Asylum by Daman Singh: A Book About Something We Don’t Want to Talk About — Mental Health

When Sushant Singh Rajput committed suicide, I thought, at last, we have a case where society will break its taboo and take on and discuss the issue of widespread mental health issues.

Having suffered a phase of panic attack around a decade back, which got treated with appropriate medical advice and continued medication, I know how this may afflict anytime, without any apparent reasons, make life so difficult, and how one can get almost miraculous remission by opening up and seeking help.

But the SSR case was not to be. Even after setting aside the obvious political manipulations, there was a large number of common people who just could not accept that a good-looking, articulate, successful actor could even suffer from mental health issues.

So, they looked for evidence of foul play, which of course was played on by the media looking for TRP. Overnight murder mysteries were concocted, villains were found, dubious witnesses were produced, and the saga went on for months (and continuing despite all evidence, including AIIMS findings and CBI investigations).

However, the saddest of all was the lies spread by the family of Sushant so that they could hold on to his legacy, wealth, or specifically for her modeling aspirant sister — boost her career. The facts that he was diagnosed with mental health issues and was on medication were hidden (including that the family members changed those on their own with fake certificates). All of them, including their father, joined the lynch brigade to bury the truth and stigmatize an innocent lady just to perpetuate a myth.

So, we missed another opportunity to talk about a very serious social and medical issue. Under the garb of the myth that a strong, young, rich, “Bihar ka beta” is beyond all such afflictions.

But the truth is different. By all estimates, about 14% of Indians are suffering from some mental problem or other. This may be minor afflictions like thyroid imbalance and corresponding mood disorders, panic attacks, frustration, depression, all the way to clinical depression.

If one of us breaks our hands, we go to the doctor and have a plaster. But if we have a break in our minds, most of us hide it and try to manage it ourselves.

Society does not help. As we have seen in the case of SSR, mental health is seen at best as a misfortune or at worst an affliction that needs to be treated with the occult to get rid of the “evil spirits”.

Even for the few who come out, most times they face ridicule or ridiculous advice from around them (“let’s catch and all will be good”).

In my experience, relationships and mental health are areas where every one of us feels native expertise, feels the need to contribute, and all wade in with their ill-informed suggestions. Which only worsens the situation, albeit despite good intentions.

Studies over the years have shown beyond any confusion, the only way to handle mental health issues, especially after the condition becomes somewhat consistent, is to seek professional medical care.

But even if one wants to get help, where can one go? How well are we equipped to do that? How many hospitals, care providers, professionals, psychiatrists, psychologists, and beds are available? What are the medical protocols? What are the rights of the individuals concerned? What are the laws? And how have all these evolved?

I came across a fascinating book on the history of mental health treatment in India, almost by accident. A gift for being one of the winners of the weekly India Facts Quiz, it is written by Daman Singh, Asylum traces the status of how this treatment has evolved from the British colony till today.

Anyone who is a health history buff, or cares for the people at the margins of society, can take up the book. At 148 pages it is an easy read. And many things are worth mentioning.

Of course, there is no surprise that India has one of the most progressive legislation in the world and one of the worst facilities even among its peer countries. With only forty-seven dedicated government mental health hospitals, 18,307 dedicated beds, one health professional for every fifty thousand of the population, and peanuts as budgets for both research and well-being, we have not focused on this area both as a society as well the government. This is for sure a centuries-old tragedy and will surely continue in the foreseeable future.

But there is hope. And this book also speaks of many such sparks. As to how, beginning in the ’80s, the role of the media and social activists played in bringing in the changes. How the push from the global community, especially the UN, made us at least adopt progressive laws.

How years of British and Indian alienists (an archaic term meaning a psychiatrist who assesses the competence of a defendant in a law court) worked through decades of resistance and non-cooperation by the powers that be, to bring in some betterment in the lives of one suffering.

The book narrates several cases where courts got involved, including some Supreme Court and High Court judges making personal visits to the facilities, and taking over administrations, at times for years, to make things better.

Many stories are amusing as well as tragic. For in Assam how a bunch of applications with the same content and handwriting was used by families in connivance with the authorities to pack perfectly fit people into the mental health asylums, and how the government released half of them in one morning as Supreme Court-appointed Advocate Gopal Subramanium visited the state for an audit.

Or how West Bengal had led in keeping hundreds of patients in jail instead of healthcare facilities using loopholes of law, and at times through flagrant violations of the same.

But most touching is the individual cases, which will give a glimpse of the epic human tragedies. Of people who have recovered but have nowhere to go, or who spent decades as no doctor looked at them for assessments, or families who refuse to take back their members, or a story of an influential government servant from Odisha who ensured letter concocted letters from various government departments to be sent to hospital, professing serious illness of his interned son, so that he can’t come back even after recovery.

Overall this book is an eye-opener to tell stories of sorrow but also hope, of extraordinary heroes among common people, of the colossal failure of the legislature (curiously many in the early years of the independence introduced bills suggesting proposing castration of the mental health patients to stop their procreation), of the role of bureaucracy which is at best execution of orders than any empathy, the aggressive media and courts which played the roles of change agents (including an unlikely hero — M J Akbar), of development of this space in England Europe but the lag in the colony, of various treatments, roles, legislations, laws.

And of course, it nudges all of us to look at mental health as yet another treatable area in case of challenges, not to fall for the stigmas, and own it up to look for remissions — which is possible in most cases.

And that, I think, will be the enduring contribution of the book for a nation that is just waking up to gargantuan reality in a stupor.

PS: Daman Singh is the daughter of Dr. Manmohan Singh. I did not know that, and it does not make a difference for the book. Nevertheless thanks to Dr. Singh and Ms. Gursharan Kaur for bringing up such a perceptive person, who can take up an arcane topic, and write with such compassion.

https://www.amazon.in/Asylum-Battle-Mental-Healthcare-India/dp/9390679680