NALGONDA: Over the past five years, hundreds of mentally disabled persons in the erstwhile Nalgonda district have passed away deprived of treatment due to rules that are seen more as hurdles than serving any purpose.
Most of these unfortunate human beings had spent their last days in various charitable trusts and ashrams in the district, abandoned by their families or having left their homes unaware of their actions.
D Vanaja and D Srinivas, who run the Annapurna Charitable Trust, told TNIE that volunteers frequently bring mentally disabled people from the streets to their facility, where they are provided daily care, food and basic medical attention. However, the lack of access to long-term treatment is the main stumbling block to providing the patients a fighting chance.
Vanaja and Srinivas said that the Institute of Mental Health at Erragadda in Hyderabad is the only government facility offering long-term psychiatric treatment. However, admission requires a complex legal process, including a referral from a psychiatrist, a police FIR, a magistrate’s order, and crucially, an Aadhaar card. This invariably renders a majority of the homeless mentally disabled ineligible for admission as they are often unaware of their origins and lack identification.
An official from the Erragadda Mental Hospital told TNIE that long-term treatment for mentally ill persons, particularly those requiring care for over a month, is only possible after a police FIR and magistrate certification. For milder cases, patients may be admitted as inpatients for up to a month, but beyond that, legal documentation is essential. Here is where the crux of the problem lies.
Efforts to obtain Aadhaar cards for these individuals are invariably futile. Srikanth, a Seva Bharathi volunteer, explained that many were rejected due to already having Aadhaar cards issued in the past. Reissuing these cards requires an OTP sent to the mobile number registered during the initial enrolment—a piece of information often lost, Srikanth says.
Activists demand change of rules to facilitate treatment
Activists and caretakers have urged the government to relax the Aadhaar and legal requirements for mentally disabled patients and allow them to be admitted to facilities like the one at Erragadda to receive the necessary treatment. Without such reforms, they warn, thousands more may die anonymously, neglected, and without proper care.
Vanaja and Srinivas say that some patients found on the streets have migrated from other states in search of work, only to become mentally disturbed due to unfortunate circumstances. They said that their trust, and many NGOs, are primarily run on donations from philanthropic individuals. “Our resources are limited. We simply cannot provide permanent psychiatric treatment, which is crucial to help these individuals regain stability and reconnect with their families,” they said.
In the erstwhile Nalgonda district, there are only two dedicated shelters for mentally disabled persons. The Annapurna Charitable Trust in Suryapet houses 48 individuals while the Amma Nanna Anadhalaku Punyakshetram in Choutuppal, Yadadri Bhuvanagiri district, shelters approximately 500. Local government employees and businesspersons contribute generously to these trusts, often encouraged by the 80G income tax exemption, which makes donations more appealing. While financial support sustains these shelters, the challenge remains access to proper psychiatric care.
Private hospitals are not a viable alternative for most charitable organisations due to unaffordable treatment costs. Although some government hospitals have psychiatrists, they can only offer temporary care. The absence of dedicated mental health wards prevents these hospitals from admitting patients for long-term care, as it could compromise the safety of other patients.
Ashram organisers told TNIE that nearly 500 mentally ill patients have died in various facilities across erstwhile Nalgonda in the last five years. Causes of death include malnutrition, infections and chronic illnesses, many worsened by their time on the streets. Police, with the help of NGOs, try to reunite these individuals with their families by circulating their photos to nearby police stations. However, success is limited.
Many admitted to these shelters cannot even state their names or origins. In cases of death, ashram organisers, with the approval of the district collector, hand over unclaimed bodies to medical colleges.
Since its establishment in 2017, the Annapurna Trust has handed over more than 100 unclaimed bodies. Most residents are elderly, and many hail from other states, although some locals from Telangana also reside there.
Vanaja noted that some families are forced to hand over their mentally ill relatives to the ashram due to financial constraints, often providing disability pensions for their care.
Beyond reach
Patients deprived access to long-term psychiatric care
Only govt facility for extended psychiatric treatment is the Institute of Mental Health, Erragadda
Private hospitals unaffordable; public hospitals lack infrastructure for long-term mental healthcare
Stumbling blocks
Psychiatrist referral
Police FIR n Aadhaar
Magistrate’s order
Many of the patients have Aadhaar but cannot retrieve it as retrieval is based on OTPs