Clinical and psychosocial profile of persons with mental illness living in non-hospital residential facilities in a district in Kerala, India: A cross-sectional survey

Abstract

Background: Clinical and psychosocial profiles of persons living with mental illness (PMI) in non-hospital settings in India have not been adequately studied. Aim: This study describes the profile of PMI living in non-hospital settings by focussing on variables like functioning and social networks. Method: Residents of all available residential facilities in one district area were surveyed and descriptive data was obtained. Socio occupational functioning was assessed using the Social and Occupational Functioning Scale (SOFS) and social network was measured by modified Lubben Social Network Scale-6 (LSNS-6). Results: A total of nine centres housing 491 residents (7–128) were surveyed via field visits. The mean age of the residents was 49 ± 14.0 years. Fifty per cent of them were never married, 22% were separated or widowed. Almost half of the people had psychotic disorders, while diagnosis could not be delineated in a quarter of the population. Almost half the people reached the facilities with the help of their families, while 40% were brought by police or volunteers who found them wandering. Impairment in socio-occupational functioning was only mild in 90% of residents, while 60% did not contact relatives or friends in the past 3 months. Conclusion: PMI living in non-hospital residential facilities were on average in their middle age and were deficient in marital bonds and other social support. They had reached the centres with the help of extended family or by police/volunteers who rescued them from wandering status. Nevertheless, most of them had only mild to moderate levels of impairment, and their functional capacity was good for independent living in the community with support. Hence, newer models of supported housing that provide greater community reintegration, like independent shared housing within regular neighbourhoods, can be tried. In persons with residual family ties, providing continuous community-based support may help re-establish family integration.