Persons with Psychosocial Disorders (PPDs) are some of the most marginalised people in our society. As in any other developing country, PPDs in Bangladesh face negligent treatment, deprivation, and abuse in every sphere of their lives. They are neglected when it comes to care, treatment, and cleanliness even within their families.
They are confined to their homes and are deprived of their basic needs. Awareness of mental illness and the acceptance of treatment are very low due to the social stigma. There is superstition due to the lack of education. Many believe that mental illness is not a disease. Rather, they believe it to be a result of sin, or the effect of a bad soul.
When people become mentally ill and engage in abnormal behaviour, they are first taken to the village quack or some religious leaders for treatment. Poor families cannot afford to bear the cost of their treatment, because there is hardly any proper treatment facility at the district level for such illnesses. They are forced to accept “traditional” treatment.
The study (in June 2011) by the National Institute of Mental Health shows that around 16.1% of Bangladesh’s adult population is suffering from some form of mental health disorder, while one-fourth of the children in Bangladesh are suffering from some form of mental health problem.
The report revealed that children growing up in rural areas were more prone to mental health problems than their urban counterparts. Political instability, violence, poverty, vulnerability to natural disasters, and psychiatric morbidity were the causes of mental illness in Bangladesh.
Research on 365 mentally ill subjects conducted in Rajshahi, Kustia, Natore and Sirajgonj found that medicine for mental illnesses were not available in those areas. Furthermore, no qualified doctors were found in those areas except in Rajshahi. Among those mentally ill people, 58% had schizophrenia, 18% suffered from epilepsy, 10% were bipoplar, 6% suffered from depression, 2% experienced anxiety, 1% had OCD.
Some mentally ill persons and their guardians shared their experiences of the situation of PPDs at the rural level.
Sofura of Godagari upazila of Rajshahi district had a vision to build her career as a teacher like her father. She appeared for her HSC examination, but secured only second division. That seriously affected her and she became depressed. Sofura wanted to gain admission in mathematics, but she did not have the required grades.
She studied biology instead. She was under intense pressure and could not handle her course load, and finally failed in her honours examination. This incident again threw her into depression. She would always be in an angry mood and speak rudely. She started exhibiting abnormal behaviour.
When she returned home, her father took her to the village quack, and her condition did not improve. Finally, she got admitted to Pabna mental hospital. There, her condition improved somewhat. But due to lack of money, her father could not continue her treatment there. Sofura was sent back from Pabna and has been living a life of neglect since then.
Shahidul Islam, resident of Sadar upazila of Natore district, worked as a day labourer cultivating sugarcane. One day, he loaded the heavy sugarcane onto his head. The load was too much, and he fell. After experiencing pain in his head, he started exhibiting abnormal behaviour.
Superstitious villagers said that it was the effect of an evil spirit. Village quacks tried to free him from the “ghost”. Shahidul’s behaviour got worse day by day, as he broke things and assaulted people. His family chained him down to control his outbursts.
He was admitted to Pabna mental hospital. After receiving treatment, his condition improved. Due to financial problems, his family did not continue his treatment. His condition deteriorated, and he reverted back to his previous state. When his mood was bad, his family fed him once a day and bathed him weekly, sometimes monthly. People avoided going close to him.
Mental illnesses do not get enough attention in Bangladesh. There are a limited number of beds in government hospitals for mental disorders and mentally ill patients. There are not enough psychiatrists either. The government and NGOs should come forward to promote this issue.
Governments should take this issue seriously. There should be an allocation for health care in the national budget, and policy to ensure mental health treatment facilities in all regions. Pharmaceutical companies should confirm the medicine for the treatment of PPDs, and make sure they reach remote areas. Above all, awareness should be increased all over.
