BENGALURU: In the past few days there have been disturbing reports of instances involving individuals with mental health issues (also known as psycho – social disabilities) in street situations in India. Recently, in Thane district of Maharashtra a man with psycho – social disability was hung upside down and beaten to death with iron rods and other sharp objects. There is no clarity about what led to this barbaric act, some witnesses claimed it was because the man had vandalised a few nearby shops, as a result of which a crowd of over 100 people gathered and began assaulting him. The crowd that had gathered also included two on duty police constables, who did nothing to stop the mindless violence and act of murder.

The second horrifying instance took place in Hyderabad, where in broad daylight a woman with mental health issues living on the street was raped by a drunken man, with no one coming forward to help the victim. The accused was later arrested based on the video provided by a nearby street vendor who witnessed and recorded the crime on his phone, later handing it over the video to the police as evidence.

With less than 1 percent of the budget spent on mental health, at least a quarter of persons with psycho – social disabilities in India are homeless. Many of them have either strayed away from home or have been abandoned by their family and relatives, who are unable or unwilling to provide the required support.

Historically and even today, persons with psycho – social disabilities in India are faced with various forms of discrimination, injustice and exclusion. Many of those in need don’t even attempt to seek treatment, fearing stigma and taboos surrounding mental health, and in the case of several others mental health care is expensive and inaccessible. At present there are only 37 state – run mental health hospitals – which is less than a fraction of what is actually required to improve mental health care in the country.

Homeless persons with psycho – social disabilities face greater forms of exclusion and marginalisation in cities and urban areas, as compared to those in rural areas, who get absorbed into the community more organically. While awareness about mental health may be poor in rural areas, individuals with psycho – social disabilities find greater acceptance within them, as compared to urban areas – despite much of the required support and infrastructure being available in the cities.

In cities, people with psycho – social disabilities living on the streets become indistinguishable from the thousands of others sleeping on the roadside – migrant workers, children in street situations and beggars. While all these groups belong to a marginalised and vulnerable section of society, persons with psycho – social disabilities are doubly marginalised for first having a psycho – social disability and then for also being homeless.

In the case of women with psycho – social disabilities living on the streets, the marginalisation is three – fold on the accounts of being a woman, with a psycho – social disability and homeless, exposing them to a variety of violent and vulnerable situations where their basic rights get violated.

In response to a query filed by the Thane Mental Hospital in 2016 under the Right to Information Act, it was learnt that 241 of the 324 individuals with psycho – social disability brought in by the policy for treatment were women.

According to sections 18 and 19 of the recently passed Mental Healthcare Act, 2017, shelter and rehabilitation homes for persons with mental health issues are mandated for in every district; to be run by the state government, however there has been little to no progress and development on this front and the plight of those with psycho – social disabilities living on the streets is worsening.

Lack of infrastructure, poor access to mental health care, social stigma and attitudes, the absence of and improper implementation of laws and policies, are however only one aspect of the problem, which as opposed to popular belief and the mainstream medical narrative, is multi – dimensional in nature.

What the recent incidents from Thane and Hyderabad have exposed is the appalling apathy, inconsideration and the lack of compassion in society and among people. Perceived as a social nuisance and seen as anti – social elements, persons with psycho – social disabilities living on the streets are constantly prosecuted and criminalised for their circumstances and faced with different forms of abuse.

With no welfare or social security support, they are caught in a vicious cycle – living on the streets as a result of their psycho – social disability, which is further made worse by their living on the street where they have no access to basics such as healthy food, shelter, clean water and sanitation, healthcare or rehabilitation.

While several community based interventions and treatment programmes have been established by civil society organisation to provide rehabilitation for persons with psycho – social disabilities living in street situations, the government has failed to provide any sort of support. Many of these organisations, even though they are fulfilling the welfare obligations of the State are not even provided with minimum funding or structural support.

The least the state can do for individuals with psycho – social disabilities in street situations is make provisions for their basic safety and well - being and be more pro – active in preventing violence and abuse, rather than being accomplices in violence against them, by the virtue of being mute spectators.

With no data on the instances and prevalence of psycho – social disabilities being available; poor and absent infrastructure; low awareness levels and denial of basic rights and welfare support, the status of persons with psycho – social disabilities in India to say the least is bad, but the status and situation of persons with psycho – social disabilities living on the street is even worse. Invisible and abandoned by society, these individuals experience constant violence and humiliation at the hands of society.