MY LIFE INSPIRATORS SERIES-1- ARUN

Time Line 2018. Venue Regional Mental Hospital (RMH) , known as Pagalkhana to Nagpur residents . The roundabout abutting RMH is officially known as Pagalkhana Chowk.

It is in the long stay ward of this asylum that on a sultry summer day I met Arun and soon he would turn my life inspirator.

Arun is not the original name of Arun. None at Regional Mental Hospital Nagpur where Arun was a long stay inmate knew what his real name was and from where he had landed in what circumstances in the asylum. Even his medical records provide no clue..

I decided to did into his personal file maintained at the asylum and found the following scribbled in ineligible hand writing-

" 'Unnamed male patient' brought in the hospital by the magistrate reception order. He was violent when he was picked up from the Nagpur road in inebriated psychotic conditions . Diagnosis- 'Psychosis- NOS' "

[ As per American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, psychosis NOS is part of USS & OPD (Unspecified Schizophrenia Spectrum and Other Psychotic Disorder) - a residual diagnosis given to individuals who are experiencing symptoms of schizophrenia or other psychotic symptoms, but do not meet the full diagnostic criteria for schizophrenia or another more specific psychotic disorder. It is ironic that when the Udaan Program computerized the full personal records of inmates there came the damning surprise that a disproportionately large number of inmates were labelled with this residual diagnosis.]

And with 'Psychosis-Nos' diagnosis Arun was condemned to the life imprisonment as a long-stay patient in the Nagpur Mental Asylum.

Why I Call Mental Hospitals Asylums

My personal predilection in all my previous writings on Mental Hospitals in India or my thematic presentations on the subject has been to use the name 'Asylum' (the name pricks conscience of many) instead of ' Mental Hospitals' colloquially and collectively called Pagalkhana in India.

And I find it truly gratifying that this is what in her most recent book 'Asylum- the Battle for Mental Health Care of India', (Westland Non-Fiction, 2021) the author Daman Singh ( daughter of former Prime Minister Manmohan Singh and Gursharan Kaur) has dubbed 'Asylum/ collectively describes 31 government mental hospitals in India.

It is instructive to note that the name 'Lunatic Asylums' in India was officially changed to Mental Hospitals in 1920 due to spirited campaign of Lieutenant Colonel Owen Berkeley Hill (along with others) a psychiatrist in British Army who became the Medical Superintend of European Lunatic Asylum at Ranchi ( Now known as Central institute of Psychiatry, Ranchi). However the change of name did not change the life of inmates- for them asylum is mental hospital and mental hospital is asylums.

MY TRYST WITH ASYLUMS

How did I meet Arun at Nagpur Mental Asylum. Most probable answer is I was an inmate there. That is not the case.

Though I was intrigued with CIP and RINPAS two reputed asylums at Kanke Ranch since adolescence, my real tryst with asylums began in Circa 2011, when my friend, philosopher and guide Late Keshav Desiraju [Cambridge and Harvard Kenney School alumni, an I.A.S Officer of 1978 batch and [a grand son of Dr Sarvepalli Radhakrishnan, India's second President] put me on the high pedestal by appointing me to eleven member Government of India Mental Health Policy Group.

This new status gave me the license to get first hand tutorial on the state of being of asylums in the country.

HOW I LANDED AT NAGPUR ASYLUM

By the time destiny brought me to RMH Nagpur, I had spent time in dozen of asylums of the country- NIMHANS, CIP, RINPAS, IHBAS, Agra, Tejpur, Ratnagiri and Pune included. What I had seen during a day/ two days visits was not which pleased my eyes even though these visits were largely conducted tours. Situation was bad and was deteriorating in asylums by day- NIMHANS, Bangalore and CIP , Kanke, Ranchi were probably the only two outliners to this which were some what better placed

Having visited above asylums which I call- good, bad and ugly', I had made up my mind to start making some difference to the life of inmates however tiny my contribution would have been.. And the opportunity knocked out of no where in early 2018, when Tasneem Raja, then Lead Mental Health of Tata Trust invited me to come to Nagpur on regular visits, at least once a month for minimum two days and guide the Udaan team on financial inclusion of inmates in the Nagpur asylum.

Thus I started on my uncharted journey to work as Mentor-Consultant of "Udaan Program of Tata Trusts"- a program which aimed to convert Regional Mental Hospital (RMH), Nagpur into a Centre of Excellence.

DISCOVERING ARUN

It was during those monthly that I got existential entry into the sanctum-sanctorum of an Indian asylum first-hand for the first time on a long term basis. Now from vicarious learning it was real learning with true immersion into the lives of men and women confined within the high walls of the asylum- many of them were there in the asylums just because their kin did not leave a forwarding address,

Financial inclusion of inmates was one of the cherished dreams of Udaan Program as a path-way for emancipation of inmates through work ( I call it Work Therapy in place of much maligned Occupational Therapy). Among many other interventions, an idea hit me suddenly which I discussed with Tasneem instantly-why not employ couple of inmates in the Udaan office of Tata Trust as office boys.

Tasneem got charged to the idea and the onus to find suitable inmates fell on me.

On a hot splintering summer Nagpur day, I armed with couple of Udaan Team members landed at the long-stay male ward of the asylum to select the right candidate, I scanned hospital records of ten long-stay inmates and shortlisted four.

But there was a problem.

To ensure that the effort paid off , we wanted to start with one- 'making an inmate part of the team was a tricky affair'. I decided to have an hour long personal interview with all the four shortlisted and finally zeroed down on Arun.

To cut the long story short, Arun was deaf and dumb and illiterate and during hour long interaction we talked through the sign language. The spark in the eyes of this special inmate told me, he is the one I was looking for.

As Arun was name-less and faceless, I gave him a name Veer. Deaf and dumb, occasionally violent with the diagnosis of Psychosis-NOS, the gun was loaded against Veer but from somewhere inside me came the voice- if Veer can be emancipated then any inmate can be.

And me and Tasneem decided to take the plunge and try him out

Tasneem put Veer as a office boy in the Udaan office with the original intent of using him as a helper for serving tea. He was given a new identity- Udaan made him fly with a new name Arun. His mental hospital dirty clothes were were dispensed with and he was given brand new Udaan dress. Arun's lunch would come in a lunch box from the asylum canteen and he would take lunch with Udaan team.

While all other inmates of asylum were locked inside their wards for 20-22 hours a day, Arun was a free bird during day and when he went to sleep inside the ward in the night he longed for the sun rise which gave him the opportunity to get back to office among humanity.

Soon Arun turned darling of Udaan team, He was now part of Udaan by day even though an inmate by the night. Also there was occupational change as well he was no longer merely a water and tea boy in Udaan office, sooner he became the most critical link between asylum and the Udaan office.

When The Banyan celebrated its Silver Jubilee on July 21st 2018 at the Sheraton Grand Resort & Spa. Chennai, during my talk I narrated the story of emancipation of Arun alias Veer in the presence of august gathering, and could see the eyes of participating Udaan team members and doctors from RMH Nagpur filled with pride

TIME MOVES ON

Time moved fast. I moved out of Udaan Program. Arun who was deaf, dumb and illiterate moved up the value chain. Tasneem and Pravin inform me, Arun was rehabilitated outside mental hospital by the Udaan Team. Today he is leading a fruitful community life in freedom and earning Rupees ten thousand per month working in a Nagpur based NGO thanks to the efforts of Tata Trust Udaan team.

I call Arun my inspirator because his condition was hopeless. The asylum had condemned him for life. There was no future for him except remain incarcerated in the asylum for the rest of life.

God and Udaan program gave him half chance- Arun clasped it with both hands to transform his life- his smiling face make us say, who says even if condemned to live and die in mental hospital one can not rise above the obvious and be a real life hero and inspirator for the world.

This piece salutes the tenacity and resilience of Arun. Arun gave Arun a new name and identity and more important choice to exit the asylum be swalambi and motivate others =accursed with severe mental illness and condemned in a mental hospital for life is not the end of the road,

There is a pathway to the life, even if it is a road untraveled

Author is a past Member of Government of India Mental Health Policy Group (2011-2014) and non-official Member of Central Mental Health Authority (2019-2021). Author worked as Mentor Advisor to Udaan Program of Tata Trust in 2018 to change Regional Mental Hospital Nagpur in a centre of excellence. Though the author got the opportunity to work with Arun while working with Udaan Program of Tata Trust, the views here are strictly personal. The author can be reached on his email id akhileshwarsahay@gmail.com and can be followed on his twitter handle @akhileshlinky