Those rescued are put through psychological assessments It was 2pm when Abdul Azim at the Nannilam mosque in Thiruvarur received a call from social worker Kanagaraj at the Emergency Care and Recovery Centre (ECRC) in Tirunelveli. He was asked if he knew of a person named Mahesh Kumar in Nannilam who had gone missing a year ago. After a long pause, when Abdul finally replied “Yes,” the entire ECRC healthcare team, including doctors, social workers, nurses, security staff, and Mahesh Kumar himself, who had once been homeless and mentally ill, breathed a huge sigh of relief. They had finally traced Mahesh’s home, just two blocks away from the mosque.Mahesh had been suffering from a severe form of psychosis, where he lost touch with reality. About eight months ago, he was found on the Anaikulam roads of Tirunelveli. Abdul, his best friend at the Nannilam mosque in Thiruvarur, was the only person Mahesh remembered once he slowly began speaking again. It had taken months of repeated attempts by social workers to get him to open up. “Mahesh’s face lit up when he saw Abdul. I’ve never seen a man smile like that, and he even shed a tear — he couldn’t emote earlier. Honestly, beyond my salary, it is moments like these that keep me going,” says social worker Kanagaraj, who played a key role in reuniting Mahesh, along with thousands of other homeless mentally ill people, with their families.It is stories like these that unfold at every ECRC, set up under the National Health Mission (NHM) to reunite the homeless mentally ill with their families. Tamil Nadu has 17 such centres, half of them run by the govt, the rest in partnership with NGOs such as The Banyan in Chennai.Since their inception seven years ago, Tamil Nadu being the first state in India to launch such centres, ECRCs have reunited 3,065 people with their families. The highest numbers have come from the Theni and Kallakurichi centres (798 and 495 reunions), while urban districts such as Chennai and Thiruvallur reported lower numbers at 89 and 31.Patients, mostly men and women above 20 years, have been reunited not only across Tamil Nadu but as far as Kolar in Karnataka, Halamkonda in Telangana, and even parts of Odisha and West Bengal. “The first thing we do is try to understand the language the patient speaks. Many times, it’s a language we don’t know. Our college students from the Northeast, studying in Chennai, have helped us a few times,” says Dr Karthik Deivanayagam, psychiatrist with NHM.When it comes to identifying potentially homeless people with mental health issues, ECRCs rely on social workers who spot them during rounds, police memos, or cases reported by good samaritans. “The first sign we look for is loss of what we call ‘insight’. In psychological terms, this means lack of self-care, loss of awareness about surroundings, or excessive talking over a long period. When our team spots such people, they report it to us.”The next step is building rapport with the patient. A team of psychologists, psychiatrists, social workers, nurses and attenders works towards getting them to do just one thing —open up. “We also give them a small welcome self-care kit upon arrival, with soap, a comb, a new set of clothes, and other items. The idea is to give them some excitement in life again,” says psychiatrist Yazhisai Meikandan from the Pudukottai centre.Once rapport is built, patients undergo diagnostic assessments through psychological testing scales. Their fine motor skills such as writing, and gross motor skills such as walking and running, are also tested. “We ask patients to throw a ball into a circular opening or walk along lines on the floor to check where they stand,” says Yazhisai. The most common diagnoses are chronic schizophrenia, psychosis, and manic or depressive disorders for which patients undergo pharmacological and psychiatric treatment. Some recover within weeks, while others take longer. “We also have occupational therapy, where we teach patients gardening, knitting, or cooking to help them reintegrate into society,” says Dr Karthik.One of the patients, Ahil Krishna, originally from Halamkonda in Telangana, discovered a passion for knitting while at the Pudukottai centre. “I was just a ‘10th fail’, but now I’m a caterer in my region. I’m doing well, earning ₹30,000 a month. I still knit. It helps me find my sense of calm,” he says over a phone call from Halamkonda.Once patients show signs of recovery, the search for their families and hometowns begins. If they have an Aadhaar card, the address is traced through it. If not, social workers try to get details by talking to them. “They first say Madurai, then Pudukottai, then Villupuram, and only later the correct location. By then, six months may have passed,” says Kanagaraj. Sometimes patients recall landmarks such as rivers or places of worship, as in Mahesh Kumar’s case. Social workers visit the spot to verify the address and begin speaking to families. “In some cases, families reunite immediately. In others, they say no, either because they believed the person was dead and have moved on emotionally, or because they lack the finances to take care of them,” says Yazhisai.When the location is confirmed, the patient connects with their family over a video call. If things go well, the reunion takes place within a couple of months. Even after discharge, social workers stay in touch with local govt hospitals to ensure patients are doing well and receiving medication on time. “The best thing about ECRCs is that they are holistic centres with a sustainable, long-term approach. We don’t leave our patients hanging after discharging them. Also, our treatment is free,” says Arun Thamburaj, NHM Tamil Nadu’s mission director.There are two possible outcomes for every ECRC patient — successful reunion with their family or transfer to a state-run rehab home. Earlier this year, Tamilarasi, who had been reunited through the Tirunelveli centre, received a call from the team, and TOI. Mistaking it for a call to bring her back, she frantically hung up, saying she was happy at home with her two children. “This is the impact of our treatment. Patients no longer want to leave their home or be homeless. We change that cognition,” says Arun.If a reunion doesn’t happen, patients are sent to rehab homes; 902 have been accommodated this way so far. These homes recreate the environment of a family, with the same team as an ECRC but more recreational activities and attenders to care for them. “We find their home or give them a home. We believe that nobody in this world is really homeless,” says Dr Karthik.
Districts with the Most Reunions
Theni – 798
Kallakurichi – 495
Thiruppur – 360
Thiruvannamalai – 334
Ranipet – 255
Districts with the Least Reunions
Krishnagiri – 35
Thiruvallur – 31
Tuticorin – 32
Tirunelveli – 54
Erode – 65
(Source NHM Tamil Nadu)Email your feedbackwith name and address tosouthpole.toi@timesofindia.com