KOZHIKODE: The middle-aged patient had recovered well enough to be discharged. Months of treatment at the Government Mental Health Centre in Kuthiravattam, Kozhikode, had restored stability, and hospital staff repeatedly contacted the family to take the person home. No one came. Days turned into weeks, hope gave way to silence, and the emotional rejection eventually triggered a severe relapse. The patient, who was ready to begin life again, was forced back into intensive psychiatric care.
Mental-health professionals say this is no longer an isolated tragedy. Across Kerala, government psychiatric institutions are increasingly housing people who have already recovered medically, but because they have been abandoned by their families or admitted under false identities, have nowhere else to go.
The numbers reveal the scale of the crisis. More than 175 patients who have made a recovery continue to remain institutionalised across Kerala’s major government mental health centres despite being medically fit for discharge. Around 80 persons are awaiting rehabilitation or family acceptance in Kozhikode. There are 55 similar cases at the Mental Health Centre in Thiruvananthapuram and around 40 in Thrissur. Mental-health advocates believe the actual number across long-term psychiatric institutions is significantly higher.
Psychiatrists argue that Kerala is facing a rehabilitation crisis rather than a treatment crisis. For many patients, the hospital has become a permanent address. Families who admitted them never returned. Contact numbers stopped working. Addresses recorded during admission were found to be false or incomplete. Elderly patients, homeless individuals and migrant workers whose relatives cannot be traced are among the most vulnerable.
The consequences extend far beyond individual suffering. Recovered patients occupying long-term hospital beds are placing enormous pressure on psychiatric institutions that are already operating beyond capacity. The Kuthiravattam facility has a sanctioned capacity of 474 beds, but accommodates more than 500 inpatients, while treating nearly 3,000 outpatients every month.
‘Rehabilitation infra remains inadequate’
The Thiruvananthapuram facility has 507 sanctioned beds but is currently caring for over 600 inpatients. The Government Mental Health Centre in Aranattukara, Thrissur, functions with 361 sanctioned beds, and doctors say the continued stay of recovered patients who cannot be discharged further strains already stretched resources, limiting the availability of beds and rehabilitation support for newly admitted patients.
Doctors say overcrowding has become a structural problem. Every bed occupied by a patient who has completed treatment is a bed unavailable for someone in acute distress. Rehabilitation wards remain full, staff resources are stretched, and discharge planning becomes increasingly difficult.
“The treatment may have succeeded, but the rehabilitation has failed,” said one psychiatrist working in the government sector. “A patient who feels abandoned by their own family is far more vulnerable to emotional deterioration.”
Kerala has 125 psychosocial rehabilitation centres and three major government mental health hospitals, but officials acknowledge that long-term rehabilitation infrastructure remains inadequate. Although District Legal Services Authorities assist in rehabilitation efforts, community-based residential facilities, supported living arrangements, and long-term care networks remain insufficient to absorb patients who cannot immediately return to their families.
The issue drew statewide attention after a division bench of the Kerala High Court, comprising Justices Devan Ramachandran and Basant Balaji, visited the Thiruvananthapuram centre in Peroorkada last month following complaints regarding living conditions. The judges reportedly expressed concern over overcrowding, ageing buildings, inadequate sanitation, staff shortages and an institutional environment that resembled confinement rather than therapeutic care.
Following the visit, the Kerala government announced a comprehensive modernisation of the Thiruvananthapuram facility, including infrastructure upgrades, improved services, strengthened rehabilitation programmes, and expanded community based rehabilitation systems.
However, professionals in the sector caution that better buildings alone will not solve the crisis.
Daisy Jose, a Kozhikode-based mental-health expert associated with a non-governmental organisation, said the problem lies beyond hospital infrastructure. “The patients waiting inside these institutions need homes, caregivers, legal protection, and community acceptance,” she said.