“Ravi is 44 years old
married man who works as an Architect. He complains of severe chest pain. On
the basis of ECG done in the hospital, doctor has advised him for angiography.
He has a family history of cardiac problems. With obesity, hypertension and diabetes,
his risk of cardiac diseases has increased. But he refuses treatment given by
doctors and demands discharge since he believes his state could be solved by
naturopathy and yoga”
Do you think Ravi
should be allowed to be discharged?
The answer to this
seems very obvious that ‘yes, he would be allowed because treatment requires
his consent! He could be counseled on the criticality of the situation and
importance of medical treatment but at the end it’s Ravi’s choice to go for
treatment or not. Even by the legal system, he can’t be coerced for the
treatment.
In the second scenario,
Ravi is coming with numerous business plans, and has applied for Bank loans
too. He is being stressed for a while, seeing that his partner has taken cheque
books from him and has informed Bank to not clear any cheque. His wife has
taken away his car keys and stopped him from driving. Ravi has a medical
history of Bipolar Affective disorder.
Do you think Ravi has consent
or any say in this situation?
Difficult and conflicting
to answer! This is how 6 day long ‘Sexuality and Mental Health Institute’
organized by Anjali – mental health right organization which works towards
ending stigma, violence and discrimination associated with mental health began
in Kolkata.
The first session ‘Mental
Health and Rights’ was conducted by Ketki Ranade, Chair of Centre for Health
& Mental Health at TISS where in the concept of ‘unsoundness of mind’ was
explored, questioned, discussed and challenged at length through various
examples.
“Why do we have laws
around mental health for so many years but not for diseases like diabetes or
any other? Are these laws enabling?” – Ketki Ranade
Talking about legal
system, ‘unsoundness of mind’ can be a criteria for dissolution of marriage,
custody of child, divorce, voting, holding of public or government office,
decision making, legal capacity, inheritance, contract etc. Whenever a person
is diagnosed with mental illness, every action by them is seen as the symptoms,
their daily routine is scrutinized; even after recovery their actions are seen
as relapse of medical history thereby reducing the person to technical
terminology. One of the crucial aspects that come up while having conversations
about mental illness – plethora of discussion over psychiatric treatment or gap
in terms of ratio of number of patients to number of doctors available, there
is mention of management of the illness rather than focusing on ‘healing’ but
no one dares to venture into challenges or lacks of rights a person with mental
illness encounters.
‘It’s not just a
socio-psychological issue but also political’
A quick walkthrough
into 2 popular systems for classifying mental disorders- Diagnostic and
Statistical Manual of Mental Disorders (DCM-5 by American Psychiatric
Association) and International classification of Diseases (ICD-10 by WHO) was
explained. Few interesting points
questioning the psychiatry department in order to understand the objectivity of
the diagnosis like there are no bio
markers for example thermometer or blood tests for determination unlike any
other diseases, secondly all these are professional ideas of diagnosis clearly
pointing out at their belief systems, context, what kind of questions are asked
and kind of language that is used for diagnosis!
In one of the activity,
the participants were provided with real life narrative of Mary who had mental
health condition – she had written a blog about the thoughts that she had
scribbled time to time during her treatment and comments of psychiatrist on the
very same days. This activity was extremely overwhelming and difficult in terms
of processing the importance and impact the treatment was that was given to
her. Few observations that I gathered from this activity were: there was distinct hierarchy of knowledge, it
was not about her being healed or treated instead it was more about how Mary
can be made fit for the society, idea of recovery was different for both Mary
and the doctor, it was this undemocratic setting that made her more stressed,
Mary’s thoughts were vivid and more articulate whereas the language used by
doctor was dry, cut off, attempting to be neutral but sounded judgmental, her
experiences, movements and the conversations had been reduced to technical
statements (symptoms), clear contradiction to authentic listening – it was like
voice of people with mental illness are totally unheard in the expert domain,
they didn’t explore creative way of treatment – it was always about medicine
while they could have just let Mary use her writing to express herself.
It was interesting to
see how the doctor thought that Mary had a choice to act but she chose to be over dramatic – leading to various questions like can people with mental illness
speak their minds? Can these experiences be considered as valid knowledge?,
where do we move with this knowledge ?
Chayanika Shah
deconstructed the understanding of sex, gender and sexuality elaborately by
indulging into what is Natural /Normal? The majoritarian view or the assumption
that most of the people are alike in certain way then that is considered as
normal. For example – most of us fit into gender binary, the ones who are
excluded or don’t fit in this system are studied in order to understand why are
they like this so that the idea of normal can be reinforced! Biology has taken
the normative understanding of nature. Through science, we are seeing normal as
natural because that belief further cements the concept of ‘normalcy’
For example: sex can be
male or female based on genitals and chromosomes is considered normative while
intersex comes under abnormal; same with gender where masculine or feminine is
normal while transgender is abnormal. The quest is you can either understand it
in terms of normal or abnormal or study in terms of diversity.
Reflecting on how things
progressed from ‘Biology is the destiny’ to ‘Biology is not the destiny’. According to feminists discourse – gender was
defined as a social construct which can be challenged or changed giving a sense
of liberation. During 1955, the term gender came up and it was said that ‘a
woman is made and not borne’. There was mention of psychologist John Money who
developed “optimum gender of rearing” system for treating intersex children.
They believed that gender was all about nurture—that you could make any child
into a “real” girl or boy if you made their bodies look right early (before
about 18 months of age), and made them and their parents believe the gender
assignment. There were lot of things that were wrong about this system - To
start with, lying to patients is unethical. Patients who were lied to figured
that much out, and often stopped getting medical care they needed to stay
healthy. The patient suffered psychological harm from these practices, because
they got the message that they were so freakish even their doctors could not
speak the truth of their bodies to them. Second, the system was and is
literally sexist: that is, it treats children thought to be girls differently than
children thought to be boys and many more.
This session constantly made us
question things that we have learnt through our lives, the things that are told
to us or mindsets around gender- why there is categorization based on the
genitals and why not on the basis of height, eye color etc.? Why puberty is
held important in the view of reproductive health? Why all the focus is on the
reproductive capacity? There are many ways to engage in sex but all emphasis
and importance is given to peno-vaginal sex even with respect to sex education
that is imparted. How much uncertainty are we ready to take in our life? There The
concept of self-determination was introduced which says that ‘deciding what
is my gender should be my choice’.
“Why don’t cis-men or women go
for self-determination? This question is for everyone and not just for people
who belong to non-normative. If you are following the given path/structures,
then you are not actually thinking about it- it is easier and acceptable
however in this way you are actually feeding the gender system. Say for example
if a person comes out to parents (they being decent) would still enquire and
try to understand why they are non-normative. Don’t you think this should be
applicable to all the children” - Chayanika Shah
The first day closed with an
intense and beautiful film based on real life narratives of two women Kajal and
Atishi with whom Anjali has been working over many years as part of their work
in mental hospitals in Kolkata.
On the basis of discussions on
first day of the institute, it was established that work on sex, gender and
sexuality works on the principles or values: self-determination (each individual
must decide for oneself), consent, bodily integrity, pleasure and autonomy. It
is highly recommended that the gender and sexuality discourse should now move
on these values.
Dr. Alok Sarin,
psychiatrist and mental health activist spoke in length about psychiatric gaze
with examples, research articles and history of ‘science and psychiatry’. I was
thrilled when he discussed about article ‘The removal of Pluto from the class
of planets and homosexuality from the class of psychiatric disorders: a
comparison’ by and
“The purpose of the
article is to draw comparisons between two different, yet surprisingly similar
controversies, namely, whether Pluto is a planet and whether homosexuality is a
psychiatric disorder. In our opinion a compelling argument can be made that
Pluto never should have been classified as a planet to begin with and that
homosexuality never should have been labeled a psychiatric disorder, and that
the decisions to re-classify them were correct.” –
Zachar and Kendle Philosophy, Ethics and humanities in Medicine, 7:4
According to him, the removal of
homosexuality from the class of psychiatric disorders is an event in which the
psychiatric gaze corrected itself.
Ratnaboli Ray, mental health activist and founder at Anjali divulged into various models of disability in her session ‘Psychosocial disability and Sexuality’. There was detailed discussion on the relevance of word ‘divayang’ and how using this word actually doesn’t support people with disability as it refers to divinity (given by god because of karma leading to more stigmatization) and this takes away the importance of their painful experiences. It is important to understand that there is more to the standard definition of impairment being the actual condition, while a disability is the restriction of ability caused by the condition. Without recognizing impairment, we can’t understand disability; the condition, interaction with family, society, ability to engage in daily chores decides disability.
She also
discussed the stereotypes associated with mental illness for example – Men with
disability are assumed to be hypersexual while women with disability are deemed
asexual; marriage is seen as one of the cure for mental illness, the set up in
mental hospital clearly assumes compulsory heterosexuality – there are separate
rooms for men and women, they just ignore that people can be attracted to same
gender while they live in the hospitals; in the whole discourse around mental
illness – there is simply no discussion about desires, fantasy, intimacy.
Dr. Soumitra Pathare,
psychiatrist and one of the chief architects of the Mental Healthcare Act, 2017
conducted the session that threw light on the important aspects of the act. I
really loved the way he initiated the session by saying that ‘it is
wasteful to focus energy on stigma, instead the focus should be on reducing
discrimination which would in turn eliminate stigmatization around mental
illness.’
The fine details and
emphasis on various definitions like Human rights- it is inherently
yours because of you being human, it can’t be given or taken away while
statutory rights are the ones that can be given or taken away from you; capacity:
can be task specific or time specific (you might have capacity today but not
tomorrow); informed consent; consent forms, advance directives and
others helped participants understand the act in an uncomplicated manner.
It is interesting to
note that unsoundness of mind is not defined in our law however there is
mention of ‘sound mind’ with examples (only law with examples) as per ‘The Indian Contract Act, 1872’
“A person is said to be of sound
mind for the purpose of making a contract, if, at the time when he makes it, he
is capable of understanding it and of forming a rational judgment as to its
effect upon his interests. Illustrations
a. A patient in a lunatic asylum,
who is, at intervals, of sound mind, may contract during those intervals.
b. A sane man, who is delirious from
fever, or who is so drunk that he cannot understand the terms of a contract, or
form a rational judgment as to its effect on his interests, cannot contract
whilst such delirium or drunkenness lasts.”
This act seems to be very hopeful,
but Mr. Pathare didn’t deny any loopholes in the same insisting on the fact
that once it is implemented, we will see how it unfolds.
The third day began with the session
'Asylum
to Custody', facilitated by Dr. Alok Sarin where he brought out the history of
mental health institutions from the 1857 Mutiny during which patients escaped
from a Delhi asylum to the present day context of custodialization within
mental hospitals. It was interesting to understand why mental asylum was
located next to jail and outside the city of Delhi during 1857, mention of
Ranchi mental hospital as there were two of them – one for Indian and another
for Europeans and discrimination in the hospital based on religion leading to
the question as to whether it is justified to let this discrimination go on or
to be sensitive to patient’s needs?
Dr. Aniruddha Deb,
psychiatrist and mental health expert, discussed the influence of language on
our identities and relationships by exploring as to what participants
understand by Identity and what is need for language? Citing a situation and
three reactions to the same situation, he asked participants to share what
could be the name, age, sex of the person and what that person must be wearing?
It was intriguing to
listen to pole opposite answers to the question; explaining how language and
identity are closely related.
Sharing an example - “Along
with me at NIMHANS, psychiatrist Zaki Mohammad (Muslim from Yemen) used to
work. He barely understood Hindi and English. One day a Muslim woman came for
consultation who was well conversed in Hyderabadi Urdu. For better
communication at hospital, a Bengali student was assigned to Dr. Zaki. Now you
can imagine how the conversation and translation would have gone by. While Dr.
Zaki took a break, this woman shared her doubts and judgments about Doctor to
the intern. She couldn’t understand that a Muslim man not being able to
understand her language and speak the same thereby questioning his authenticity
of being a true Muslim.”
Human beings can’t live
in isolation, they need acknowledgement; Language helps to represent world to us
and to others, also it is an expression of inner emotions. Since we have
multiple identities, language can create ‘us’ and ‘them’. It also changes power
dynamics at home and work. For example – There are 2 people who are working for
the same post, the one who is fluent and eloquent in communication would be
invited to social events, his/her chances of promotions are high while the
other one would be pushed to the background. Language helps us in building
friendships and relationships. We understand language not just with the words
but also with the tone, body language, facial expressions and everything else!
Another story shared by
Dr. Anniruddha that would stay with me was – “He is a regular customer at this
shop in his neighborhood for grocery shopping. This shop is not so big, has
three employees – one that handles computer for billing, another two help
customers to get whatever they want. One day, he saw a young boy standing
clueless at the corner in the same shop. Because of the rush and limited staff
capacity, the employee at the computer kept giving the other two employee
instructions. Unfortunately this boy didn’t understand the language so he was
not of much help, at the end when he was scolded he burst into tears. After
about 3 months, he goes back to the same shop- there he sees this boy who is
now proficient, more confident and easily gliding through the racks very well
managing the store. However, this time person at the computer is new and is
finding it difficult to code the items and bill them. The same boy guides him
through the step wise process making his learning and work easier” This example
actually made me reflect on how in daily life I use words, expressions and
gesture for communication – Do I use it in constructive way or in a way that it
is judgmental and offensive.
The session on
‘Language and sexuality” started with a group activity where the participants
were given three situations and were invited to discuss over it to stir the
discussion on language and sexuality
1. “Forcibly groped
and kissing” and “a very friendly relationship/borderline romance” These are
two versions/descriptions of the same sequence of events. What does this tell
about language?
Points discussed – The
first sentence says the situation is not consensual while the second statement
is ambiguous- not sure what is the relationship between the two people, there
is presumption of consent, gives the clear indication of sharing from #Metoo
movement. The context, the cultural dynamics, the intention or interpretations
need to be understood. Clearly it seems that the first statement is by a woman
and the second one is by a man reflecting upon the shackles of strong gendered
structures in which we are born and raised.
2. My pronoun is
they. This is ridiculous and ungrammatical. What makes both these statements
possible in the same time and space? What are the histories from where these
statements are coming?
Points discussed- This
may be seen as assertion of identity and second statement is more like a
reaction to something new. It may be voices in the same community – some people
might want to take up the pronoun and rest not wanting to adhere to the same. Another
interesting observation said that this indicate the place of change – that we
are growing, being progressive but still not reached the destination –
somewhere in between. We have a history of gender binary, and colonial baggage,
this isn’t known to many people, also there is force to preservation the
language and its purity. We inherit
language, it does what we want it to do, through this we are trying to change
the structure of language by using the existent structure employing the
flexibility of it.
Interestingly, Queer,
Trans and gender rights can also be seen illegitimate because they are unheard
of, not written or invisible that’s the reason why in queer pride or movements
the sentences like ‘we are here, we are queer’ used so that we acknowledge the
presence of non-binary people.
3. Situation from
Mary O’Hagan – ‘Two accounts of Mental Distress’. How do you understand
this piece in terms of language and communication?
Shals Mahajan writer
and queer rights activist discussed the kind of language used in gender and
sexuality discourse; we say violence against women – where is the next part –
by whom? A woman is raped – why not say that so and so raped the woman? There
is so much scrutiny on the language of the victim/survivors – they are always
at the receiving end for example why is she saying like this? But no one
questions perpetrator! Emphasizing on the need for changing the language used
while addressing gender issues, she mentioned the beauty of language – “there
is vividness, intimacy, power, and brilliance in language which goes because of
correctness of language. It is personal in nature.”
The
session smoothly transitioned into ‘Literature and Sexuality’ facilitated by
Paromita Chakrabarty. The session entrapped me with the beauty of words,
powerful pictures, poems and master piece of literature like Hamlet, Macbeth to
weave understanding on the gendered nature of madness in literature. She
brought out certain crucial points which emphasized how Hamlet’s madness was
deemed heroic, controlled and poetic as against Ophelia. Hamlet’s madness is fueled
by his father’s death and his desire to seek revenge on the man who killed him.
Ophelia’s madness stems from her lack of identity and her feelings of
helplessness regarding her own life. Ophelia was costumed in virginal white to
contrast with Hamlet's scholarly black, and in her mad scene she entered with
disheveled hair, singing bawdy songs, and giving away her flowers, symbolically
deflowering herself. Drowning, too, was a symbolically feminine death. There
was so much more to her character but was sexualized, everything about her was
stereotyped in a way that screamed ‘she is sexually available’
Unlike
Ophelia, Lady Macbeth seeks for masculinity, she prays to witches so that she
is possessed thereby removing her feminine side. Though she is projected as
powerful, evil and blinded by power- does she really have agency? In a powerful
picture where she is standing with a doctor and nurse, in her madness she is
babbling and the doctor is taking the notes in form of her confessions –
indicating the shift in power from priests to doctors. There is always
something about how women are said to be possessed by demons/witches when they
suffer from mental illness which is interestingly interpreted in this play.
Citing the example from World War-two, where in America men were sent to war,
so women were made to engage in all the work giving them agency and
independence. However when men came back, the women were told to return to
household and resume their duties of wife, mother etc. In that era, the
suicide, depression and many more types of mental illness spread like a
phenomenon among women. It was alarming and disturbing.
This
was followed by poems by Sylvia Plath and other poetess who talked about
suicide, madness and death. Paromita also discussed about Bhakti movement in
medieval times in India where women’s sexual agency was legitimized. They not
only challenged the patriarchal structures of society but with bravery and
devotion to god they created autonomous space for themselves. Akka Mahadevi and
Mira Bai find special mentions in the movement where madness strings a
beautiful amalgamation with expression of sexuality. The session ended with a
bhajans of Mira, Sant Kabir and Bowl performance. The session was consuming,
enthralling, disruptive, challenging and blown the sanity of minds so to say! I
was stunned because for this time, I actually wondered does something like
‘rationality’ exists and the power literature have over so called sanity of
human minds.
Lawyer
and Disability rights activist Amba Saleklar dissected UNCRPD and brought out
the limitations of legislations on disability and mental health rights. For
example- there is no clarity of support arrangement, Parens Patriae
jurisdiction of the court or the state (Hadiya case- where court interfered
with the decision of an adult person) and others.
However
if legal system is used in a constructive way, it could actually support the
person in need- She shared a real life narrative of a woman named Suchitra
Srivastava with mental illness who lived in a Nari Niketan and then when she
was shifted into another one in Chandigarh, she was found to be pregnant. 15
weeks into pregnancy, the authority wanted her to abort the child which was
obviously not legal. The case went to High court where she refused to abort her
child (though she was subjected to obnoxious and atrocious questions). This
case was then argued upon in Supreme court- the woman was subjected to mental
examination where she was diagnosed with mild to moderate retardation, so using
the law which states that the person have rights unless she is mentally ill, SC
distinguished between retardation and mental illness and gave the judgment in
the favor of woman. On the contrary, if she was diagnosed with schizophrenia,
she would have to abort the kid.
The
next session on ‘Mental Health Act and other legislations’ facilitated by
Ruchira Goswami, an Assistant Professor at the National University of Juridical
Sciences discussed the implications of the new Mental Healthcare Act. She threw light on very crucial points as to
how legal language is masculine – “He” is used; the concept of ‘rational’ being
problematic and complicated, intoxication is compared to mental illness in
contract law with respect to ‘unsoundness of mind’. She raised an important
question as to why social activists are working in isolation in their
respective domains, why there is no intersection because clearly issues are
related while emphasizing the need for social movements to ensure a concerted
effort towards actualizing existing legislation into rights of persons with
mental illness and disabilities.
The institute provided
a great combination of academic discourse and lived experiences of gender,
sexuality and mental illness thereby cementing the understanding of the
intersection.
Rumi Harish, musician
and activist, shared his personal journey of being a Trans man, stories of
working with trans and queer persons alike and the close knit community that
they have built. Talking about his exhaustive work – they provide support for
legal way of eloping for queer people, the hilarious and not so hilarious
situations they are subjected to, support at times of crisis management,
self-care in times of conflict and crisis to name few.
"the trans ness
changes from person to person and it is reflected in the way we dress, choose
our wardrobes, jewelry we wear, watch we strap, the hair which are never
considered important by mental health professionals in rendering support and
care"
- Rumi Harish
I
was enamored by the way Rumi Harish narrated his personal experience of Mental
illness, challenging the psychiatrist at NIMHANS because of their ignorance on
queer and trans identity – ‘I facilitated them about homosexuality, trans
and queer; I had no option because how will they treat me if they don’t know
who I am or what my body is like’ . And now doctors consult him when a
non-normative identifying individual seek support from them.
The
various narratives some of them being very painful, his personal connect with the
work actually made us question and reflect on the work we are engaging in along
with understanding LGBTQi being more than just sexual identities.
Sreevatsa Nevatia,
journalist and writer, through his deeply personal and moving narrative, shared
his experiences of child sexual abuse and mental illness. It was frightening
and extremely difficult to hear his experience of abuse, guilt, mental illness,
aftermath or consequences of his action as part of illness.
The next day began with the session by Anuradha Kapoor, founder and
director of Swayam, a feminist organization committed to ending gender-based
violence. It started with an exercise where the participants were asked to
think about an act of violence against them by a closed one, followed by few
questions-
How did
you feel at that moment?
What were
your thoughts?
What was
the support you were looking for?
What
support you got?
How did
you behave?
She summed
up the answers in the form of feelings (isolated, betrayed, angry); thoughts
(why me, giving up, enough); behavior (withdrawn, crying, avoidance,
silent, harming, going back to same person); support (to be understood,
heard, validated, believed, protected, not judged); Received (no
support, sympathy, pain, judgments, blame, lectures on problem solving)
With these
points, she explained domestic violence, violence circle, effect on women and
children in terms of mental health and their life ahead. Anuradha Kapoor
discussed the step wise process, programs, support they provide and challenges
in work with victims of domestic violence through various real life narratives.
One of the interesting points of reflection as to why women are not coming out
of violence – they are young, have desire for sexual relationship, if they
separate with their partners, men do have ways to get their sexual desires
fulfilled but where will women go? Secondly they may have great sexual
relationship with their partners but all the other aspects go downhill. Thirdly
– horrible sexual relationship: 6-8 times sex, things they are subjected to
during sex which may not be comfortable, things they derive and experiment from
porn and lastly no sex!
Domestic
violence survivors and mental illness- Women have been raised in a way to
subside their anger, they don’t know how to communicate their emotions
especially anger, they don’t have time or space to share hopes, desires, they
may have various issues that could impact their self-esteem and confidence in a
negative way. This also impacts their children because many a times women blame
their children for not challenging the violence before and also they have over
expectations.
On being
asked what is the change that they have seen in their 23 years of work?, she
smiled and said, “The situation has moved from no support or where should I go
to seeking support and finding sexual pleasure outside marriage.”
Another
question – You are bringing survivors of violence together, don’t you think
that trauma would increase or inflict on each other – “Quite opposite, this
yield support for example – if a woman is going to doctor then the other woman
would handle her child. When they see each other’s problem they understand that
it’s not unique problem and it can be dealt with. Also when they see that a
woman has progressed from bad situation to a much better situation- the other
women get hope that they can also deal with it and move ahead.”
Mohd. Tarique, director of Koshish, a TISS project
on homelessness and urban poverty engaged with the participants through his
experience, real live narratives and divulged deeper into the existing
stereotypes, beliefs and the vulnerability
associated with homeless people, also bringing in the layers of gender,
sexuality and mental illness in this extremely marginalized group. The session began with the legislation against
the people on street, there are different laws on beggary in different states.
24 states in India have a law according to which a person can be arrested for
beggary, he will be jailed for 1-10 years and police don’t need warrant for
doing so. In case the person is lunatic, blind, have leprosy or is incurable
helpless then, they would be subjected to indefinite detention, even their
family or children can be detained. Who
comes under the category of ‘homelessness’- people begging on streets, the one
who sells on traffic signals, people with mental illness, someone who doesn’t
have home. They are most visible and non-visible people- as others are scared,
intimidated by them, or they rarely intervene on their situation. Driving the meaning of home through mind
mapping, Md. Tarique shared that people on streets are not just missing out
shelter, but also comfort, family support, social identity, sense of belonging, lack of access of
various services and provisions as they have no residential proof and their
very existence is considered illegal.
One of the incidents that made a huge impact on him
was from his college time. He used to volunteer in a night shelter in New
Delhi. He along with few friends decided to celebrate new year in the shelter
home, so they brought food which was constituted in form of packets for ease of
distribution. Each person was given one packet, one of the man asked for extra
samosa, we gave them. After the distribution, we sat for tea, the same man came
back and apologized for extra samosa by saying that he has taken more than what he was entitled for. I was taken back, this person had not
eaten food for 3 days but he felt guilty for extra samosa thinking that he has
taken away someone’s share. This incident challenged the very mindset that
homeless or poor people are dishonest.
He challenged another stereotypical thought by a frequently
occurring incident- You see a person who seems homeless, his/her appearance
seems disturbing to you – what do you do? Call police- unknowingly you initiate
his/her arrest, may be police would pick up the person and leave them in other
territory. However can you think that
may be this person has developed some sort of support from the people in terms
of food, water etc. It takes lot of month to build that, but because you feel
that you are helping them, that bare minimum support is also snatched. Then
there is this feeling of entitlement for making decision for people on street
without even talking to them- is it justified? He discussed the kinds of sexual
abuse, humiliation and violence perpetrated on trans and queer persons residing
in beggars homes.
The horror that women living on streets face is
never talked about, why do we see women with a child or children and never a
man with a child? Because women enters and stay in a relationship with a man
for the time he chooses, in this course of time she might get pregnant. Once
the first man moves, she finds another partner; this person doesn’t mind the
children because he knows that he won’t be living with her for long time. It’s
not that she falls in love with man and then another, this is a mechanism to
protect herself from different men at different time. She feels that instead of
getting raped by different men, it is better to bed one man for a particular
time.
He enumerated various challenges while working with
homeless people – absence of trained people to engage and deal with homeless
people; our own conditioning, mindsets and prejudices. The tendency to take
decisions for other, causing severe damage; absence of active advocates to
support the issue, also the way social sector works- more concerned about
gathering impact in form of numbers then actually rooting out the problem.
What surprised, intrigued and restored my faith in
social activism was the “Bihar shelter home case’ as effort by Koshish that
brought the extreme brutality and horrors of shelter homes in light. They knew
the danger they were being subjected to while doing the investigation and
exposing Brijesh Thakur who had strong political connections locally as well as
with in the state government, still they went ahead with the case.
Ratanboli Ray in her session ‘Institutions, Mental
health and sexuality’ brought out the reality of ‘What is life like inside
mental health institutions? She shared her personal journey of mental illness
to working with the people inside mental hospitals through Anjali in west
Kolkata.
“If you are in prison, you know when will you come
out, you have legal assistance but in mental hospitals- you have no idea and no
support!”
Through the pictures of mental hospitals, she
inquired the relevance of insitutalisation of people with mental illness-
because clearly the presence of barricades, seclusion rooms, lack of hygiene,
locks cages will make them more ill, it’s like penalizing the person because
this is not just infrastructural issue but also about attitudes, beliefs, and
ethics- not physical but social shackles!
Sexuality
is forbidden in such institutions, there are no televisions – why?
Because according to medical staff they would resort to perverse behavior just
by seeing television, bed number becomes their identity; clothing
is a way to desexualize women in mental hospital – unisex green gowns, no
sanitary pads, no undergarments, tonsuring (head hairs are shaved) leading to
decrease in self-esteem, self-worth and confidence; the kind of food given and
way it is served. Ratnaboli shared the work of Anjali and how it has brought
about changes in the mental health institutes – the women have access to their
own clothes, shampoo, soaps, make up; there is conversations on love and
sexuality; there is constant engagement with the medical staff to break the
stringent and orthodox mindsets around mental illness.
The
beautiful narratives from their work brought hope and light not just for the
patients in the mental hospitals but also opened the conversations around
challenging the stigma around mental illness.
Pramada Menon in her
session discussed the meaning and importance of intersectionality in the realm
of mental health gender and sexuality. She encouraged the participants to learn
and understand the history of feminist movements, things that activists need to
think upon while engaging on the issues namely privileges and oppression,
governance, how the laws have come to existence through movements and others.
‘Sexuality and Mental
Health institute’ is a path breaking initiative in many ways; it brought out
the most tabooed, stigmatized and invisible topic of mental health in focus
along with the intersection of gender and sexuality. Through the diverse and
extremely experienced people from the field of mental health, literature, law,
activism and the collaboration of academics and lived narratives- the
institute’s efforts to create knowledge and build understanding so as to
facilitate discourse around the issue is commendable. Having working on gender
and sexuality issues for over few years, my understanding of mental health and
illness was restricted to types of disorders and medication. These 6 days were
like a crash course on mental health for me where I felt challenged, intrigued,
vulnerable and conflicted about things that I have learned and engaged till
now. Now, I am able to see mental health and illness beyond orthodox mindset,
in a more humanized way. There is no denying fact that very little or no
conversations happens on mental health issues which has led to stigmatization
and discrimination so when we say this person has mental health issues, the
person is reduced to the word ‘pagal’ ‘social misfit’ or ‘someone who is
dangerous to the society and people should be protected from them’. There is
strong need to build more discourse like these in order to change the present
narratives and build constructive ways to bring about social change!
“The medical practices,
legal and social environment for people with mental health issues should be
enabling and focused on healing rather than reducing them to symptoms, words or
dehumanizing them.”
