Untold Stories

Untold Stories
Glimpses from lives of a few women with mental illness in India
Sir Ratan Tata Trust & Navajbai Ratan Tata Trust would like to acknowledge
the contributions of several people who we can remember and many more who
we apologise for not being able to mention here.
We profoundly thank Dr. K. V Kishore Kumar (author), Consultant Psychiatrist,
NIMHANS for selflessly sharing his work for production of this book. We thank
Dr.H. Sudarshan, Honorary Secretary, Karuna Trust; Mata Pragnamayeec,
Trustee, Karuna Trust, Dr. Kantharaju C. Kalegowda, Project Manager, Manasa,
Karuna Trust; Mr. R. Abhinandan, Social Worker (Ex-employee), Karuna
Trust; Mr.Srinivas Jadav, Ms. Prathibha and other staff of Manasa, Ms. Rosa
A. Ferdinando for her editing inputs and asking very relevant questions and
Mr.Raghpathi Bhat for his detailed illustration, on the cover. We thank Professor
Dr B.N Gangadhar, Professor of Psychiatry, NIMHANS for writing the preface of
this collection of short stories. The designing and printing inputs given by Corporate
Communication Services are also acknowledged.
Most of all, we thank the residents and staff of Manasa who openly welcomed us
and shared their life stories. The names of the women have been changed to protect
their identity.
We hope this book does justice to them and promotes provision of mental health
services in our country.
U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India
P re fac e
evere mental disorders affect individuals across all ages and spare no social class. Thanks to the progress
in allopathic medicine, a majority of these disorders are treatable and outcomes are positive. Ignorance,
stigma, poverty and non-availability of professional help can lead to delay and even denial of treatment to
most patients. As a consequence, there exists a large treatment gap for people with severe mental disorders. Most
patients are exposed to long periods of untreated psychosis. Even in those who are treated, adherence to treatment is
unsatisfactory and relapses are very common. One of the dreaded consequences of this is illustrated with examples
in this book.
Individuals, who are mentally ill and not in touch with reality need attention and comprehensive care. They
tend to withdraw from social situations and wander away often becoming homeless. Their state of mind might
prevent them from acting judiciously, which may lead to separation from family. Once rendered homeless, they are
exposed to the hazards of society including exploitation and the violation of human rights. Women may be sexually
exploited with untoward consequences, whereas men are often mistaken for people of an antisocial nature. In the
latter scene, the public resort to cruelty leading to physical assault, emotional hurt and other types of abuse. The
inability to act logically is likely to prevent the severely mentally ill from carrying out effectively planned violence
against other civilians. Yet, the public image against the severely mentally ill is that they are dangerous.
Though mental illness is not communicable (infectious), people shun the mentally ill as they fear their unpredictable
behaviour. This also deters public action and samaritanship to help the mentally ill. The case studies should help
allay these fears/concerns and motivate the public to come to the aid of these unfortunate mortals. A humane
approach by civilians as well as the law and the staff of the health department can bring about a sea change in these
souls by initiating appropriate treatment as early as possible.
Early detection and treatment- initiated at the primary care level can help intervene at an early stage which may
prevent the severely mentally ill from becoming severely disabled and consequent wandering away. The district
mental health program is about empowering the primary health care staff to be able to intervene at an early stage.
Diligent implementation of this program has an important role in closing the treatment gap (proportion of patients
who do not get the required treatment) in psychosis. The law and home department should become sensitive to the
issue of severe mental disorders in the community and help reach the carer (mental health team), assist the ill/their
kin to reach the treatment facility and also undertake public awareness measures.
Only a concerted approach by different departments can help contain the consequences of mental disorders in a
public health program.
Dr. B.N. Gangadhar, MBBS, MD, FNAMS, DSc

Professor of Psychiatry
NIMHANS
U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a
Case illustration
Mansi
hailed from the Maddur Taluk of district

Mandya in Karnataka. Her father, a farmer with an
acre of land, worked hard in his fields but was unable
to earn enough to make both ends meet. He had three
children two girls and a boy. The eldest, a girl, was
married when she was barely 16 years old. Mansi, who
was the next-born, was 15 years old when we met her.
Mansis younger brother, the hope of the family,
succumbed to a respiratory tract infection in 2008. In
spite of spending a lot of money, all efforts to save him
proved futile.
Mansis parents sat near the temple wondering what to

do next. The next day, they lodged a missing persons
complaint at the local police station and although they
continued their search in the surrounding villages and
nearby towns, no clue was found. As the days passed,
their hope to find Mansi alive diminished and Mansis
mother could not hold back her tears when people talked
about her. In June, Mansi was to start her high school.
Her school teacher promised all help and retained her
name in the school register while waiting for Mansi to
return and resume her schooling.
While the family was coming to terms with the loss of

their only son, another tragedy struck them. This time it
was Mansi who started behaving strangely. Mansi, a very
shy and reserved girl, started to sing and dance without
any provocation. Her family was at a loss to understand
the reason for such behaviour. They consulted the
local priest who recommended a set of rituals, to be
performed in the local temple to drive away the ghost
Mohini which had apparently possessed Mansi.
However, efforts to drive Mohini away from Mansis
body yielded no result. The father deeply worried about
the series of disturbances in the family and wondered
what else he could do to solve the problems of his
daughter, when he was struck by devastating news that
Mansi had mysteriously disappeared from their home.
The family started searching for her all over the village.
Soon neighbours joined the search, but they found no
trace of Mansi. Some friends suggested searching the
wells and ponds in the local area, presuming that she
might have committed suicide, but even that did not
yield any result. Meanwhile, a girl reported that she had
seen Mansi walking towards the main road.
One day, nearly four weeks later, the family was

informed by a neighbour that Mansi was in Manasa in
Mysore. The family rushed to Mysore in response to
this news and could not believe their eyes when they
saw their daughter alive and healthy. Tears of joy rolled
down and they all prostrated at the nearby temple,
thankful for the divine intervention.
Mansi was rescued from the streets of Mysore by
volunteers of Odanadi an agency working exclusively
for women in distress. The volunteers realized that
Mansi was mentally ill as she was hyperactive, talked
excessively and danced without inhibition. She was
taken to Manasa at Chickahalli, Mysore for treatment.
At Manasa, Mansi was diagnosed with mood disorder
and started taking antipsychotic drugs and mood
stabilizers. Mansi recovered completely in about 12
weeks. Her parents were educated about the nature
of her illness and she was reintegrated with her family
members after the complete remission of symptoms.
In February 2010, a team from Manasa visited Mansis
home to review her condition. Mansi was well, at the
time of evaluation, but the team learnt about several
undesirable changes Mansi had discontinued school,
stopped medication and was involved mainly in
household work. Her father informed the team that the
local hospital did not dispense the required medication
and he could not raise enough money to buy the drugs.
As Mansi was functioning normally and helping the
family manage the household like anyone her age, they
thought that she would not require medication and
therefore did not bother to talk to anyone, about it.
Mansis parents were daily wage earners who lived in a

single room accommodation. The family is trapped in
the web of many problems: Mansis ill health, consequent
stigma and discrimination in the village, financial
problems after her elder sisters delivery, repayment of
loans, etc. Her father struggled to manage the day-today needs of the family and Mansis ill health, hence
medication was his last priority. Mansi had to be readmitted to Manasa due to the recurrence of her illness.
Fortunately, the recurrence was identified early as the
team had been visiting the family on a weekly basis.
The following were the key issues in the case:
Poor access to mental health care even though
they lived in Maddur Taluk close to both,
Bangalore and Mysore cities.
No treatment prior to dislodgement of Mansi
from her home.
Severe financial difficulties and poverty.
Many adverse events in the family.
Discontinuation of schooling, giving Mansi little
chance for future development.
Poor awareness about the nature of her problem.
Discontinuation of medication and no followup visits to Manasa because the family could
not afford the travel. Further, her health and
medication, was their last priority because of
other pressing issues.
Recurrence of illness.
Case illustration
Triveni alias Meena a resident of Bangalore
lived in Koramangala in a small house. Triveni had two

daughters, one of whom was married. When we met
the family, Triveni had disappeared from the home a
couple of days ago. We had to initially interact with the
neighbours and tenants to collect information about
the family and Trivenis current status, as her daughters
and son-in-law could not be contacted. In due course,
we did contact her daughter who worked in a school
as a teacher. She reported that her mother had been
ill for nearly 10 years. The key difficulties reported
were - being withdrawn, talking to herself, wandering
aimlessly, sometimes smiling to herself, being irritable
for no understandable reason, sleeplessness and neglect
of self-care.
The family members took her to a nearby medical
college hospital for psychiatric treatment, suspecting
that she may have mental illness. Evaluation confirmed
their suspicion as she had psychotic illness. She was
advised medication and took medication regularly for
some time. The daughter recollected that her mother
had recovered quite well and taken up the responsibility
of the house. Since, she was doing well mentally, the
family members thought that there was no need for
medication and gradually they stopped medication.
The daughter reported that Triveni had been drinking
alcohol frequently, long before she developed the
illness. Apparently, she got used to alcohol as she was
encouraged to consume alcohol during the postpartum
period. As time passed, the occasional use of alcohol
changed to frequent use and ultimately to regular
use and consequent addiction. This forced her family
members to physically confine her to the house. She
managed to break the chains many times and wander
away from home. She was often found begging near
the park in the neighbourhood and would use the
money for drinking. Trivenis drinking became a source
of concern for the family members on one side and
an embarrassment on the other. It is during one such
episode that Triveni disappeared from home and did
not return for months.
It was a great surprise for the family to hear that Triveni
was alive and getting treatment for mental illness at
Manasa. The family members often feared that, if she
returned home, they would find it difficult to control
her and administer medication. The family members
felt the need for support from the Manasa team and the
Manasa team responded very positively by promising a

continual supply of drugs, through post. Though the
family members were uncertain, they had a plan to
manage her by keeping her restrained so that the risk
of wandering away and drinking could be reduced
completely.
The improvement shown by Triveni took the family
members by surprise and they once again stopped
medication. They were not perturbed because Triveni
was in good health for three to four months. The family
members took the restraint away and suddenly realized
that she had started drinking, wandering and begging
for money. They could not collect the parcel sent for
them by the Manasa team because they could not adjust
the time with the postman.
Meanwhile, Triveni left home for the third time and
the family members felt really ashamed of her. They
sometimes prayed that she would die so that their
problems would be solved once and for all. The last
reports revealed that she had returned to the house and
had been physically restrained, once again.
Despite these traumatizing experiences for years, the
family members hoped that she would be cured of
her illness and would also overcome her addiction to
alcohol. However, what was remarkable was that her
family had neither taken her to the hospital for a review
nor contacted Manasa on a regular basis to discuss issues
in managing Triveni. They managed to take care of her,
without much emotional commitment, which could be
indicative of carer burnout.
Long-standing psychotic illness with remission
and exacerbation.
Associated substance abuse.
High-expressed emotions in the family.
Significant caregiver burnout in the family.
Lack of adequate locus of control and poor social
support for the family.
Poor drug compliance.
Stigma and discrimination.
Wandering away repeatedly.
Poor follow-up care.
Inadequate managementperhaps she needed
regular home visits & evaluation for substance
dependence.
Case illustration
Neha
, an engineer by profession was the mother

of a boy. She hailed from Mysore city and had a very
comfortable life and childhood because of well-placed
parents. Her life was sailing smoothly till she delivered
her son. All hell broke out after the son was born.
Apparently, she suffered a mental breakdown and her
life partner who she thought would share her happiness
and sorrow went back on his marital vows, after the
onset of her mental illness. He moved away as though
she was an untouchable. Her parents who were both
scientists were devastated after the debacle in her life.
The sorrow and grief they endured when their beloved
daughter was struck by mental illness, was too much to
bear. They died prematurely, leaving her all alone to face
the harsh realities of life.

Long duration of illness.
Good response to treatment despite chronicity.
Significant stigma and discrimination resulting
in marital separation.
Lack of social support resulting in long-term stay
in a facility for destitute women.
Looking at her plight and that of her child, one of

her neighbours facilitated admission in Shakthidhama
without realizing that Neha could be mentally ill.
Neha was becoming increasingly withdrawn, dull and
neglected her personal hygiene. She used to get poor
sleep and hardly ate anything, which necessitated
psychiatric referral. It was at that time, that Neha was
evaluated and her psychotic illness was confirmed.
Neha was diagnosed with schizophrenia and started
taking antipsychotics. She was kept in Manasa for a
period of six months and improved remarkably. As she
did not have a family to go back to, she continued to
live in Shakthidhama. She considered this place as her
home and other residents as her relatives. She was afraid
of moving out as she could not trust anyone.
Nehas son was pursuing a course in music in Chennai
at the time and hoped that he would be able to take
his mother to live with him, once he was settled. At
Shakthidhama, she taught computers to other residents
and immersed herself in office work and correspondence.
Case illustration
Swapna
At the time of meeting

, a resident of Mysore
city who was diagnosed with schizophrenia, was 45
years old. She remained unmarried because of the illness
and several other issues such as poverty and a sense of
commitment to her mother. The family consisted of her
mother, a brother and herself. She graduated in science
and taught school children for a living.
Her job as a teacher came to a grinding halt soon after the
onset of her illness. She was found muttering to herself,
had become withdrawn and suspicious, and often
wandered away. Her family members had to make an
effort to contain her within the house, to prevent people
from knowing about her illness. Despite their efforts,
one day she wandered away from home precipitating a
crisis. Mother and son blamed each other for lapses in
taking care of Swapna. Several months later they learnt
that she was alive and safe in Chickahalli.

Long duration of illness.
Dramatic recovery despite chronicity.
Regular follow-up and good compliance with
medication.
Productively employed.
Had given up a teaching job and worked as a
house maid.
Very hard working and wanted to be
independent.
Minimal disability but no interference with
occupational functioning.
Swapna was a resident at Manasa for 16 months and

improved significantly. Her family members were
ecstatic the moment they saw her. She was relocated to
Bangalore and worked as a housemaid as she wanted to
be closer to her mother and did not want to be a burden
to her brother.
Swapna was very regular with follow-up and medication.
She said I cannot take the risk as the illness could
return and my life would be in shambles, once again.
She consulted the doctors in the government hospital
and got the benefit of free medication from Manasa.
Swapnas life is an inspiring story of a fighter. She was
not only careful about her health, but also made changes
in her life so that she could take care of her mother as
well.
Case illustration
Shashi,
one of four children of elderly parents

hailed from Chamarajnagar district of Karnataka State.
She was found wandering in the streets of Mysore city
and was rescued following a call on the helpline. When
the team reached the spot she had disappeared and after
some effort, she was located in one of the by-lanes in
Jayanagar. Shashi looked fearful, exhausted, and deeply
distressed with the strange experiences she had been
going through for years. She reluctantly agreed to go
with the team and then admission procedures were
completed.
Various attempts to fix the problem of Shashi did

not yield any results. The few assets that they had in
the form of gold were also sold, in search of the cure
which remained elusive. Around the same time a
misunderstanding between the parents and their
daughterin- law started surfacing. The sister-inlaw did not want Shashi in the house since she was
creating a nuisance, which resulted in frequent quarrels
and subsequently an increase in alcohol intake by her
husband. It was against this background that Shashi
went missing.
After the initial care to bathe her, feed her and remove
head lice, she was medically evaluated and diagnosed
with schizophrenia. Antipsychotics were initiated but
three groups of drugs failed to control her symptoms
despite an adequate dose given over a sufficient period
of time. It was decided to change the medication to
Clozapine (a drug administered to a person who
is resistant to conventional drugs). Following eight
months of care and treatment, her family members were
located in Chamrajnagar town. She was relocated to her
house and her elderly parents were very pleased to see
their daughter alive and wondered about her recovery.
Shashi was found wandering in the streets of Mysore

city. She was rescued by the Manasa team and put
on treatment. The course of her recovery in Manasa
resulted in the reconstruction of her past, which led to
reintegration with her family. Shashis parents were so
poor that they could not arrange for the medication.
They recollected that Shashi went to school like other

children her age and was above average in studies.
However, she was described as a very shy and reticent
girl. She did not mix with her peers very freely, though
she would reluctantly participate in games. She cleared
class 10 at the second attempt and did not show interest
in pursuing her studies after that. Besides, it was not
possible for the family to spend time and money on her
studies because of overwhelming poverty.
Shashis marriage was arranged with financial help from
relatives and friends. Unfortunately, the marriage fell
apart following a relapse of the illness. The person who
they thought would stand by and support their daughter,
soon deserted her because of her mental breakdown.
Initially, she was sent to her house for rest and treatment
and subsequently the in-laws communicated that they
did not want their son to share his life with a mentally
ill person. The devastated parents were drowned in
sorrow by the failed marriage of their daughter and the
onset of mental illness.
Shashi had failed to respond to two drugs in the past

which necessitated the initiation of clozapine. The
Manasa team made special arrangements to regularly
post clozapine. Despite that, Shashi had a relapse. On
enquiry it was found that the family was struggling with
many problems at the same time. One of the issues was
her fathers ill health. Shashi was therefore shifted to
Manasa, since there was no one to take care of her at
home.
Shashis condition improved with the initiation of
treatment, but she could not return home as her father
was still hospitalized. He was later diagnosed with blood
cancer. Shashi was shifted to Shakthidhama because of
her family situation; the ill health of the father, severe
financial problems and the strained relationship with
her sister-in-law made it particularly unfavourable.
In the safe and secure environs of Shakthidhama, she
was certain of her next meal and her daily medication,
without thinking of the cost. She was encouraged to
participate in the activities of the centre. It was great to
see Shashi back to her old ways of working in the fields,
picking tomatoes and collecting edible greens from the
farmland, in the premises of Shakthidhama.
With a new lease of life, Shashi began to dream, but

only time will tell whether she is able to realize those
dreams.
Long-standing illness.
Stigma and discrimination resulting in marital
separation.
Poor response to more than two groups of drugs
resulting in initiation of clozapine.
Poverty and lack of support.
Several psychosocial problems in the family.
High-expressed emotions in the family and an
indifferent brother.
High commitment to care on the part of the
parents.
Use of appropriate case management by Manasa.
Readmission at the most appropriate time.
Case illustration
Radha the only daughter of her parents, lived in

impoverished conditions with her family. At the age of
21, she was still unmarried. One fine day, the Manasa
team found her wandering in Mysore city. She seemed
to be amused by everything she saw.
Her history suggested that she had been suffering from

episodic illness, since the age of 17. She talked and
laughed excessively, slept poorly, sang songs, was very
religious and danced without inhibition. She would talk
about films, actors and actresses, demanded food, new
clothes and often applied too much makeup. She bathed
very frequently, so much so, that the water stored in the
house would get used up within no time. Radha would
get angry when her mother corrected her, but her locus
of control rested with her mother.
Family members could not understand the reason
behind Radhas behaviour. Some neighbours said that
Radha was exhibiting such behaviour because she was
thinking of marriage, therefore her parents should get
her married. Others said that she was possessed by a
ghost. Everyone in the neighbourhood could see what
was happening to Radha. Some made her sing songs
while others were amazed with her knowledge about
films. Radha could not sustain her attention for a long
period of time, with anyone.
None of the opinions that were voiced, considered the
possibility of mental- illness. She was never taken for
any psychiatric evaluation.
Post-reintegration, Radha was visited at her house as

part of an evaluation process undertaken by Manasa.
The parents said that she had gained weight and become
generally slow in all activities. Her neighbours often
wondered what happened to her enthusiasm as she did
not seem bubbly or energetic as before. She helped her
mother in cooking food at home. She expressed a desire
to get married but felt frustrated as proposals were hard
to come by.
Radha was on regular medication and attended the
psychiatric OPD at Mysore Medical College.
The following were the key issues in the case
Radha was the only child of her parents.
Diagnosed with BPAD.
Was never treated for her illness before she went
missing.
Rescued in a short period of time.
Recovered quickly and reintegrated into her
family.
Early rescue and recovery led to better recovery.
Non-treatment could be attributed to poor
awareness about her illness.
Everyone in the neighbourhood came to know
about Radhas problem, soon after the onset of
illness yet, no one suggested psychiatric treatment.
Due to the stigma it was hard for her to get
marriage proposals in spite of recovery.
When Radha arrived at Manasa she was diagnosed with

Bi-Polar Affective Disorder (BPAD) and immediately
put on treatment. This enabled her to settle down easily.
In due course of time, it was found that she belonged
to Mysore city. The address provided was accurate and
her parents were located within a short period of time.
Her parents were delighted to hear the news that she
was alive and safe in Mysore. They prostrated in front
of God and gave thanks for the blessings showered on
their family. They wanted to leave immediately to see
their daughter to confirm what the social worker had
said.
Case illustration
Babita
, a middle-aged lady from Ooty in Tamil

Nadu was found wandering in the streets of Mysore,
Karnataka and was rescued by the Shakthidhama team.
In Shakthidhama, she was observed to exhibit abnormal
behaviour and was referred to Manasa. Evaluation at
Manasa suggested evidence of psychotic illness of long
duration.
Babita was put on medication and showed remarkable
improvement. Her life was a mystery as not much had
been known about her past and she showed a great
degree of reluctance to talk about the same. But from
information gathered in bits and pieces, it was learnt
that she was married and had a son. Her husband
deserted her, perhaps, because of her mental illness but
the reasons are not clearly known. She claimed that for
all practical purposes she and her son were the only two
people related to each other.
It was quite disheartening to come to terms with the fact
that one is all alone in the world. She found it difficult to
survive and take care of her only child and so she moved
to Mysore. Surviving without her husband was a very
difficult part of her life. People in her neighbourhood
were so concerned about her that they initiated social
action to relieve her.
Babita was admitted to Manasa twice, on the first
occasion she was a resident for two months. As there
was no credible information about her relatives, she
was sent back to Shakthidhama with a diagnosis of
schizophrenia. Her mental health problems got worse
when she was moved to Shakthidhama and she had to
be re-admitted to Manasa. On the second occasion,
she was a resident for nine months. Despite the long
duration of illness, she improved in a short period of
time and returned to Shakthidhama. As she did not
have any relatives and had nowhere to go, she continued
to stay in Shakthidhama.
Her son did not have any health problems and was
pursuing an education in engineering. He was keen on
settling down with his mother from the moment he
starts earning.
Middle-aged lady with chronic mental illness.
Rescued in time by the Shakthidhama team and
referred for psychiatric care.
Significant improvement with medical
intervention.
Lots of gaps with respect to information about
Babita and her past.
She had to be accommodated in Shakthidhama
as she had no relatives.
Currently engaged in agricultural work.
Her sons education was supported by the local
philanthropists and other socially conscious
people in the community.
Facilities like Shakthidhama have played a very
crucial role in supporting organizations like
Manasa without which, not much would have
been achieved in this case.
The possible revolving door phenomenon, quite
prevalent in such situations, was avoided by good
networking on the part of Manasa.
It is heartening to note that organizations like
Shakthidhama and Manasa have redefined
dignity and safety for vulnerable women like
Babita.
Babita was on regular medication. She enjoyed working

in the fields and her familiarity with agricultural work
and a passion for the same suggested that she must have
had an exposure to similar work in the past. The staff of
Shakthidhama was pleased with her commitment and
they encouraged her all the time.
10
Case illustration
Manisha lived in a village on the border between
Tamil Nadu and Karnataka. She was a native of Mysore,

who married a person who settled in this border village.
She lived with her husband, two children and motherin-law in a single room accommodation. Everyone
in the village knew Manisha because she wandered
aimlessly around the place. Though they realized that
she was not well, they could not get her treated because
there was no facility where they could go for help.
Manisha had been ill for more than 10 years. Initially,
she had very active symptoms and gradually her
symptoms changed to wandering aimlessly, talking to
imaginary voices, muttering to herself, hoarding things
and neglecting self-care.
Her mother and other relatives lived in Mysore, but they
did not realize that she was mentally ill. The treatment
given to her was in the form of religious and magical
healing rather than any medical intervention, till she
disappeared from home.
The Manasa team in Mysore city rescued Manisha, and
evaluation suggested chronic psychotic illness. It took
four months to stabilize her. She gradually revealed
information about her family. Manisha was reintegrated
into her family and information about her brother and
other relatives was also obtained in the process.
Her husband was a very tolerant man and her motherin-law was more than a mother to her. They were
never upset with Manisha and they were prepared to
do anything for her. The husband and mother-in-law
would leave for work after making arrangements for
food and other necessities. They were never angry that
Manisha was not making any meaningful contribution
to the family. The family was very poor when it came to
material comforts and other necessities, but they were
rich in their love, care and concern for Manisha. They
never seemed upset with Manisha despite the practical
problems and inconvenience created for others in the
family. Manishas family situation was evaluated and
the decision to support her medication was taken.
Medication was posted regularly for more than two
years, since her reintegration.
When Manisha was reintegrated into her family, her

husband was speechless. A question rose in his mind
what made you think of going away from home I
have stood by you all the time, is it not? His mother
was also very pleased and said If you can take care
of your children, I will be more than happy and will
serve till I breathe my last. Manishas family really
epitomizes a caring and concerned family, which was
the norm about two/ three decades ago in our country.
While remnants of such families are still seen in the
country, most families have lost this ability to care for
their mentally ill kin. This is because of the growth of
the nuclear family unit, the need for autonomy, changes
in values, migration etc. It is very disturbing to imagine
what will happen if more families become indifferent
towards their mentally ill relatives.
At the time of the home visit, Manisha was alone at
home. It looked like she had not bathed for days. She
had discontinued medication for some time and no one
supervised it. Her husband and his mother were away at
work across the hills, while her children were in school.
The dislodgement of Manisha seemed imminent, based
on her current status. Medication was restarted and one
volunteer in their area was identified to supervise her
medication. She had not been going to see the doctor in
the local area and the only source of support for her was
Manasa, which is 65 kms away. The volunteer seemed
confident that an NGO was about to start services in
the local area for the disabled as well as the mentally ill.
Married lady, mother of two children.
Suffered from chronic psychotic illness.
Lived in a village bordering Tamil Nadu and
Karnataka.
The family did not recognize mental illness in
her.
Not on any treatment before she went missing.
Very supportive family.
High tolerance and acceptance of dysfunction by
the family.
Good recovery despite long duration of illness.
Reintegrated about 5 months after dislodgement.
Lack of supervision resulting in exacerbation of
illness.
11
Case illustration
Radhika was 19 years old and had completed 10
years of schooling when we met her. She considered

herself to be an unfortunate person because she was
caught between the warring factions in her family. Her
father was a very skilled mason and remarried after
Radhikas mother had a mental break down. The family
hailed from Chamarajnagar district.
Radhikas mother had two children a boy, besides
Radhika. Both the children had grown up amidst
mistrust and hostility in the house. Radhika always
witnessed too many fights, quarrels, disagreements and
unhappiness in her childhood. The attitude of her father
and stepmother angered her. She felt victimized for no
fault of hers. She developed irreconcilable differences
with her stepmother and father and wanted to stay away
from them. Her mother moved to the grandmothers
house because of the same reason. The thought that her
family was fragmented, made her feel very angry. She
prayed to God every day and stated God please do not
give this kind of trouble to anyone else, let this stop
with me.
Radhika was diagnosed with bi-polar affective disorder
(BPAD) and she took a long time to settle down. She
was admitted to Manasa by a concerned police officer.
The fact that the transit care facility (Manasa) had
gained a reputation for providing care for the homeless,
mentally ill women in Mysore city was evident by the
action of the police officer. Further, it was found that
she did not recover well with one mood stabilizer and
therefore needed two, for the control of symptoms.
Radhika was readmitted once again and the duration of

this second admission was four months. Having burnt
their fingers, the Manasa team explored the possibility
of locating her in Odanadi. When she was in this
facility she felt very happy and grateful to everyone in
the organization. She was part of the security staff and
enjoyed her work. Her job was to protect vulnerable
women. In passing, she said, Women are womens
worst enemy. In the last evaluation, it was found that
Radhika was euthymic, and had been taking medication
regularly with support from Odanadi.
The following are the key issues in the case:
Episodic illness.
Strong family history of mental illness.
Father remarried because of mental illness in the
mother.
Marital separation.
Family fragmented because of the onset of mental
health problems.
Non-supportive family.
Indifferent and negligent attitude.
Availability of short stay facility.
Traumatic childhood.
After she settled down, she was reunited with her

family. It seemed that neither Radhika nor the Manasa
staffs were welcome in her house. The reluctance of the
father and stepmother was very evident. Their gestures
seemed to say the following we thought we got rid of
them once and for all. The team from Manasa could
not think of any other alternative and had to leave her
at home. She was well for nearly a year but suffered a
relapse despite regular medication. Radhikas family
situation warranted dispensing free drugs every month
through the post but this could not prevent a relapse.
12
Case illustration
Payal,
10
one of six children, lived in T. Narasipura

in Mysore district. She completed her schooling and
graduation in Mysore. Like other women her age, she
got married as soon as she completed her studies. When
she was seen at Shakthidhama (a long stay facility in
Mysore for rehabilitation of women in distress) she was
about 45 years old.
Gradually, as she moved on with her life, several
undesirable events affected her. She conceived but had
three consecutive miscarriages. Her role as a mother
remained elusive because of this. Gradually, her
husband became indifferent towards her because she
could not facilitate the growth of their family. Against
this background, Payal started exhibiting abnormal
behaviour.
She used to become very suspicious, irritable, and
aggressive, for no reason. She would not sleep at night,
and pace up and down the house, disturbing every one.
She screamed at night and often talked about voices
speaking to her, sometimes commenting, sometimes
abusing and threatening her. She also believed that
someone was trying to poison her food. Payal was
diagnosed as a paranoid schizophrenic.
The in-laws could not understand what was happening
and requested help from her father and simply sent her
back home. Her father who was a teacher in the local
school thought that his daughter could be mentally ill
and took her for consultation to NIMHANS. After
evaluation, Payal was put on treatment, which resulted
in a gradual improvement.
As she was recuperating from her illness, she learnt that
her husband had married again. This news shook her
to the roots and the thought of sharing her husband
devastated her. She decided to deal with the adversity
and moved out of T. Narasipura to Mysore. While, she
was taking treatment, she also tried to work and save
money.
She decided to leave Odanadi- a place, which protected

her to be able to live on her own. Her effort did not
take her very far. She went back to Odanadi and this
time around they were not supportive of her. The cold
attitude of the people made her think of returning to
Manasa for help again.
Eventually, she came to Shaktidhama again. She took
her medication regularly, remained well, but started to
pick up frequent quarrels with the manager. She did not
comply with the managers instructions and therefore
she was thrown out from there. From there she was
moved to a destitute relief centre in Mysore, where she
lived.
Payal had her cup of sorrows and setbacks from the
moment she started her marital life. Her lack of trust
in anyone as well as her dislike of any kind of intrusion,
resulted in total instability. She still hoped that she
would make it on her own without anyones support,
despite falling down frequently.
Long-standing illness with remissions and
exacerbations.
Marital separation because of mental illness and
inability to procreate.
Inability to accept that her husband had to be
shared with another lady.
Frequent relapses because of poor compliance.
Obstinacy made her lose all the support that
existed for her.
Unwillingness to participate in certain activities
sometimes made her very unpopular.
Confident that her life was going on well, she stopped

medication only to have a harsh relapse. Meanwhile,
the shattered father died, making Payal very vulnerable.
She moved from one place to another in search of peace
and landed in Odanadi in Mysore, where she came in
contact with Manasa. With medical intervention, she
stabilized in a short period of time and returned to the
short-stay facility.
13
Case illustration
11
Gayathri a 65 year old woman lived alone in her
house, while her daughter and grandchildren stayed

in the immediate neighbourhood. Her share of the
property was given to her after the partition of her
house. Though she lived close to her daughter, their
relationship was strained because the daughter was
unwilling to accept the fact that the mother was ill. Her
daughter, granddaughter and other relatives were very
unkind to her, quarrelled with her and ill-treated her
all the time. The daughter in particular was very hostile
and critical of her behaviour and refused to believe that
she was ill. All the family members remarked how
can she be mentally ill when she is so possessive about
her property? They further added that she refused to
part with any of her belongings. Would any mentally
ill person do that? they asked. This annoyed the family
so much, that they became very indifferent towards her.
When Gayathri was reintegrated into her family she
lived alone in her house, despite the close proximity with
her daughter and other grandchildren. She continued
to remain without any treatment till date and the family
members did not seem concerned. It was a strange
paradox that although one of her grand-daughters was a
medical doctor in government service and her husband
was also a doctor, they had not done anything about
the care of their grandmother. The predominant feeling
they had towards her was one of anger and hatred as
she was not obedient and compliant. They used to sayshe should do things to help the younger generation
develop and lead a comfortable life, yet she is always
coming in their way.
Her history suggested that Gayathri had been ill for
14
30 years. She developed the illness when her husband

was alive and the daughter said that a lot of time and
effort was invested to treat her illness, but she did
not improve. However, on further probing, it was
found that she heard voices and feared that people
were planning to harm her, kill her, etc. She was
known to be very suspicious, refused food offered by
the daughter and grandchildren, because she believed
that her food was poisoned. She also exhibited strange
behaviour like clogging the drains by throwing curry in
the basin, putting washing powder in the sambar and
overusing water. They said that they paid exorbitant
water bills because of that. Gayathri lived on her own,
in the portion of the house given to her after partition
and managed her business, on her own. She did not
interact with any of the family members. She either
went out to eat her food or cooked at home. Gayathri
received a family pension and managed to deal with
the government officials on her own. Examination did
not reveal any cognitive dysfunction but she exhibited
symptoms of paranoid schizphrenia.
One day Gayathri was found wandering aimlessly by
the Garuda police. She was restless, refused food and
was not co-operative. The next day after she was calm,
an attempt was made to trace her address and she was
driven to her place. Fortunately, Gayathris house could
be located and she was handed over safely to her family
members.
Long-standing illness.
Poor compliance and persistent symptoms.
Death of her husband, onset of illness and
consequent lack of support.
Poor understanding about the illness.
Indifference and neglect by the family members.
The patient could have stayed in Manasa for a
longer period of time so that the team could have
worked on symptom reduction.
No clear instruction to the family members
about further management.
Case illustration
12
Ashima spoke a dialect of Telugu, which made one
think that she hailed from Andhra Pradesh. When she

was brought by the police to Shakthidhama a centre
for destitute women in Mysore she was 30 years old.
She was later shifted from Shakthidhama to Manasa
for evaluation and care. Ashima did not talk a lot and
not much information could be obtained from her
because of her intellectual disability. In addition to her
intellectual disability, she also suffered from psychotic
illness and the degree of retardation was categorized as
severe.
Ashima was stabilized in two months with antipsychotics and was later shifted to Shakthidhama, once
again. The medication was provided by the Manasa
team. During the evaluation of relocated residents, it
was found that Ashima was shifted to the Beggars Home
(Nirashithara Parihara Kendra) since Shakthidhama did
not have enough resources to take care of her condition.
She tended to soil her clothes, and could not take care
of herself during menstruation, which was an indication
that she needed long-term supervised care because of
her intellectual disability.

Not being able to locate the family members
because of lack of information.
Intellectual disability categorized as severe
Mental Retardation (MR) needing long-term
care in a supervised facility.
Aggressive efforts to relocate her using the law
enforcing machinery of the State.
Scanning missing persons register.
Most often lack of centres taking care of such
individuals resulted in persons being shifted from
one centre to another.
An attempt was made to shift her to the state home

or any other agency within the state, where care was
available for persons with intellectual disability. The
possibility of coordination between the police of two
states, working towards locating her family members
using the electronic media, would have to be aggressively
explored, failing which long-term supervised care in
a governmental or non-governmental set up would
have to be organized. The possibility of Ashima being
relocated to her family home was nil, as she was unable
to provide any information about her whereabouts, her
family, etc.
15
Case illustration
Lata
13
was diagnosed as having Bi-Polar Affective

Disorder (BPAD) with personality difficulties. She had
one son and their life seemed fine, till she developed the
first episode of mental illness. Lata had several episodes
since the first episode, 12 years ago. Her husband said
I loved her and was very sympathetic towards her. I
suddenly realized that all that I did was useless and I
do not want to know anything about her. I wish her
good luck and happiness. I do not want to live with
her because it has been a nightmare to live with her. At
times it was humiliating and very traumatic.
Lata had completed her education in Pre-University
College and soon got married. She and her husband
lived in Mysore city after their marriage. It was an
arranged marriage and the couple respected each other
to a great extent. She had two brothers and they also
lived in Mysore. Life changed to a great extent for Lata
after the onset of her illness and her value also decreased
with the recurrence of every episode. Her husband
developed such hatred towards her that he did not want
to see her again.
The above information was obtained when attempts
were made to reintegrate Lata into her family. She
was 40 years old at the time. It was learnt that her
mother had died many years ago, both her brothers had
committed suicide because of mood disorder, substance
abuse and consequent physical and social problems.
The only person with whom she had anything to do
with in this world, was her husband.
In addition to episodes of mood disorder, Lata had a
bad temper. She was very demanding, always had her
way in everything and looked at issues only from her
perspective. She always felt that she was right while
others were wrong. All of this made her a difficult person
to live with. During one of the episodes, Lata wandered
away from home and spent weeks on the street. She was
rescued by Odanadi a voluntary agency for homeless
women in Mysore. They soon realized that Lata was
mentally ill and very difficult to manage because of
her destructive behaviour, unprovoked aggression and
demanding nature. They shifted her to Manasa and she
stabilized, over a period of five months.
Lata was then sent back to Odanadi as the team could
not locate her husband. Her husband was evasive and
remained aloof as though he had nothing to do with her.
He simply refused to pick up the telephone and answer
16
calls. Luckily, he did not change the telephone number

or else Latas life would have remained a mystery. She
was eager to join her husband and live life as normally
as others did, but she could not succeed. She was so
frustrated that she demanded to walk out of Odanadi
to live on her own in Mysore and trace her husband.
This behaviour of Lata was not taken kindly by anyone
who helped her. Apparently, she had some money in
her account, which made it possible for her to think of
such an option.
Lata meanwhile stopped medication and developed a
full-blown relapse and wandered away. It is pertinent
to note that she left Odanadi to live on her own in the
community. While she lived on her own, she did not
adhere to the drug treatment which led to a relapse.
This time she was picked up by the police and admitted
to Nirashrithara Parihara Kendra (NPK), Mysore.
Since the Manasa team gives inputs for the mentally
ill residents of NPK, they recognized her instantly.
The team stabilized her once again and tried to make
contact with her husband after numerous attempts
to locate him. However, he flatly refused to take her
responsibility. He indicated that he would be able to
extend financial support for her hospital treatment
and medication, but nothing beyond that. While
negotiations were on, Lata was shifted to Shaktidhama
a home for destitute women in Mysore.
Despite her pleas to her husband to allow her to live
with him and their son, he refused to accept her. Lata
lived with dignity and self-respect in the safe environs of
Shakthidhama amidst women who shared similar family
problems and were waiting for a miracle to happen.
Long standing illness with relapses and
exacerbation.
Comorbid personality disorder.
Marital separation.
Poor compliance with medication.
Non-availability of any relatives.
Non- existent support systems.
Poor understanding about the nature of illness
on the part of the husband.
High expressed emotion on the part of the
husband.
Indifference and neglect by the husband.
Case illustration
14
Chandni, a 22 year old unmarried woman from
a very poor family lived with her mother in a village

near Hunsur. The mother reported that Chandni was
above average in studies till about the 7th standard.
Unfortunately, her performance started declining from
the 8th standard onwards and she stopped going to
school. Her family consisted of her mother, a sister who
was married and an uncle who was responsible for the
family. Chandni spent her time doing household chores
as her mother was engaged in earning for the family.
While the family was coping with the desertion by the
father, Chandni suddenly started exhibiting strange
behaviour - she began spending a lot of time in front
of the mirror and laughed while looking at herself. She
used to pace up and down frequently and got angry for
no reason. She lost interest in self-care, refused to bathe
or change her clothes and gradually started talking to
imaginary voices. Her mother and uncle felt that spirits
possessed her and they took her to the nearby traditional
healer. The interventions by the traditional healer were
expensive, but not useful. Therefore, they had to resort
to the priest for help. In spite of all the interventions,
the mother noticed a further deterioration in Chandni.
She used to wander away very often and had to be
locked in the house.
The mother was finding it very difficult to cope with her
work and manage the household. The other daughter
was also working because they had to clear the loans.
These problems made things worse for the mother. She
could not prioritize between her daughters ill health
and generating income for the family.
Chandni went missing one day and the mother was
devastated. She was deeply perturbed and felt guilty
that she did not perform her role of taking care of her
daughters needs. Yet, she also felt that she did things to
the best of her ability to earn, manage the household and
perform the social responsibilities, given the situation.
She often felt the absence of a male in her life, who
could share responsibilities with her.
The mother was on her knees all the time, asking her
lord (Jesus Christ) to save her daughter from antisocial
elements and bring her back. Her never-ending prayers
yielded results and one day she heard from Manasa that
Chandni was safe in their custody.
The day she went missing Chandni had taken a bus
and reached Mysore although she did not intend to
go to Mysore. She was wandering around in the city

when one of the volunteers from Odanadi rescued her
from the streets. They soon realized that Chandni was
mentally ill and tried to contact Manasa, where she was
later shifted for evaluation and treatment. Chandni
was found to have increased motor tone, was mute and
refused to eat. It was extremely difficult to feed her and
she refused medication. She was admitted in the local
medical college psychiatry department for further care.
She exhibited symptoms of chronic psychotic illness.
As her health was deteriorating, she was administered
electroconvulsive therapy (ECT) and improvement
was seen after the sixth ECT. She was shifted back to
Manasa and was started on oral antipsychotic drugs.
Unfortunately she did not respond to risperidone
and fluphenazine depot injections in adequate doses,
separately. She was ultimately stabilized on sulpiride
and olanzapine.
As she got better, her past life was reconstructed and
her roots were traced to a village close to Hunsur.
Evaluation of the family situation warranted dispensing
free medication and the same was posted to them every
month. It was extremely disappointing to note that the
family had discontinued medication and packets of
the drugs were lying in the house, unused. The most
serious of the consequences had been the relapse of
illness and Chandnis refusal to take medication. This
virtually pushed the mother to the wall and she was
totally helpless not knowing what to do. It was rather
disturbing to note that despite so many problems, the
mother had not contacted Manasa or any other facility
for help. Following a home visit she was shifted to
Manasa once again, to initiate treatment.
The following were the issues in the case:
Chronic psychotic illness.
Single parent family.
Lack of support and poverty.
Poor awareness about the nature of the problem.
Low priority given to health in the family.
Lethargy and apathy on the part of the mother
due to burnout.
Poor compliance and relapse of illness.
Lack of regular follow-up with mental health
services.
The above case example illustrates the need for
proactive home-based care in the community.
17
Case illustration
Nisha
15
was rescued from Mysore following a call

from a concerned citizen, through the helpline. It was a
real miracle that Nisha was reintegrated with her family
because she was diagnosed with Mental Retardation
associated with Epilepsy. Experience suggests that
persons with mental retardation have the poorest
reintegration rates. Nisha was very weak when rescued.
She could hardly utter a word, but soon regained
strength with regular food and care in Manasa. It is to
the credit of Manasa that she was alive and safe with her
family members.
Nishas story unravelled after a visit to her family. She
lived with two other normal sisters who worked in the
local garment factory as they came from a very poor
background. Her father was an alcoholic and earned
only to drink and take care of himself. Hence, the two
daughters and mother had to work hard to make both
ends meet.
Nishas family had very limited support to take care of
her and supervise her. She was therefore locked in her
house to ensure that she did not wander away. Despite
this, she wandered away, but fortunately she was rescued
very early.
Nishas mother reported that she could not take her
to the doctor for a long time, because she did not
know that her daughter could be treated. She had
consulted a private practitioner who had prescribed her
anticonvulsants, which they could not afford. Since she
was not showing any improvement as she grew up, the
mother lost all hopes of change and so, left her alone
without any anti-convulsants.
When she followed up for a review, it was disheartening

to note that Nishas health had deteriorated markedly,
because of malnutrition and frequent seizures. The
family members did not take her to the local hospital
ever since she was relocated nor did the Manasa team
bother to follow up the remarkable work they had done.
Nisha was isolated and confined to one corner of a
room, which was allotted as part of the ASHRAYA
scheme. She was a source of shame and embarrassment
to the family since she soiled her clothes and was often
cursed for that. Despite difficulties, the mother did as
much as she could to care for her at home, while the
sisters remained indifferent, because the bed-wetting
continued frequently.
Intellectual disability and seizures.
Poverty and lack of social support.
Alcoholic father and indifferent sisters.
Caring mother but unable to cope with the needs
of the family and Nisha.
Poor awareness about the nature of the problem.
Uncontrolled seizures because of poor
compliance.
Had to be physically locked up in the house
because of several other compulsions.
Not receiving welfare benefits.
While she was at Manasa her general condition

improved significantly. She was able to provide patchy
information of the name of the town and area she
lived in. Using this information and other resources,
Nisha was miraculously relocated to her home and was
advised to consult the local government hospital doctor,
for further follow-up.
18
Case illustration
16
Savita moved from one place to another after the
death of her husband. Despite all the hard work done

to care for her family and relatives, she had no place to
go and none of her relatives wanted her. It is against this
background that she went missing from Nangangud
near Mysore. She was rescued by the police and
brought to Manasa. Evaluation revealed that 67 year old
Savita suffered from memory disturbances, and right
hemiparesis with hypertension. She was very agitated
and confused initially, but settled down gradually.
Information obtained from her was accurate enough to
retrace her steps back to her house. On talking to her
relatives and neighbours, it was found that Savita ajji, as
she was affectionately called, was a neglected soul. Her
son had been very indifferent towards her for a long
time. Apparently, his wife did not like the way she was
handled when she was married. She was criticized for
not managing the household efficiently and hence had
a lot of anger and hatred towards Savita. The son had
conveniently assigned the responsibility of caring for his
mother to his relatives, just because Savita wanted to
spend her last days in Nanjanagud.
He finally decided to meet his mother and initiate

appropriate action so that the old mother gets her due
share of care. It was a huge effort to bring him to the
negotiating table. His employer had to be contacted
and apprised about Savitas plight.
Elderly individual with progressive memory
disturbances with hypertension and residual
hemiplegia.
Neglect by son because of family conflicts.
Support from other family members was
available but could not be sustained for a long
time.
Lack of facilities for the elderly in the local area.
Fast changing social and ethical values in the
community. It is amazing that an elderly mother
had become a liability to her only son.
The cousins were very affectionate and took good care

of her, but they were doing all this under duress. They
were unable to assert that they could not take care of
a disabled old lady because of various constraints and
financial difficulties. They could not negotiate with
Savitas son about the implications of care and the
finances involved, simply because he was evasive. They
were managing her helplessly.
Her sons address was traced and he was asked to come
and meet the Manasa team. He reported that there
were too many differences between his mother and his
wife, which were difficult to manage. He was unable to
appreciate the fact that his mother was living her last
days and needed some personal attention from people
who mattered in her life. He also stated that he had a
lot of financial problems and was struggling to meet the
demands of his family. Moreover, he said that his mother
was not willing to live in an alien city like Bangalore
and became agitated the moment he suggested that she
should move to Bangalore.
19
Case illustration
17
Neelam, a 23-year-old unmarried lady lived with
her family members, in Mandya district. Her family

consisted of her father, mother, brother, sister in-law
and niece. Neelam was admitted to Manasa through the
police of Mysore city. Apparently she was controlling
the traffic in the city, which made the police swing into
action. They soon realized that she was mentally ill and
took her to Manasa.
Neelam is a well-built young lady who dreamt of
becoming a traffic police officer. She often fantasized
being an inspector and realized the same in her morbid
state. Retracing her steps back to her house, her family
members were delighted to see her alive and safe. They
were, perhaps anticipating the worst, from the time she
mysteriously disappeared from home.
Her parents recalled that she had episodes of overactivity, increased energy, optimism and boastfulness,
periodically, for the last 5 years. She experienced the
first episode of mania when she was 18 years old and
this disrupted her education. She managed to complete
her studies till pre-university, but could not continue
because of the periodic recurrence of these episodes. In
a way, her mood disorder had seriously interfered with
her progress and shattered her dream of becoming a
police officer. In school, she had joined the National
Cadet Corps with the intention of serving as a police
officer. Her ideas were further reinforced by friends and
class mates, because of her physique.
Neelam had been ill periodically from the age of 18,
as mentioned earlier. She was taken for consultation
at NIMHANS, Bangalore and she was referred to JSS
medical college in Mysore for further follow-up. The
problem started when she was advised to continue
medication, despite being well. The parents were unable
to understand the doctors persistence to continue
medication although she was asymptomatic. The lack
of trust and inability to accept the medical advice, led
to several recurrences, since no prophylactic medication
was taken.
20
It was interesting to note that Neelam and her family

had not learnt anything, despite the setbacks suffered
by the family. They had stopped medication, when
the family was contacted as part of the evaluation of
Manasas rehabilitation work. They reported that they
could not afford to buy lithium. This reason did not
seem very genuine, because the cost of the drug works
out to only four rupees a day.
The entire family was educated about the nature of her
illness and the need for regular medication to prevent
further episodes. The family further reflected upon the
need for welfare benefits and the necessary arrangements
were made for facilitating the processing of the same.
The team informed the family that the medication had
to be taken regularly. They would have to contact the
Manasa team as and when required and provide all the
information. One could only hope that Neelam would
work towards shaping her future, by being careful in the
years to come.
Episodic illness for the last 6 years.
Being unmarried despite being of marriageable
age.
No experience of stigma or discrimination.
Economic difficulties leading to frequent
discontinuation of medication.
Poor compliance with medication.
The above example highlights the need for
proactively reaching out to families who are
unable to purchase medication.
Poor understanding about the nature of the
illness and the need for continuity of treatment.
Need for welfare benefits.
Case illustration
Lalita,
18
a married lady with two children, hailed from

Srirangapatna taluk. She developed the first episode of
mental illness when she was 30 years old. The episode
lasted for about one month and remitted spontaneously.
Lalita was very irritable, aggressive, disruptive, abusive,
suffered from insomnia and talked excessively. She
worked as a gardener in a local factory. The second
episode occurred five years later. This episode was much
more severe and she suddenly disappeared from home.
She was walking on the road unmindful of the traffic,
when she was rescued by the police and admitted to
Manasa.
The following were the key aspects of the case:

Episodic mental illness.
Untreated before she was dislodged.
Diagnosed as BPAD currently manic.
Reintegrated into her family.
Discontinued treatment despite being given free
drugs.
Poverty, financial and social difficulties.
Lalita was initiated on antipsychotic drugs and settled

within a short period of time. Efforts to rehabilitate her
resulted in her revealing an address near Mysore city. A
volunteer was sent to confirm whether such an address
existed. After meeting the family, they requested the
family members to come to see Lalita.
Her husband was pleasantly surprised that he had got
his Lalita back. She was discharged with information
regarding regular treatment. The family was visited as
part of the evaluation and it was found that she had
stopped medication because she was feeling fine.
The team had to wait for a while to meet her. Apparently
she was busy in the fields. We learnt that she had
changed her job from the one in the factory, to work in
the sugarcane fields. She and her husband would take
up contracts/piece work of harvesting the sugarcane and
transporting the same to the sugarcane factory.
Interaction revealed that she felt very insecure about her
future, since she had two daughters. Her husband felt
overwhelmed, whenever she talked about their life and
their daughters in particular. Current evaluation revealed
that she was euthymic without any issues, except that
she had discontinued medication. She and her husband
felt that she did not require medication because she was
keeping well and functioning adequately in all spheres
of life.
21
Case illustration
Priyanka
19
, a 46 year old woman had migrated to

Thiruvanamalai town, after some reorganization in her
family. The family disposed their property in Bangalore
and decided to move to Tamil Nadu. Priyanka got
dislodged from the family nearly 15 years ago. She
was married and had three children, when she went
missing. Apparently, she got married to a man of her
choice, which resulted in a strained relationship with
her parents and other siblings.
She was in good health till she had three children.
Gradually her life started to fall apart like a pack
of cards. There was no sign of any ill health, till her
husband suddenly died of a heart attack. Priyanka
was so ill-prepared that she could not handle her life
after her husbands death. When she suffered a mental
breakdown, her oldest child was 10 years old and her
youngest was three.
Following this set-back, some degree of reorganization
occurred in the family. She was admitted to NIMHANS
and initiated on treatment and subsequently discharged.
Priyankas family members had just come to terms with
the two major events- the death of her husband and her
mental break down. It was unfortunate to note, that the
family somehow remained distant from Priyanka. There
was no cordiality amongst key relatives. There was no
supervision of medication, which must have led to a full
blown relapse and dislodgment.
Priyanka was reintegrated and continued to remain

well. She was on 4 mgs of risperidone per day. Her
eldest son started working and he had taken over the
responsibility of running the family. Her brothers also
provided her with the required support to manage her
affairs. As she was a widow, it was crucial in her culture
and community to have the support of her brothers
and other relatives so that she could perform her social
obligations smoothly.
Continuous illness for more than 15 years. Illness
precipitated after the death of her husband.
Initially the family was supportive but
relationships got strained because of property
disputes.
Lack of continuity in care after being discharged
from NIMHANS.
Relapses and remissions resulted in dislodgement
and homelessness.
Very poor physical health which required life
saving measures to stabilise her.
Despite long duration of illness Priyanka showed
remarkable improvement.
Remained well without any relapse or
exacerbations after nearly two years of good
compliance and good treatment adherence.
In Mysore, the Nirashrithara Parihara Kendra (NPK)

staff picked up Priyanka from the street, because she
was begging. She was in the destitute relief centre
when she was first seen. She was shifted from NPK
to Manasa and evaluation suggested schizophrenic
illness. In the acute phase of the illness, Priyanka was
catatonic (a state characterized by mental and motor
retardation) and needed admission in the local medical
college. Her nutritional status and hydration was poor.
Electroconvulsive Therapy (ECT) was administered to
stabilise her condition. She improved dramatically and
once she was manageable, she was shifted to Manasa.
22
Case illustration
Sonali,
20
a 32-year old married woman, with one

girl child, lived with her husband and daughter. Sonali
was more like a child in the family, than a wife and
mother to her husband and child. She belonged to
a rich family and her husband was from a very poor
family. He was aware that she was different from the
day of the marriage. The husband was quite loyal to her
father and brother-in-law, as they were highly placed
in their community due to their educational status and
financial position.
Sonalis life had been rather unfortunate, since birth.
She lost her mother soon after she was born and she
was taken care of, by her stepmother. As she grew up,
she could not establish a bond with her stepmother. She
did not go to school because the family did not send
girls to school. Instead, she was being tutored at home
by a special teacher who was appointed for this purpose.
Sonali lost contact with her family after marriage as
there was some misunderstanding between her husband
and her parents.
Sonali had been ill for the past eight years, when we met
her as part of an evaluation. She had been married for
ten years and the first episode occurred soon after the
delivery of her first daughter. She suddenly developed
withdrawal symptoms, mutism, unresponsiveness, and
sadness. For the first time, her husband recognized
that she had severe problems and she was hospitalized.
Subsequently, she was discharged after recovery.
Since then, there have been recurring episodes every
year. Each of these episodes was characterized by
being overactive, an increased sense of familiarity,
talkativeness, sleeplessness and a compulsive urge to be
on the move. It was reported, that she had gone missing
on three occasions, since her return from Mysore.
Sonalis husband married again as she was not able to
manage the household and her only child. Whenever
she worked in the kitchen, she would make a mess and
no day would pass without a disastrous incident.
From the time her husband remarried, Sonalis position
in the house was like that of the eldest child of the
family. She would wake up after 10 in the morning
and help in the kitchen, as and when required. Her
main role was to wash the dishes and clean and sweep
the house. One major change that the husband made
with respect to taking care of her was that he locked
the house whenever he went out, to ensure that she did
not wander away. He said that Sonalis trips (wandering

away) caused huge losses to the family. She had lost gold
jewellery on several occasions, burkhas and several other
valuables. Interestingly, Sonali was not distressed about
this at all, as she was unable to realise the value of the
things that she had lost. The scariest moment was when
she disappeared the last time around with her sisters
son. This caused a great deal of tension in the family.
The child was found near a police station left there
forgetfully, rather than deliberately. Luckily, someone
recognized the child and informed the police about the
childs father and their address. The child was sent home
late at night and the matter was easily sorted out, since a
complaint was lodged in the same police station.
Sonalis husband was a real estate agent and made his
fortune during the last boom in Bangalore. He had
neither taken her for any consultation, since her return
from Mysore nor had he administered medication, as
advised. There had been no telephone contact with
Manasa despite Sonali going off, without informing
anyone, on three occasions. Sonali was euthymic when
last evaluated. However, supervision of medication and
compliance was inadequate. Both these issues were
addressed and one hopes that she will be managed well
in the years to come. Compared with many unfortunate
women in the community, Sonali was lucky to have a
very considerate and affectionate husband. He is willing
to take it in his stride and move on.
A case of an intellectually challenged person with
comorbid mood disorder perhaps rapid cycler.
With the onset of mood changes, she felt a
compulsive urge to move on and wandered away
to see places/ talk to people, etc.
Has been diagnosed with mental retardation
and Bi-Polar Affective Disorder (BPAD) rapid
cycling.
Compliance with medication has been poor.
No supervision of medication and follow-up in
Bangalore after reintegration.
Accepting her disability and assigning roles
appropriate to her ability.
No follow-up contact with the family outside the
evaluation related contact.
23
Case illustration
Jyothi
21
s life changed forever, after the onset of her

illness. She along with her two children lived with
her elderly parents in Bangalore. The parents found
it difficult to be on their own, but had no choice but
to care for their elder daughter. They often wondered
whether Jyothi would ever become independent and
live on her own. They were in a way deeply disappointed
that she could not completely manage her own life and
nurture her children. They wondered who would take
care of her, after them. The thought of her becoming
homeless and wandering away from home haunted
them and made them feel apprehensive.
Jyothi like any other girl her age, got married with
dreams of a happy life. Things got bad with the onset
of illness, five years after she had two children. The man
whom she trusted as her life partner became indifferent
and negligent towards her.
Jyothi was found in Manasa after being rescued from
the streets, following a call on the helpline from a
concerned citizen. Her family members were delighted
to learn that she was alive and safe at Mysore. In fact,
they had taken her to Shimoga to try interventions
from the psychiatrist there. Unfortunately, she escaped
from there and all attempts to find her, failed. The
father returned home deeply disappointed and guilty.
He often thought that he should have just kept quiet
and taken care of Jyothi at Bangalore itself. After nearly
three months, he received a visitor from Manasa who
broke the news that Jyothi was safe at Mysore.
The father decided to bring her back to the house and
she continued to stay with him. He had been responsible
for taking care of her and her children. The husband
did come to see her but was not willing to do anything
more than pay courtesy visits.
The son who had to take over the reins from the father,
did not live up to the fathers expectations. He was
preoccupied with issues in his own family and even
reduced the number of visits to his parents. He had
even stopped taking his sister to the hospital for a review
despite working in NIMHANS, which is considered one
of the best psychiatric centres in the South East Asian
region. With all the pain, sorrow, misery, suffering and
disappointment, the old father is able to stand up on his
weak legs to take his daughter periodically for a review,
to the hospital. He apologetically says Anyway I have
to do what I have to do for my daughter; regardless of
my poor health. I do not want my daughter to wander
away once again.
Jyothis father has been purchasing medication on his
own and encouraging her to take it regularly. Despite
regular treatment she continues to have symptoms and
disability. It would have been beneficial if she were taken
to the doctor for regular reviews so that new drugs could
be administered to make changes in her life.
Long-standing illness with significant disability.
Mother of two children.
Stigma and discrimination.
Separated from husband who provides practically
no support to her.
Primary carers are elderly parents.
Continues to be symptomatic despite regular
treatment.
Very poor follow-up care.
Disability welfare benefits would have been of
great value to her.
Jyothi is one among three siblings to her parents. Her

father was a government servant who retired more than
a decade ago and lived on his pension. Another married
daughter was well, but had issues in her own life and
therefore has no time for her sister or elderly parents,
except to make a courtesy call on special occasions.
24
Case illustration
Sonam
22
originally belonged to Salem district of

Tamil Nadu. She migrated to Bangalore and was
involved in the fabric business. The family was located
on the outskirts of Bangalore. Sonam and her husband
had a significant age difference. While Sonam was in
her early fifties, her husband was in his early seventies.
They had a married son who was 32 years old. All four
lived in the same house.
According to her husband, Sonam wandered away
mysteriously one day. She was mentally ill and was being
treated at NIMHANS for nearly four years, before she
left home. She was diagnosed as schizophrenic and when
we met her she was HIV positive. She was rescued from
Nanjanagud town close to Mysore city and later shifted
to Manasa, after completing the admission formalities.
Initial evaluation suggested that she was floridly
symptomatic. She was hearing voices and felt very
distressed about it. She believed that people were
performing black magic, to harm her. She was restless
and tended to be very suspicious and agitated at times.
In addition, she was incoherent and complained of
multiple body aches. She was put on depot injections and
oral antipsychotics, resulting in gradual improvement.
She was on Anti Retroviral Therapy (ART) and

consulted the doctor regularly. Her son and daughterin-law took care of her as well. Sonam followed-up
with NIMHANS, regularly and she had been well for 8
months after reintegration.
Was treated at NIMHANS before she was
dislodged from home.
Was HIV+ and was on ART.
No evidence of opportunistic infection when last
evaluated..
Significant reduction in symptoms but had
moderate disability.
On regular follow-up at NIMHANS.
Retracing her steps back to where she came from,

she was able to give us a coherent address, which was
located in Bangalore. The sudden change in the physical
health of the person was not known to the family. The
HIV positive status and long term implications were
also discussed. Fortunately, her son worked in an
organization which provided assistance to HIV positive
people.
25
Case illustration
Sunila
23
s story is one of the dramatic stories of

reintegrated, mentally ill women. She was 55-years old
when she was reunited with her son and daughter-inlaw in Bangalore.
Sunila developed psychotic illness after the birth of her
son. She continued to remain unwell all through his
early childhood. Her son did not have the privilege to
be breast-fed by the mother. She was never treated for
the mental health problems with allopathic medication.
The family members thought that she was affected by
the evil eye, since she gave birth to a male baby. So she
mainly received religious and magical healing. There
was no significant change in her clinical condition for
months and subsequently she wandered away.
The son did not remember anything about his mothers
illness and whatever he knew was through his father and
other relatives. Her husband died and this information
was not known to her. Sunila was rescued by the staff
of The Banyan in Chennai. She was being treated there,
with great difficulty because they could not understand
the Kannada dialect she spoke. She claimed that she
was from Sira taluk of Tumkur. From the information
available, efforts were made to talk to people in Sira
taluk. Luckily, the volunteer was able to meet a person
who had known Sunilas husband. He was able to
reconstruct the story of her mental breakdown and
subsequent dislodgement. Fortunately, he was able to
trace the location of her son who had completed his
MBA and was living in Bangalore.
The reintegration of Sunila picked up pace and all efforts
yielded results, without any hindrance. Perhaps it was
Gods wish that Sunila becomes part of the newlyweds
life. When she arrived at home, Sunila was able to see
her son married and living with his wife, in Bangalore.
Her son, could not immediately recognize his mother,
but eventually did with the help of other relatives. The
union of the family was so apt and the entire family
was overwhelmed with emotions. The union was indeed
miraculous and sort of a divine intervention. She came
back to bless the young couple and guide them through
their lifes journey.
What if the girls relatives cast aspersions on the

family?
When they were processing the marriage alliance, they
were under the impression that his mother was no
more. They never considered the possibility of someone
arriving at the right moment to say that they were
related to the boy. The divine intervention worked at
the right time and perfectly well. Sunila lived with her
son and daughter-in-law and oversaw work at home,
passively. Sunila had significant disability and dressed
up to receive guests when they came to visit. She seemed
to want to catch up with all that she had lost. She was
unable to respond appropriately to people with whom
she interacted, because of affective blunting. However,
she saw herself as being part of the family and living as
the head of the family.
Long-standing psychiatric illness.
Returns home after 20 years.
She could not see the face of her life partner.
Miraculously appears three days after the
marriage of her son.
Broken links were joined by the relatives.
The most dramatic aspect has been the
acceptance of her by the son and daughter- inlaw.
Continued to be on treatment.
Diabetic and attended regular follow-up with a
private psychiatrist.
Wonderful example of the usefulness of
networking among agencies working for the
homeless.
She was rescued and treated in Chennai but
joined the family at the right moment.
The whole episode of the reunion was full of

uncertainties. The issues were as follows:
What if the son fails to accept Sunila as his mother?
26
Case illustration
Anushka
24
lived with her two children in

Doddaballapur Taluk, which came under the
jurisdiction of Chickaballapur district. One studied
in the 10th standard and the other in the 2nd year of
Pre University College. As an agricultural family they
earned enough to manage their lives and although
they faced many problems, they were able to make
ends meet.
She was 40 years old when she was rescued by the

Manasa team and diagnosed with BPAD. Her history
suggested that Anushka was well, till about 2 years
before she was rescued. The family members noted
that she developed dullness, withdrawal symptoms,
decreased sleep, decreased appetite and crying spells
for which no treatment was sought. These symptoms
lasted for several months and gradually disappeared.
They reported that she was consulting doctors
frequently during this phase of ill health and generally
spent a lot of money, so much so, that they incurred
debts. Anushka felt frustrated that all her attempts
to sort out her ill health did not yield results and
therefore started consulting faith healers.
They suggested that her problems were because of
black magic performed on her by jealous neighbours
and relatives. Anushka believed that the interventions
by the faith healers and exorcists yielded results, as
her symptoms decreased. Over several months, all her
bodily complaints and sadness disappeared and she
functioned like any other person, her age.
About, a year later, Anushka started becoming very
strange. She began talking a lot, had great plans to
improve her village and believed that she had special
powers. She was found talking to people (both men
and women) without any inhibition. She sang songs,
danced, often changed her clothes and sometimes
used a lot of makeup, which was very unusual for her.
The neighbours and relatives thought that she was
possessed by a young girl who had committed suicide
some years ago. While they were preparing to drive
the ghost away, Anushka disappeared from home.
She had some money and travelled by several buses
to reach Mysore. All her money was exhausted by the
time she reached Mysore.
It was during this time that she was rescued by the

Manasa team. Evaluation revealed elation, interfering
behaviour, grandiose delusions and sleep disturbances.
As she got well, she was able to communicate well
and she could recollect her permanent address. It was
surprising to note that the family members arrived as
soon as they got the information and they were pleased
to see her in the facility. They soon took her home and
she was on regular medication provided by the Manasa
team, by post.
Anushka was visited at her home, as part of evaluation
work and it was heartening to note that she was at home
and well. What was disappointing was that she had
discontinued medication for the past four months and
the reason was that she suffered a burning sensation in
the stomach. It was also noted that she had not contacted
Manasa, to report about the burning sensation in her
stomach and thought that as she was well, she could
stop medication. Anushka did not consult any mental
health professional or the local primary care doctor for
advice, regarding the dose of medication.
Anushka was reintegrated about 15 months
prior to evaluation.
She had been maintaining improvement.
She had discontinued medication because of the
burning sensation in the stomach.
The family had no contact with the Manasa
team to report about the progress.
She was receiving the medication sent by post
and they were just storing it. She had four
months stock with her, at the time of evaluation.
Anushka had two episodes depression followed
by mania. She had left home during the manic
phase of the illness.
The family accepted her and life was normal
since her return.
No experience of stigma or discrimination.
27
Case illustration
Shreshtha
25
married when she was 22 years old, but

became a widow when her husband died of tuberculosis.
She was well, till the age of 30. The members of her
community decided to get her married once again, so
that her life would be secure. Shreshtha, who had two
children by her second marriage, lived in a single room
accommodation in Mysore. She had been ill for the
last ten years and was admitted to NIMHAMS soon
after the onset of illness. She was started on medication
and sent back to Mysore. Realizing the gravity of the
situation, and recognizing Shreshthas inability to take
care of her kids, the children were shifted to Bangalore
so that one of her sisters could take care of the children
and educate them. Shreshthas children did not want
to be with their mother because she tended to be very
irritable and abusive. They considered their aunt as their
mother.
Shreshtha wandered away from home while she was in
Mysore. She was rescued by the Manasa team and shifted
to the transit care facility. Despite the long duration of
illness, she made symptomatic recovery within four
weeks of treatment. Retracing her steps back to where
she came from, Shreshtha was successfully reunited
with her family.
Gradually things started to get worse because of her
deteriorating mental condition. Shreshtha was shifted
to Bangalore, because she could not get along with her
sister-in-law. She started accusing her sister-in-law of
being a woman of bad character, resulting in frequent
quarrels at home. Having shifted to Bangalore, she
discontinued treatment because the Manasa team did
not know that she had migrated to Bangalore.
Shreshtha suffered a relapse and her job was terminated

as her efficiency and dependability was progressively
decreasing. She often got into arguments with her
employers and they terminated her services.
Shreshtha was symptomatic when the team visited her
in Bangalore as part of the evaluation work. It was found
that she was using enormous amounts of snuff about
3 boxes per day, costing nearly twenty rupees. Her sister
was constantly after her, to persuade her to stop the
habit and this only increased the conflict between them.
Ten years duration of illness with relapses and
exacerbation.
Poverty and severe financial difficulties.
Two children who were being taken care of by
the aunt.
Very supportive family though at times they were
indifferent.
Family was unable to take advantage of the
professional help and practical support provided
by the Manasa team.
Despite the long duration of illness the response
to the treatment was good.
Lack of proper information about migration
resulted in not having access to medication.
Follow-up evaluation made it possible to gain
new insights into the life and world of Shreshtha.
Her sister who was ill was hospitalized as her
physical and mental condition was quite bad.
A good example to plan assertive home-based
care.
The family had been struggling with many issuespoverty,

accommodation
problems,
financial
difficulties, one more sister being mentally ill and so on.
Supervision of medication became the last priority for
the family, since they had to deal with many problems,
and no one had the time to give attention to her. The
family had to relocate Shreshtha to Bangalore so that
she could receive care and attention from one of the
sisters who was a widow. Her sister was able to find her
a job as a housemaid in the neighbourhood where she
earned about Rs.600-800 per month. The family had
to move from one accommodation to another and the
drugs posted could not reach them and therefore, the
drugs were stopped.
28
Case illustration
26
Ghazhal, a 25 year old unmarried woman, resided
in Chamarajnagar. Her only hope was her sister, with

whom she was staying. Her parents had passed away
and the responsibility of taking care of Ghazhal rested
with her only sister, who was married. It had been a
great challenge for Ghazhals sister to take care of her.
No one in the family or in the neighbourhood was kind
and considerate towards Ghazhal. They felt sorry that
God was very harsh towards the sister, who had been
given the responsibility of looking after Ghazhal.
Ghazhals sister was very upset about her predicament.
Her husband and in-laws had not been very supportive
of her decision to take on this responsibility. The
sisters response to the difficulties faced was to pray that
Ghazhal would go away. Ghazhal was being kept like an
untouchable in her house, bundled up in a gunny bag
as though she did not deserve anything more than that.
Her sister managed the situation with great difficulty.
Ghazhal, her sister and a brother are siblings. The brother
had conveniently forgotten Ghazhal, even though he
should have taken her responsibility. Hence, the sister
took over the reins of care. Historically, Ghazhal had clear
developmental delays, which is indicative of intellectual
disability, which in itself was not a very difficult problem
to deal with. The issues were behavioural problems
growing to psychotic proportions. In addition, Ghazhal
soiled her clothes, threw up when she was forcibly fed,
and needed constant attention. When the family was
visited as part of evaluation, the sister seemed very upset
and angry. She asked us Why have you all thrown me
in hell to burn, by bringing Ghazhal back to the house?
I thought she had gone missing and that she was dead.
No matter how much effort was made to convince
them that although Ghazhal had a permanent disability
which could not be fixed, the psychotic behaviour that
she suffered from time to time could be managed easily
with medication, they were not convinced. The family
members kept grumbling and were not prepared to
listen.
In view of the practical problems faced by Ghazhals
sister, the team had to suggest that Ghazhal could be
shifted to Manasa for some time till her condition
stabilized and would be brought home later. Ghazhals
sister was a bit relieved, for a while. Her eyes glittered
for a moment when she felt that her prayers were being
answered through the Manasa team. Ghazhal was
shifted and her condition stabilized in a short period of

time. She returned home once she was well.
Later, it was found out, that the sister apparently,
stopped treatment once again and gradually things got
worse, which led to another admission, at a later date.
Thanks to Manasa, Ghazhal is alive and safe. She was
vulnerable to abuse and exploitation while she was
on the streets, but this was prevented by early rescue.
Further, she was reunited with her sister based on the
few leads provided by her. She was later rescued from
the grasp of an unsupportive family, which indeed is a
remarkable achievement.
The following were some key issues in the case:
Ghazhal was an intellectually challenged person.
Of the two surviving relatives the sister was the
only person who cared for her with a lot of duress
because her husband and in-laws were unwilling
to support the idea of long term care.
Ghazhal tended to soil her clothes and she had to
be force-fed at times.
Taking care of Ghazhal needed a lot of time,
which was not possible for the sister who lived in
a joint family.
Ghazhal also had psychosis for which free
medication was being posted every month.
Decision to stop drugs was unilateral and no
discussion occurred with the Manasa team.
The sister was the only carer who tended to burn
out frequently as she had other responsibilities as
well.
Ghazhal needed long-term care and regular
medication.
Ghazhal tended to become very regressive when
she was criticized and this made matters worse.
Ghazhal is a good example of the need for
long term care for some individuals in the
community. Often, inability to link such families
to long term care can result in the revolving door
phenomenon, as seen in the above case.
29
Case illustration
27
Juni lived in Tumkur district. She did not go to
school and used to live with her parents. After the death
of her parents, it was her responsibility to take care of
her brother, which she did to the best possible extent.
Following the onset of illness, Juni and her sisterin-law did not get along very well, because she was
considered a burden. She developed psychotic illness
and stopped doing household work. As she could not
play a meaningful role in the family she was rebuked,
constantly. Juni became a source of conflict in the
family. Her sister-in-law considered Juni to be a lazy
person, and a liability for the family.
Juni was never treated for her mental illness, which she
suffered from for more than 12 years. They physically
restrained her, rebuked her if she made a mistake,
locked her up if she was disruptive, starved her if she
was aggressive and so on. About eight years ago, she
went missing and the family members thought that she
was dead. The conflicts reduced dramatically after Juni
disappeared from the home.

Chronic psychosis with predominantly negative
symptoms.
Reintegrated into her family.
Non-supportive sister-in-law who subjected the
patient to a lot of cruelty.
Increase in family conflicts after she returned
home.
Juni had to move to her sisters house.
Discontinued medication for the last three
months.
Significant disability.
This was a good example which highlighted
the need for proactive assertive care in the
community through the existing health care
system. Often, inability to provide such care,
results in many problems and enormous
expenditure which could be avoided by early
intervention.
She was rescued in Chennai and admitted in the transit

care facility where she remained for nearly four years.
She was then, 48 years old and started providing some
information about her family. Her whereabouts were
reconstructed and it took months to clearly locate the
family.
Juni was handed over to her family. The medication that
she was taking was provided free of cost and arrangements
were made so that she received the medication, by post.
Juni was visited as part of the evaluation and was found
in her sisters house. She was reintegrated and lived with
her brother but was later sent away to a new location.
She did not take any medication from the time she
moved to her new location.
When last heard of, she was with her sister. Her sister
reported that she was withdrawn, dull, muttered to
herself and neglected self-care. She moved around very
slowly, and spoke very little. She needed to be supervised
to ensure that she took care of herself. She was unable
to perform any task on her own, without supervision.
30
Case illustration
Ashabanu
28
lived in Jadupalya near Gubbi of

Tumkur district. She was reported to have developmental
delays and cerebral palsy, from childhood. She grew
up as a special child in a large joint family. As a young
woman in her twenties she developed comorbid mood
disorder. She had episodes of illness and each episode
was characterized by her being very happy for no
understandable reason. She sang, danced, laughed
without any reason, frequently changed clothes,
demanded money from people and was sleepless. She
was taken to the local Durgah for treatment, for many
months. They thought that her illness was cured after
complete remission.
During the last such episode, she wandered away and
reached Mysore. When she was rescued, Ashabanu was
pregnant and she found it difficult to describe what
happened to her. Ashabanu was reportedly living in a
sewage pipe for a long time. She would go out to beg
for food when hungry and spend the rest of the time in
her house. Her pregnancy may have been caused by the
sexual abuse she may have suffered, when homeless.

Ashabanu was diagnosed with mental
retardation with cerebral palsy and mood
disorders.
Episodic illness characterized by elation and
depressive symptoms.
Had been homeless for nearly 5 years.
Sexual abuse while on the street resulted in
pregnancy.
On regular medication.
Participated in all household activities.
Good compliance with medication.
The entire village kept a vigil on her to prevent
her from wandering away.
She was admitted to Manasa with florid manic symptoms

and she made symptomatic recovery after intervention.
Ashabanu started communicating about her relatives,
her home, her village and the reconstruction of the same
led to the location of her family in Jadupalya in Tumkur
district. The homecoming of Ashabanu was a great
event for the whole village. The entire village consisted
of one community and most of them were related to
each other. Every member in the village was genuinely
happy, that one of their daughters had returned home.
Ashabanu delivered a healthy male child when she
was actively ill. Her child was handed over to Bapuji
Childrens Home in Mysore. Manasa had to take such a
decision as the family members did not want the child.
Ashabanu received medication regularly every month,
by post. She remained euthymic and participated in
household activities. The entire village took care of her
on a regular basis to ensure that she did not go away,
once again. The family was grateful to Manasa, for all
the services they provided to Ashabanu and her family.
31
Case illustration
29
Shraddha was rescued by the staff of Manasa in

Mysore city in June 2006, when she was 30 years old.
The reintegration of Shraddha was one of the high points
in the work of Manasa. She was unkempt, incoherent,
slept poorly and would hallucinate, sometimes. She was
treated with antipsychotics and she made a symptomatic
recovery over the next four months.
The real challenge started after symptom remission, as

Shraddha also had mental retardation. With persistent
effort, the name of the village, taluk and district was
identified and successful reintegration was carried out
in November of 2009. It was sad to note that there were
no relatives or family members in her village. She used
to live alone in Shikaripura taluk of Shimoga. However,
the house that belonged to her family, remained intact,
and the gram panchayat members and other significant
people in the community, joined together to support
her. The process of support was always a challenge.
As she was a female, only a female could be of help to
support and supervise her. The experience was that, the
help for supervision was not consistent.

Mental retardation from childhood.
Psychosis for the last 5-6 years.
Wandered away from Chickasalur during the
psychotic phase.
Lived alone.
The above example reflects the need for longterm care for persons who live alone. Merely
depending on the community resources may not
take us a long distance in care.
Villagers provided her with food and clothes.
Supervising her has been a great challenge as it
requires female support.
Needed support during menses.
On regular medication, but took more than
what she was supposed to take.
Gets free drugs by post from Manasa
Reintegration of Shraddha was one of the
highpoints in the work of Manasa, because it is
almost impossible to reintegrate such individuals.
The neighbours reported that she sometimes took

an excessive dose of medication, because of lack of
supervision. They realized this when she was very
drowsy and did not open the door for a long time. They
also reported that she was unable to take care of herself,
whenever she had her periods. This was complicated
by the administration of medication. Efforts were
made to link her to social welfare benefits, soon after
the visit to her village. Hopefully, she now receives the
disability welfare benefits, as the district clinic issued
her a disability card.
32
Case illustration
Bhavana
30
lived in the serene surroundings of

Bantawala taluk in Mangalore district. Reports
suggested that she was married and had one daughter.
Her husband deserted her and married again. His
parents had property and a part of that was given to her.
Her aunt took care of her and facilitated people to take
care of Bhavanas part of the land. The land lease fetched
her some money every year.
Bhavana had a daughter who was pursuing her
education, with support from her aunt and other
relatives. Her aunt reported that Bhavana had been ill
for more than 15 years. The predominant problem was
that she was dull and withdrawn, wandered aimlessly,
talked, laughed and muttered to herself, neglected selfcare and suffered from disturbed sleep.
When Bhavana disappeared from the house the family
members thought that she had committed suicide or
that some wild animal had eaten her. The surroundings
where they lived had a very good forest cover and wild
life. She was never treated during the entire course
of her illness, due to the absence of parents and the
unavailability of a treatment facility, close to her home.
The nearest treatment facility was about 80 kms away.

Predominantly negative symptoms.
Concomitant tobacco use.
Poor compliance with medication and poor
treatment adherence.
Lack of mental health services in the vicinity was
a major barrier to use services.
Desertion by husband.
Death of parents.
Had one daughter who was pursuing her
education.
Severe disability.
No review with psychiatrist.
No communication with Manasa outside
evaluation visit.
The above case also brings up many issues such
as guardianship, protection for her share of
property, etc.
After her reintegration into the family, she lived with

her aunt who took care of her. The aunt reported that
Bhavana was disabled. She was very slow in her work and
needed constant supervision to do anything from simple
self-care activity to other activities. She complained of
tiredness all the time and felt comfortable, when she
was left alone and not pressurized to do anything.
Although she was on medication, she often talked about
stopping it, because she felt drowsy, all the time. She
also smoked beedis daily and needed about 10-12 per
day. She managed to get them despite being instructed
not to do so.
Bhavana received the medication by post and did not go
for a review with the local doctor. When last reported
it was found, that compliance with medication was
poor. One parcel of the drug packet was unopened,
which indicated either reduced intake or stoppage of
medication.
33
Case illustration
Lalitha
31
was separated from her husband following

the onset of mental illness. Lalithas separation from her
husband was a protracted battle between two families.
In fact, her husband married again and lived happily
with his second wife and children. There was no contact
after separation.
She was reported to be ill for nearly 40 years. Many
attempts were made to initiate treatment for her, but
the response to treatment was inadequate. Her only son
worked in Mumbai and visited her once or twice a year.
She disappeared from her house in Mangalore and
was away for nearly 25 years, before she was rescued
in Chennai. Perhaps, this is the longest dislodgement
known to us so far. She spent almost 6 years in The
Banyan and was shifted to Mysore after the new
network was established between The Banyan and
Manasa. During her stay in Manasa, repeated interviews
yielded results. Retracing her steps, led her to the port
area of Mangalore. It was a matter of coincidence that
the reintegration team met a person who had known
this family. He faintly remembered that Lalitha went
missing more than 20 years ago. The hope of finding
her was not considered at all. He hired a taxi to help
the reintegration team to identify a few locations. After
five hours of struggle they were able to locate her house.

Long history of illness, predominantly negative
symptoms.
Inadequate recovery despite treatment in the
initial period of illness.
Dislodged 25 years ago and reintegrated.
Need for disability welfare benefit was clearly
established but access was unavailable.
This case also generates the need for long-term
care in the community.
On regular medication.
Severe disability.
Minimal support.
Free drugs from Manasa made available by post
every month.
It must have been a great moment of joy for her sister

to see Lalitha after 25 years. She said I never thought
I would see my sister in my lifetime. I do not know
whether it is a dream or real life. It is the will of God
that I see and take care of my sister.
65 year old Lalitha received her quota of medication by
post from Manasa every month. She was on 4 mgs of
risperidone and 4 mgs of pacitane. Despite medication,
the degree of disability was severe. She needed
supervision for most tasks such as bathing, washing and
cleaning. Her socialization was very poor and she was
unable to communicate with people.
34
Case illustration
Sharada
32
was diagnosed with schizophrenia. She

was rescued by the staff of Manasa and stabilized over
a period of four months. Sharada was known to suffer
from mental illness for nearly 30 years. The family spent
most of their time in religious healing, which was not
beneficial.
Evaluation, soon after rescue suggested the following
abnormalities-auditory hallucination, delusions, disorganized speech, poor eye-contact and lack of insight.
She was medically stabilized in four months and
reintegrated into her family.
Sharadas family was very poor and ridden with
conflicts regarding who would take care of her. She was
accommodated in one of her relatives house. She was
reported dead due to severe gastro-enteritis.
Case illustration
Garima
33
from Chickamagalur district was a

commercial sex worker and was diagnosed HIV
positive. She did not have any diagnosable mental health
problems. There was very little information available
about her as she lived in real isolation. Everyone was
keen to know about her problem. People talked to
her from a distance and even women talked to her by
covering their faces. Efforts were made to ostracize her
from the village. Garima later developed herpes on the
face and these lesions complicated her life.
Garima would have to visit the ART centre for further
treatment.

Sharada was ill for nearly 30 years.
Lack of treatment, persistent symptoms resulted
in her wandering away from home.
Poor response to treatment.
Conflicts over who would take care of her had
resulted in finding a foster family.
Unfortunately she died due to severe
gastroenteritis.
35
Case illustration
34
Rashida was separated from her husband, possibly
due to mental health problems. She had two children

and lived in Belgaum District. Her life was shrouded in
mystery. She went out of the house frequently and no
one knew what she did for a living.
She developed mental health problems after she
delivered her second child. Her husband conveniently
sent her to her mothers house and openly declared that
he did not want to live with her. Her community could
do nothing to stop him, nor did they provide her with
the treatment that she required, although Belgaum has
a number of psychiatric services.
Rashida was reportedly suffering from psychotic
illness for many years. Even her mother suffered
from severe, mental health problems. Rashida was
rescued in Mysore by the Manasa staff and admitted
for treatment. Examination revealed evidence of nonaffective psychosis and treatment was initiated. Good
symptom control was achieved over months and efforts
to rehabilitate her with her family were successful in
October, 2008.
The following were some of the issues in the case.

Long-standing psychiatric illness.
Family history of psychiatric illness - mother as
well.
Very poor family support.
Divorced from her husband because of mental
illness.
No effort was made to take her follow-up in the
local area.
Continuity in treatment was ensured by posting
medication regularly.
Last reliable reports suggested that she wandered
away.
As the family could not afford the drugs, arrangements

were made to give free drugs by post, from Manasa.
Despite this support from Manasa she was reported
to have discontinued medication and suffered a full
blown relapse. She wandered aimlessly, and tended to
be restless, and irritable. She spoke to imaginary voices
and was very abusive. Efforts to contact her were not
fruitful, as she wandered away.
From the last report received from her family, she
continued to be missing.
36
Case illustration
Karishma
35
belonged to a middle-income
agricultural family, who lived in Hassan district. The
family consisted of two daughters and a son. Karishma
was one of the daughters. After she completed ten years
of schooling the father got her married to a person of
equal status in the same district.
Karishma who had been ill after her marriage, found
it difficult to adjust with the family. She realized that
things were not all that well in her life. She learnt that
her husband was already married and that she was
not aware of the same. She was then sent back to her
parents house in Hallimysore and she never returned to
her husbands home.
Karishma started exhibiting strange behaviour. She was
very suspicious, irritable, refused to eat, and seemed
very sensitive to routine comments at home. The family
members thought that she was upset because of her
broken marriage. Her father tried to convince her that
he would take the responsibility to sort things out. He
soon realized that his son-in-law was not a trustworthy
person and so did not want to go back to their house
when they cheated him, so blatantly.
Karishma was missing from the home, when a couple of
days later, they received a telephone call from the local
police station stating that they had found a person who
belonged to Hallimysore and that she was unwell. The
father went to the police station and brought Karishma
back. The entire family consoled her. They did not
realize that she was ill and required treatment. Everyone
kept a close vigil, as though containing her, would cure
the mental health problems she had.
As part of the evaluation visit, Karishma and her family

members were contacted. Karishma was with the family
members, but she continued to be ill. She was very
uncooperative, irritable, withdrawn, did not mix with
people, and remained dull most of the time. The family
members administered the medication regularly, but
there was no evidence of any further progress in her. She
took care of her personal hygiene but needed constant
supervision to keep her engaged in work. She said that
she did not want to return to the hospital.
Two years duration of continuous illness,
progressive with gradual deterioration in
biological and social functioning.
Separation after marriage once she realized that
her husband cheated her.
Not on any treatment before dislodgement.
Poor awareness about mental health problems.
Delays in treatment because they mistook mental
health problems for a reaction subsequent to her
failed marriage.
No follow-up after reintegration.
Remains symptomatic despite medication.
One week later, she was again missing from home.

Devastated, the father lodged a complaint with the
local police and started looking for his daughter in the
local and surrounding areas. They learnt that someone
fitting the description was seen near Holenarasipura,
but Karishma could not be located.
After six months they were pleasantly surprised to
hear that she was alive and safe in Mysore. The staff
of the Manasa team visited the family and the issue of
Karishmas mental health problem and the need for
treatment was discussed. Karishma was reintegrated
into her family in January, 2008.
37
Case illustration
Reshma
36
was a very bright student, who lived with

her parents and sister, in Mysore city. When she joined
an engineering college she had to stay in the hostel,
which she did not like. Reshma had a very good track
record academically, but gradually her performance in
studies showed a declining trend for no understandable
reason. She seemed preoccupied all the time and missed
classes, often. She hardly interacted with her roommate
or her classmates. She was always considered unfriendly
by her classmates and many of them in fact avoided
Reshma. However, what was surprising was that she was
not distressed about not having many friends. She did
not talk to her parents, as often as one would expect.
The parents were very surprised, when they learned that
she did not do well, in her first semester exams. In fact
they were very upset and very angry with Reshma for
not clearing all the subjects. When the second semester
classes began, things started getting worse. She was
talking excessively; often the content reflected her
suspicion about people in general. She gradually started
to suspect her parents as well. When her parents heard
about all these changes, they immediately rushed to her
college and made enquiries about her behaviour. They
were very surprised to learn that there were a lot of
changes in their daughter, which they were not aware
of.
Reshma was unusually hostile, irritable and tended to
be argumentative with her parents and sister. She was
unusually jealous of her sister and hated her parents.
Unfortunately, they could not understand the plight of
Reshma. They were deeply concerned about some new
developments at home. Reshma paced up and down,
started talking to imaginary voices, and argued with
the voices, so much so, that the parents thought that
someone was with her.
Reshma was becoming increasingly difficult to deal
with. Her behaviour was strange and all interactions
with her were becoming very unpleasant. Her parents
failed to understand the changes in her. They consulted
astrologers and religious healers who said that her star
position was not good and suggested some remedies.
Reshma was neglecting her personal hygiene and was
unmindful of herself even when she was menstruating.
Whenever, the mother tried to correct her or even help
her, she met with tough resistance. They often thought
38
of consulting doctors but she refused to budge. She

argued vehemently I am not mentally ill, if you all
have problems, you go and see doctors for yourselves It
is against this background that she left home, one day
after a big fight.
The father lodged a complaint in the police station
and also went around the city many times, without
much success. They learnt after 72 hours, that Reshma
was safe in Manasa. Initial evaluation suggested that
Reshma had florid delusions, hallucinations, grossly
disorganized speech, highly irritable moods and lacked
insight. She was very guarded and did not divulge any
information, so much so, that one could not understand
what she was going through. The diagnosis of severe
mental disorder was clear, but the Manasa team could
not administer any medication because she refused to
take any. Meanwhile, her father was located, based on
the complaint he had lodged at the police station. They
were very keen to take her home as though all the secrets
would come out if she stayed any longer in Manasa.
The parents were instructed to take her to a psychiatric
institution and medicate her. The father was not very
keen to do that. He began administering medication to
Reshma without her knowledge, but she continued to
be symptomatic.
Insidious onset of illness characterized by dullness
and withdrawal.
Progressive academic decline, poor socialization.
Failure in the first semester exams.
Very poor compliance with medication.
Wandered away from home after quarrel with
family members.
Florid symptoms as the illness progressed.
Inability of the family members to identify the
nature of the problem.
Deeply concerned about stigma and
discrimination.
Sensitized police personnel brought her to
Manasa presuming that she had mental health
problems.
Very poor progress made as she refused
medication.
Themes
Some of the following themes are prominent in the case studies along with several other issues. The
reader might have come across many more. We would be interested to know of any issue that the reader
finds significant in ensuring provision of care, to persons with mental illness.
S. No.
Themes
Case Study No.s
Faith healing or no treatment before getting dislocated from home 1, 7, 8, 18, 32, 35, 36
Stigma and Discrimination
2, 6, 21, 33
Poor Drug Compliance
10, 17, 18, 24, 25, 30, 34
4
Need for Long Term Care due to inadequate psycho-social support 5, 9, 11, 12, 13, 16, 26,

19, 26, 31
5
Need for proactive Home Based Care or assertive community care 14, 15, 17, 20, 26, 27
Good Social Support
22, 23, 29
Inspiring others and fighting well with adversity
3, 4, 7, 19, 28
You could write to communication.health@gmail.com
39
Afterwo rd
Sir Ratan Tata Trust & Navajbai Ratan Tata Trust
Sir Ratan Tata Trust (SRTT) & Navajbai Ratan Tata Trust (NRTT) are amongst the oldest philanthropic foundations in India. The Trusts have collaborated with Non-Profit Organizations (NPOs) on the issue of Mental Health
for over a decade. The Mental Health Initiative (MHI) was born out of a need felt by the Trusts for a nationwide
action on the issue. The Trusts supported Manasa under MHI, since 2007.
These case stories are part of an assessment study commissioned by SRTT & NRTT in 2010. The evaluator and
the author of these case studies, Dr. K.V. Kishore Kumar, Professor of Community Psychiatry, National Institute
of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, personally visited each of the women mentioned
in the story, in their habitat.
To know more about the Trusts & MHI, please visit www.mentalhealthinitiative.in / www.srtt.org
Karuna Trust Manasa

Karuna Trust (KT), located in BR Hills, (Chamarajanagar, Karnataka) is a public charitable trust affiliated to
Vivekanda Girijana Kalyana Kendra (VGKK). KT was established in 1986 in response to the high prevalence of
leprosy, in Chamarajanagar district. Having achieved great success in controlling the disease, KT diversified into
epilepsy, Mental Health, tuberculosis and management of Primary Health Centres (PHC). Presently, KT manages
44 PHCs in five states of the country (Karnataka, Arunachal Pradesh, Meghalaya, Andhra Pradesh and Orissa).
KT is recognised as a pioneer in establishing an innovative public-private partnership model for effective primary
health care delivery.
Manasa Project was started by Karuna Trust, in 2006. It works for persons with mental illness, and specially for
Homeless Women with Mental Illness. Manasa provides psychiatric services in Nirashrithara Parihara Kendra
(NPK) better known as the Beggars Home in Mysore, in addition to helpline for homeless mentally ill people.
Apart from these, under Manasa, KT is implementing Community Mental Health Programme in 27 Primary
Health Centres in Karnataka.
40
Odanadi Seva Trust Mysore

Odanadi has 20 years of experience in developing initiatives to combat human trafficking. It is committed to providing a safe place for victims of human trafficking, sexual exploitation, slavery, domestic abuse and poverty. Many
have been rescued from the hands of brothel owners and sex traffickers, others from abusive homes, child marriages
or domestic servitude.
At Odanadi residents are provided with the skills they need to heal, empower, educate and eventually to reintegrate
them into mainstream society. Rehabilitation only represents a small percentage of what Odanadi does. Over the
course of almost two decades, Odanadi has worked with communities, organisations and individuals across India,
to raise awareness and create a peoples movement against human trafficking and sexual exploitation.
Shakthidhama Mysore
Shakthidhama has been housing women who are exploited and abused in the society, since 1997. Shakthidhama
gives them shelter till they find a better place to live. The women who stay here have the chance to become selfreliant. Work in Shakthidhama is conceived as a therapy. Continuous involvement in work helps the inmates overcome lingering delinquencies, that they might have acquired in their past life.
The inmates who are literate teach other inmates who are illiterate. A family counseling center is run and regular
counseling is given to the needy families as well as the relatives and parents of the inmates. The inmates often need
psychiatric consultation and the same is provided as and when needed.
Shakthidhama also runs a helpline, provides free legal aid and medical treatment for distressed women.
41
Published by Sir Ratan Tata Trust & Navajbai Ratan Tata Trust
Sir Ratan Tata Trust & Navajbai Ratan Tata Trust

Bombay House, Homi Mody Street, Fort, Mumbai 400 001
Tel. : 022-6665 8282 Fax: 022- 6665 8013
Website: www.srtt.org
www.mentalhealthinitiative.in

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Untold Stories

Glimpses from lives of a few women with mental illness in India

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

Dr. B.N. Gangadhar, MBBS, MD, FNAMS, DSc

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

hailed from the Maddur Taluk of district

Mansis parents sat near the temple wondering what to

While the family was coming to terms with the loss of

One day, nearly four weeks later, the family was

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

Mansis parents were daily wage earners who lived in a

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

Triveni alias Meena a resident of Bangalore

lived in Koramangala in a small house. Triveni had two

Manasa team responded very positively by promising a

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

, an engineer by profession was the mother

The following were the key issues in the case:

Looking at her plight and that of her child, one of

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

At the time of meeting

The following were the key issues in the case:

Swapna was a resident at Manasa for 16 months and

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

one of four children of elderly parents

Various attempts to fix the problem of Shashi did

Shashi was found wandering in the streets of Mysore

They recollected that Shashi went to school like other

Shashi had failed to respond to two drugs in the past

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

With a new lease of life, Shashi began to dream, but

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

Radha the only daughter of her parents, lived in

Her history suggested that she had been suffering from

Post-reintegration, Radha was visited at her house as

When Radha arrived at Manasa she was diagnosed with

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

, a middle-aged lady from Ooty in Tamil

Babita was on regular medication. She enjoyed working

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

Manisha lived in a village on the border between

Tamil Nadu and Karnataka. She was a native of Mysore,

When Manisha was reintegrated into her family, her

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

Radhika was 19 years old and had completed 10

years of schooling when we met her. She considered

Radhika was readmitted once again and the duration of

After she settled down, she was reunited with her

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

one of six children, lived in T. Narasipura

She decided to leave Odanadi- a place, which protected

Confident that her life was going on well, she stopped

Gayathri a 65 year old woman lived alone in her

house, while her daughter and grandchildren stayed

30 years. She developed the illness when her husband

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India

Ashima spoke a dialect of Telugu, which made one

think that she hailed from Andhra Pradesh. When she

The following were the key issues in the case:

An attempt was made to shift her to the state home

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in In d i a

was diagnosed as having Bi-Polar Affective

calls. Luckily, he did not change the telephone number

U n t o l d S t o r i e s : Glimpses from lives of a few women with mental illness in India