A mental hospital with a difference

As you enter through the gates of San-ker Hospital in Shillong, it is difficult to believe that it is a hospital you are walking into. Small but well maintained garden area, a wooden cottage style structure housing the reception area, wooden huts for waiting sheds, a pond are things you do not expect in a hospital. At the day-care facility for people with chronic mental illness, music is playing while the space is being cleaned. All the patients are lounging under the bright sun on the lawn outside. Some of the patients smile and offer greetings as you walk past. Families bring their loved ones here in the morning and collect them in the evening. “Here they learn how to take care of themselves, get therapy and get to socialize as well. Once a week they are all taken for an outing to a park,” informs sister in-charge, Lawanpli Wallang Pahsyntiew. As we are talking, a patient comes up to us smiling and says, ‘Dosti, Dosti’. Founded in 1990 by Psychiatrist Dr Sandy Syiem, San-ker Hospital is the only private mental health facility in Meghalaya and among the few in Eastern India. The hospital was established on a 6 acre spread that was previously a farm. What began from a cowshed converted into a 10-bed room, San-ker is now a 100-bedded mental hospital with a day-care facility for the chronic mentally ill and provides services like detoxification, rehabilitation and after-care for substance dependence. Dr Syiem worked with the government for a while but felt the need to do more. He quit his government job in 1988-89. “I then approached non-government organizations but nobody was interested. In 1987-88 I formed a mental health society but people quickly lost interest in it. I came to the conclusion that I can’t depend on anybody else. I have to do it myself,” he shares. In the late 80s when local sentiment against Bengalis was on a high, the farm which was owned by a Khasi-Bengali family came under attack. “The family was looking to sell the land and move away so I bought the land. It was in the middle of nowhere. There was no electricity, no roads or water supply. People were convinced I was crazy,” says Dr Syiem. He bought the land with a loan of Rs 18 lakh from Meghalaya Industrial Development Corporation which eventually took him 17 years to repay. A cowshed was converted into a room with 10 beds. “In two weeks’ time we had to convert another cowshed into a 10-bed room,” says Dr Syiem. Over the years, donations from organizations and individuals helped the hospital expand. According to Dr Syiem, the hospital caters mostly to people from underprivileged families. “We charge Rs 50-80 per bed per day and some struggle to pay even that. But they come back after 2-3 years and give whatever they can. Ultimately it is the goodwill of people that works,” he shares. In the initial years, his private practice also helped sustain the hospital, he mentions. There are no private rooms in the hospital and Dr Syiem explains it to his belief that people need to see themselves as who they are in order to heal. “We’ve had politicians, engineers, doctors, all living in the same room, eating the same food. If we give you TV, telephone, internet, then what are you lacking? You can’t see yourself as you are,” he says while highlighting the importance of community living at San-ker. He is critical of government interventions in mental health and believes that since the time he quit his government job, little has changed. “Only 100 out of 600 districts have full-fledged mental hospitals in the country at present. That means there is something wrong. 4% of budget is earmarked for health and out of that, 0.3-4 % is for mental health,” says Dr Syiem. In the open courtyard patients are enjoying the afternoon sun and on the verandah of a building next to it, sit Dr Lahiri and Dr Rani monitoring the patients. "San-ker is one of a kind, I would say, in the Eastern part of India. Mental hospitals are usually barricaded, closed, with a lot of restrictions but you can see here it is not like that. The approach we take is holistic," explains Dr Lahiri who has worked in San-ker for around 15 years. She says that most patients who are brought to San-ker are severely ill which offers many challenges for the hospital staff. "Working with families is a big challenge. Families are usually not very aware about mental illness or are not ready to accept that their loved one is suffering from a mental illness. The overall challenge for the society is the stigma attached to mental illness," she says. However, it is worth facing these challenges, she adds. "The treatment here is different from other hospitals. Here we treat patients like our children. The patients abuse us, scream at us but we just laugh it off," says Dr Rami who has been with San-ker for the last 5 years. The hospital also offers short courses in counselling for addiction and mental health. The duration of these courses range from one to three months. San-ker in the Khasi language means 'growth within protection' and for the mentally ill, this is what it offers.