Disability in a Group of Long-stay Patients with Schizophrenia: Experience from a Mental Hospital

BACKGROUND: Recovery from schizophrenia is a complex concept. Remission of symptoms of psychotic illnesses is not necessarily linked to better functioning. Among various causes of disability, mental illnesses account for 12.3% of the global burden of diseases. Long-term hospitalization has been recognized as counterproductive and a contributory factor of disability associated with schizophrenia. Under various circumstances, many persons with mental illness are brought to mental hospitals but the measures taken for their rehabilitation and follow-up care is insufficient. AIM: In the present study we tried to find out the level of psychopathology and the associated disability in a group of patients with schizophrenia who have been staying in a mental health institution for more than 5 years due to lack of proper caregivers in the society or in their home. MATERIALS AND METHODS: The study is conducted in a mental hospital of northeast India. Of the 40 patients staying for more than 5 years in the hospital, 28 fulfilled the criteria for inclusion. The Brief Psychiatric Rating Scale and World Health Organization Disability Assessment Schedule II (WHO DASII) were used for those patients. Analytical statistical methods were used subsequently. RESULTS: Male patients were significantly older and had prolonged duration of stay. But the level of psychopathology did not differ significantly between male and female patients. Under WHODASII, understanding and communication problems are more prominent in both the groups. Of late, there are very few cases that required prolonged stay in the hospital. Many patients are fairly functional and are considered suitable for care outside hospital premises. CONCLUSION: Prolonged hospital stay is associated with more disability. Shorter hospital stays with proper family support is an ideal way to counteract this issue. However, due to the inadequate mandate in the Mental Health Act (MHA) 1987 and lack of other supportive facilities, patientsoften tend to languish in the hospital for longer duration, causing harm to the patients and draining scarce state resources. It is therefore necessary to revisit the MHA 1987 and provide adequate rehabilitative measures for the needy patients.