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Health Care of the mentally Challenged Persons
The What of it
The Mentally disabled persons constitute around 3 - 4% of the Indian population: yet, their morbidity rate i.e. the rate of their falling & remaining ill, is substantially greater, as a major part of illness does not surface, due to the obvious reasons of poor communicability, emotional expression and social stigma attached to this "Special Population". The efforts put in to explore & to understand this area of human sufferings has been grossly inadequate leaving the enormous amount of their misery & their deplorable state of health as the Tip of an enormous iceberg, concealed under the social, professional and attitudinal indifference.
Another aspect of grave concern is that, due to lesser emphasis in the existing medical curriculum on the different associated conditions of mental disability, the doctors do not develop/ they lack proper knowledge, skill, approach and orientation towards the MR persons, leading to unnecessary (perhaps unintended) harassment of the parents, under diagnosis, over diagnosis and wrong diagnosis - all resulting in improper & inappropriate therapeutic management.
Role of the parents & family members needs special mention. Being frustrated & confused, they are not able to discharge their appropriate duty effectively: as a result of this & the factors mentioned in the preceding section, the 'Special Persons' need a specialized management as far as their Health & well-being are concerned.
An avowedly welfare state like India can ill afford to ignore its responsibility regarding this issue. Thus the issue of the right to health of the mentally challenged persons & those with other related disabilities like Autism, Down’s syndrome, Cerebral Palsy & Multiple Disabilities becomes a burning one.
The How of it
The WHO defines Mental Retardation/ Disability, as, "disturbances in the performance of social roles that would normally be expected of an individual in his habitual milieu, arising in association with diagnosable mental disorder". The disability produces problems in the following areas of human functioning:
- Activities of daily living including self-care, keeping clean, personal hygiene, looking after one’s health etc.
- Social relationships including communication skill ability to form and sustain relationships etc.
- Occupational functioning including cognitive and social skills required for a job etc.
The Why of it
Inter-alia, these malfunctions are the result of (i) General Psychiatric Syndromes, (ii) Developmental Conditions, (iii) Physical Conditions and Abnormal Psychosocial Situations.
Thus the health care of the mentally disabled needs special consideration, particularly because the target group is being affected by a variety of Somatic & Psychiatric ailments many of which are genetic or developmental and are lifelong in nature. [to cite a few - communication problems, due to which they cannot explain their symptoms clearly in an understandable way, leading to confusing & erroneous inputs to the physicians, non-cooperation with/ obstructing diagnostic tests etc due to fear psychosis, (as in an immature child), rejecting treatment prescribed & thus lead to a poor state of patient compliance].
The problems of this marginalized group are rarely highlighted, as they themselves cannot do that. Many of them are on lifelong medication and must be kept under regular Medical Vigilance. They are also in need of consistent assistance of a number of Professional Experts like Clinical Psychologists, Pediatrician, Neurologist, Orthopedic Surgeon, Psychiatrists, Physio-therapists, Speech-therapists, Occupational-therapists, Mobility Instructor & last but not the least important Yoga-instructor.
Keeping in mind the above requirements of MR Children including problems of epilepsy, allergic skin conditions, poor digestive problems, dental & visual problems, Lekhadeep is at present providing medical care through professional experts in Clinical Psychology, Psychiatry, Physiotherapy, Speech Therapy, Allopathic [and where specially needed Homeopathic] Medicare, Music and Yoga Therapies.
A "tall order", the Know-all, well-informed ignoramus will say. Are you in that set or do you have an open mind & want to learn more about this?