjure are based on the depiction of severe mental illnesses in mass media (that has shaped the way people think about mental illness since centuries), or our limited interactions with people who are living with severe mental disorders. And this has led to several misconceptions regarding the disorder that hampers a good, healthy life for people living with it.
The first misconception among the general populace is that people with schizophrenia are violent. This widespread assumption that people with schizophrenia are dangerous, or will cause harm, deprives them of their autonomy. Anger (that often results from a feeling of helplessness) and non-conformity (another characteristic of the disease) are often misinterpreted as dangerous behaviours, and often people with schizophrenia get incarcerated either in mental asylums or at homes in the most inhumane conditions. This assumption of people with schizophrenia being dangerous is so strong that it overrides all data that has proven that persons with the disease are no more likely to be dangerous than anyone else in the society.
The second widespread misconception is that a person living with severe mental illness cannot be productive. Not only is this belief without fact or truth, I can say from various personal experiences that people living with schizophrenia are quite capable to work and hold on to their jobs for a long duration. Unfortunately, there is no data to support this, as most people living with the disease and employed gainfully often do not want to disclose the status of their mental health for the fear of losing their jobs.
These false assumptions lead to discrimination, exclusion and infringement of the rights of people living with mental illnesses. The process of exclusion starts with the denial of the right of the patient to be informed and involved in their treatment process, and it slowly progresses to a patient's exclusion from decision-making in family matters, financial matters and legal matters.
The way ahead
The effective treatment of any illness is a function of the larger health system. In India, we require strong public health interventions so that a person living with schizophrenia can live a life of dignity. This can be achieved through a strong campaign to fight the assumptions of incapacity and dangerousness as the clinical model of illness has supported these assumptions and the media has reinforced them for years. We need to adopt a public health model because a person with schizophrenia is a person first, and lives with the same problems of daily life as any "normal" person. We also need measures to uphold the civil rights of people with the disease.
People with schizophrenia must be included in the employment guarantee schemes and provided treatment nearest to their homes. The new mental health policy of the country provides a hope as it emphasises on the rights of people with mental illness and is sensitive to the social impacts of mental illness.
Moreover, we need to start talking about schizophrenia in public discourse. Sadly, there is no family celebration when Ramit manages to finish his degree in management while living with symptoms and the news of a boy chained in his room is forgotten too soon. We need to start talking about schizophrenia because many mental health facilities in India still have patients who have been staying there for years waiting for their families to return. We need to talk about schizophrenia so that we can develop new models that go beyond just dispersion of drugs. Clinical interventions can help in the abatement of the symptoms, but to reclaim precious lives, we need to move to the area not claimed by drugs.
Last week, the Fourth Global Mental Health Summit was held in Mumbai themed "Nothing about us, without us" and its aim was to bring to the forefront voices of individuals from marginalised backgrounds; those who are rarely represented in discussions related to the mental health agenda. The summit truly celebrated the sense of survival and resilience of people with severe and enduring mental disorders. In spite of the reality that a large chunk of society misunderstands and ignores the reality of illness, the summit highlighted the innovations happening in the field of mental health, by those who are passionate about mental health and who are trying to listen to people and make things simpler and closer to real life.