Sarada Menon: A life well lived
The girl appeared to be about 16-years-old. Ensconced in a bed guarded by rails, she was flailing her arms, wailing. Sarada, a final year MBBS student stood watching her. She felt helpless. All the girl had been given were a few sedatives. There were around 15 patients in that ward who appeared to be aggressive, gesturing aimlessly, and completely out of touch with reality. They were also filthy, clearly not cared for enough. This girl was one of them.
A few days later Sarada learnt that the girl was discharged. None of the doctors at the Government Mental Hospital, Chennai could diagnose what she or any of the other patients were going through.
Their plight was burnt into her mind. And moved Sarada Menon enough to become India’s first woman to be a psychiatrist.
“I felt very sad, helpless, sympathetic and felt guilty thinking that doctors could not do anything, and there arose a deep desire in my mind to contribute something to the welfare of the mentally ill patients1”
Choosing a path
Menon was born in 1923 to a Malayali family in Mangalore but soon shifted to Chennai after her birth. “My family was conservative. They didn’t want ladies to study,” Menon admits2 as she remembers the resistance she met with when she wanted to pursue science after high school.
Menon persisted, a trait she showed throughout her life, and went on to become an MD in 1957. But it was not long before she changed tracks and embarked on her lifelong journey in mental health and psychiatry. In 1959, Menon obtained a diploma in psychiatry from NIMHANS, Bangalore.
Historically, mental health in India has seen scanty development. In the 1950s and 60s, mental hospitals were set up for the “detention and custody of persons with mental disorders”3 and not for their care or nourishment. Only a handful4 of trained psychiatrists existed and most patients with mental disorders were treated by non-specialists. Government health initiatives for mental health were non-existent and were instead heavily focused on controlling diseases like malaria, leprosy, and tuberculosis.
The milieu at the time Menon was beginning her career as a psychiatrist was one of extreme stigma, disdain, and fear towards all aspects of mental health. Patients as well as their families across classes were isolated in society causing many patients to be abandoned by their families.
An era of reforms
Fresh from her psychiatry training, Menon joined the Institute of Mental Health in Chennai and by 1961, she became the Superintendent, unspooling an era of reforms ahead. She brought in professional social workers5, began meticulous documentation of medical records and set up PG courses to offer extensive training and education.
But perhaps the most colorful feather in her cap was her successful management of one of the biggest issues then – the growing number of abandoned patients. When she took charge, there were 2800 patients6 in a facility meant for just 1800.
People who brought in mentally ill patients often did not return to take them back and the numbers kept growing. Menon set up an outpatient section with a rule that anyone living close to the hospital would not be admitted as an inpatient but would receive therapy and care as any regular patient.
“This won a lot of appreciation as those attending to the mentally ill at home were relieved of stress — physically and emotionally — at least through the day,” Menon said with pride to The Hindu.
When she retired in 1978, she had brought down the number of inpatients to a comfortable 1800.
By this time, stories were beginning to emerge in the media. It had begun to aggressively report7 on the pitiable conditions of mentally ill patients who were left to fend for themselves in hospitals, and even jailed for their irrational behavior leading to much public outrage. Finally, in 1982, the government drafted the National Mental Health Program (NMHP) and much later in 20178 the Mental Health Care Act was passed to “provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfill the rights of such persons.”
Founding of SCARF
Although Menon was now retired, her work was not yet done. “After her retirement, she became restless realizing that there was much more to be done to fulfill her ambitions in integrating rehabilitation with mainstream mental health care,” says Dr. R. Thara9 about her mentor to The Hindu.
That’s how the Schizophrenia Research Foundation (SCARF) came about in 1984. By now, Menon had seen the wonders that good care and therapy could do for her patients, many of whom were able to successfully integrate back into society. After prolonged discussions, Menon founded SCARF, an NGO, with Dr. Thara, which offers rehabilitation, research, and other services for people with schizophrenia and other mental illnesses. Recognized as a Collaborating Center of the World Health Organization (WHO) for Mental Health Research and Training, SCARF focuses on
- Research and training
- Treatment and rehabilitation
- Creating public awareness through community outreach initiatives
People with schizophrenia are most often discriminated against and experience extreme stigma. According to one study10, people “reported being ridiculed, avoided or looked down upon. A few were given stale food, stopped from leaving the house, beaten or hit with stones. Some spoke about lack of respect from family members.”
SCARF was built on a strong foundation of compassion and care, which is reflected in its services and facilities, which include tele-psychiatry, residential options, and tools for deep research.
Ever since its humble beginnings SCARF has now grown into an internationally recognized entity for having nurtured a strong community and support system for the truly needy. “Communication, care and constant review are essential to help the affected at every stage,” Menon says11.
For her unwavering focus and immense contributions to society, Menon has received multiple awards in her lifetime including India’s highest honor, the Padma Bhushan. She was even made the Secretary General of the World Association for Psychosocial Rehabilitation (WAPR) and was responsible for setting up the India chapter. But she took all her honors the same way she did the challenges she faced in life – with equanimity. 1
After nearly 50 years of unconditional giving, a pillar of Indian society crumbled. Menon passed away in December 2021, at the age of 98, leaving a void in the hearts of thousands whose lives she had touched. Yet, her words and work live on.
“Give affection. Be considerate.”12 Menon’s motto is a reminder to all of us on how we can be the light for others around us.
References
[1] Mathrubhumi: Meet 97-year-old Dr Sarada Menon who says women are more vulnerable to mental illness
[2] Reset Your Everyday: ‘Nobody Showed Interest in My Medical Career.’ Meet Sarada Menon, India’s First Female Psychiatrist
[3] Wiley Online Library: Global, national, and local approaches to mental health: examples from India
[4] Biomedcentral: The development of mental health services within primary care in India: learning from oral history
[5] The Hindu: Dr M Sarada Menon, India’s first woman psychiatrist, is remembered for reforms, and kindness
[6] The Hindu: Unconditional giver
[7] Wiley Online Library: Global, national, and local approaches to mental health: examples from India
[8] National Mental Health Program
[9] The Hindu: Dr M Sarada Menon, India’s first woman psychiatrist, is remembered for reforms, and kindness
[10] National Library of Medicine: Experiences of stigma and discrimination of people with schizophrenia in India
[11] [12] The Hindu: Unconditional giver
Featured image source: Reader’s Digest
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