ON A RAINY FRIDAY MORNING IN LATE JULY, Rajesh Castellino sat in a tiny room in Karjat, Maharashtra, a two-hour drive south-east of Mumbai. Files lay stacked in a corner, and an assortment of pictures and notes fluttered on the cracked walls; a sense of quiet and loneliness reigned. Castellino has big eyes, a lean frame and a dusky complexion. He stared into the distance, and in his mind seemed to be miles away, exploring a different time and space.
On my prompting, Castellino, who is 39 years old, told me how he’d gotten to where he was, to the Shraddha Rehabilitation Foundation. On 30 January 2011, he was wandering through Mumbai’s Sion area, dazed and with no idea of why he was there. He remembered suddenly hearing a question: “Where are you from?” A social worker approached, and took him to Karjat. Castellino, I later learned, suffers from schizophrenia, a psychiatric illness characterised by a severely altered perception of reality and an inability to distinguish between real and imaginary entities. I also discovered that he had already been at Shraddha before, the first time after a similar episode in 2010, though Castellino himself did not remember it.
Shraddha works to rescue destitute people with mental illnesses from the streets and reunite them with their families. This is a long, tedious process: patients are picked up, often by the group’s ambulances on patrol; they are fed and housed to ensure good nutrition and hygiene; and then given a course of treatment. Once a patient starts to recuperate, social workers start asking questions: Where did you grow up? Who did you have with you at home? Where’s home? When a family is located, Shraddha sends patients home. If the group cannot identify any kin, or when families refuse to take patients back, a lack of funds and space often forces Shraddha to send them on to other NGOs or shelters after a few months of recuperation. By the records it has available, since March 2006 the organisation has arranged over 2,500 reunions, and often handled cases from as far away as Karnataka and Uttar Pradesh. This year, by mid August, Shraddha reunited 350 patients with their families. In all this work, Shraddha battles Indian society’s seemingly indelible stigma against psychiatric illness.
Two days after I met Castellino, I joined Dr Bharat Vatwani, the psychiatrist who founded Shraddha in 1989, on his drive back to Mumbai after his weekly visit to the rehabilitation centre. One day in May that year, he recalled, he noticed a young man with long, straggly hair drinking sewage on the streets of Mumbai. Realising the man was mentally ill, Vatwani and his wife Smitha, who is also a psychiatrist, decided to take him in at their private treatment centre. The young man, they discovered, was schizophrenic. They also learned he was well educated, and from a middle-class family that was looking for him. After a few months, he returned to this family. Inspired, Vatwani set out to help others in similar situations. The mentally ill don’t “deserve to be on the road,” he said with deep conviction.
But the work is often hard. Even after successful treatment, patients are often rejected by their families. Even when reunions are successful, patients are still seen as objects of shame. Dr Vatwani recalled one particular young man who turned out to be from a very influential family. As thanks, the family decided to donate to the organisation, but insisted anonymity so as not to be associated with mental illnesses. In other cases, Vatwani said, families have refused to acknowledge mentally ill relatives for fear of jeopardising the marriage prospects of their younger members. In 1997, when Shraddha was based in Dahisar, a northern suburb of Mumbai, residents of the area began protesting against the presence of the mentally ill people. That was when “I was closest to shutting down,” Vatwani remembered. The matter went to the Mumbai High Court, and fortunately the judge ruled in Shraddha’s favour.
Today things are somewhat better, though Vatwani told me support for the organization is still “minimal.” There haven’t been protests in Karjat, and local college students volunteer regularly. But for the patients themselves the outlook often remains bleak. Castellino, for instance, was first reunited with his family in February 2010, but disappeared again for reasons that he wouldn’t specify. After he was picked up in January 2011, he was returned home again the following month. But he wandered again, and found his way back to Shraddha on his own in July that year. He has lived at the centre since, though he does occasionally visit his family. Shraddha is home for him now.