Recovery Month at SAA

I happened to come across the movie titled The Sixth Sense other day. This Bruce Willis starer is horror-thriller movie, with supposed to be having basis of mental illness case of one of the main characters(child). This movie, which came 15 years earlier, had become famous then. Bruce Willis plays a role of doctor trying to help the child who is suffering from schizophrenia, who also gets visual hallucinations. The line ‘I see dead people’ from this film, is said to be one of most famous lines of films ever. I, having been associated with the domain of mental health for almost 10 years now, mainly, involved in activities of Pune’s organization called Schizophrenia Awareness Association(SAA), I was watching this movie keenly. Much has has been written about this movie’s mental health angle. At the end of the film, I kept wishing the film touched upon using techniques of self-help and recovery. But alas, it is a movie, not a documentary of child dealing with mental illness!


Poster of the movie, courtesy Internet

I remembering all this, as one of the main proponents of self-help techniques and recovery techniques, Dr Abraham Low, whose birth anniversary is falls next week, on Feb 24. He was Polish by birth, but made USA his home, where he went on founding organization called Recovery Inc more than 80 years ago. SAA is going observe his birth anniversary as Recovery Month. Various programs are arranged on this occasion. One of the main activities of SAA, apart from spreading awareness, is facilitating and conducting self-help support groups(SHSG). The very basis for SHSG is Dr Low’s techniques. Some time back I had read Marathi translation of Dr Low’s biography titled My Dear Ones and I had written about it here. On the Feb 24 itself, there will be a session on recovery method. The recovery method is a system of cognitive behavioral techniques for controlling behavior and changing attitudes. People who practice the living skills detailed in the recovery method, learn to change their thoughts and behaviors. The changes in attitudes and beliefs follow.


Recovery International’s Logo, from their website


Dr Abraham Low, image courtesy Internet

One first things is there using spotting tools as listed below. The purpose of using a tool list is to enable newcomer Shubharthi(person with mental illness) to easily and rapidly participate in a recovery meeting.

  • Treat mental health as a business and not as a game
  • Humor is our best friend, temper is our worst enemy
  • If you cannot change an event, you can change your attitude towards it
  • Be self-led, not symptom-led
  • Symptoms are distressing but not dangerous
  • Temper is the intellectual blindness to the other side of the story
  • Comfort is a want, not a need
  • There is no right or wrong in the trivialities of every day life
  • Calm begets calm, temper begets temper
  • Don’t take our own dear selves too seriously
  • Feelings should be expressed and temper suppressed
  • Helplessness is not hopelessness
  • Some people have a passion for self-distrust
  • Temper maintains and intensifies symptoms
  • Do things in part acts
  • Endorse for the effort, not only for the performance
  • Have the courage to make a mistake
  • Feelings are not facts
  • Do the things you fear and hate to do
  • Fear is a belief-beliefs can be changed
  • Every measure of self-control leads to a measure of self-respect and ultimately self-confidence
  • Decide, plan, and act ,
  • A firm decision steadies me
  • Anticipation is often worse than realization
  • Replace an insecure thought with a secure thought
  • Bear the discomfort in order to gain comfort
  • Hurt feelings are just beliefs not shared
  • Lower your standards and your performance will rise
  • Things happen by chance and not by choice
  • People do things that annoy us, not to annoy us

This and other recovery techniques are used by counselors and SHSG facilitators world over. This is the time to remember his contribution, and spread awareness about his work in the society.

Anyways, the movie serves its purpose of horror/thriller, with a twist in the end, which I won’t reveal(no spoiler here!). The film also has been shot in Philadelphia, I could recognize some locations as I have traveled there few times. As I said at the beginning, much has been written about The Sixth Sense, specifically about treatment and portrayal of mental health in the films. I also had written about this topic in the past on the blog here. I appeal the readers to participate in spreading awareness about various aspects of mental health. I keep writing about various topics related to mental health here, and what we do at SAA. You can check them out here. Lastly, please participate in various programs SAA would be conducting during this recovery month. For more updates on this, stay tuned!


The Reader

नुकतेच मावळलेले २०१७ हे वर्ष म्हणजे रशियातील क्रांती होऊन १०० वर्षे झाल्याचे तसेच दुसऱ्या जागतिक युद्धाला ७५ वर्षे झालेले वर्ष. या दोन्ही किती महत्वाच्या, जग बदलून टाकणाऱ्या घटना आहेत. काही दिवसांपूर्वी मी Sergei Eisenstein या प्रसिद्ध फिल्ममेकरने बनवलेला ऑक्टोबर हा सिनेमा पहिला, जो रशियातील राज्यक्रांती वर आधारित आहे. मी भाग घेतलेल्या चित्रपट रसास्वाद शिबिरात याबद्दल तसेच ह्या फिल्ममेकर बद्दल बरेच काही बोलले गेले होते. त्याबद्दल लिहायचे आहे केव्हातरी. आजच्या ह्या ब्लॉग मध्ये दुसरे जागतिक युद्धाशी निगडीत तितकीच महत्वाच्या घटनेबाबत लिहायचे आहे. ती म्हणजे ज्यु लोकांवर झालेल्या अत्याचार. मी याच विषयाशी संबंधित एक सिनेमा पहिला, तसेच एक बरेच प्रसिद्ध असलेले पुस्तक देखील वाचले. तसे पहिले ते दुसरे महायुद्ध, हिटलर, ज्यु लोकांवरील अत्याचार या विषयावर बरीच पुस्तके(holocaust literature), सिनेमे निघाले आहेत, अजूनही निघताहेत.

मी पाहिलेला सिनेमाचे नाव The Reader, आणि पुस्तकाचे नाव Man’s Search for Meaning. दोन्ही नावांवरून विषयाची कल्पना अजिबात आहे, आणि तीच मजा आहे. The Reader हा सिनेमा कथा सांगतो ती एका लिहिता वाचता न येणाऱ्या, अशिक्षित अश्या स्त्रीची(हाना तिचे नाव). सुप्रसिद्ध चित्रपट Titanic मधील अभिनेत्री केट विन्सलेट हीने ही भूमिका केली आहे. हा चित्रपट आहे  दुसऱ्या महायुद्धाच्या काळातील, जर्मनीतील. ही सामान्य स्त्री, ट्राम मध्ये कंडक्टर म्हणून काम करत असते. एकटी, अलिप्त अशी राहणारी हाना, गावातील एका तरुण ओळखीचा असतो आणि त्याला माहीत असते की हानाला लिहिता वाचता येत नाही ते. पण हानाला त्या गोष्टीचा न्यूनगंड असतो. पुढे आपला अशिक्षितपणा उघड होऊ नये या कारणास्तव, ती, जर्मनीने ज्यु लोकांवर अत्याचार करण्यासाठी तयार केलेल्या कारागृहात(Auschwitz Concentration Camp) सुरक्षा रक्षकाची नोकरी करू लागते. आणि चित्रपट वेगळीच दिशा धरतो.

जर्मनीचा ह्या दुसऱ्या महायुद्धामध्ये पराभव झाल्यानंतर मित्र देशांनी पराभूत जर्मनी देशाची जडणघडण कशी होईल, holocaust मध्ये सहभागी असणाऱ्यांचे काय करायचे याबद्दल घडामोडी सुरु झाल्या. ज्यु अत्याचाराशी संबधित व्यक्तींवर खटले भरून त्यांना शिक्षा देण्याची कारवाई सुरु होते. तिच्या ओळखीचा तरुण, जो पुढे Heidelberg Law School मध्ये कायद्याचे शिक्षण घेत असतो. त्यावेळेस त्याला एक court trial बघायला मिळते, ज्यात ३०० ज्यु स्त्रियांच्या जळून मृत्युमुखी पडल्याला काही स्त्रियांवर आरोप ठेवलेला असतो, त्याची सुनावणी असते. त्यावेळचे काही प्रसंग महायुद्धानंतरच्या जर्मन समाजाच्या आजी, माजी पिढीच्या, त्यावेळी झालेल्या अत्याचाराच्या विषयी असलेला मनोभाव दर्शवते. ह्या सुनावणीत एक तरुण ज्यु मुलगी ही प्रमुख साक्षीदार असते. ती आणि तिची आई हे ह्या अत्याचारामधून बचावलेले असतात, आणि त्याबद्दल तिने लिहून ठेवलेले असते. सुनावणीच्या वेळेस हाना असे सांगते, कॅम्पमधील सुरक्षा रक्षक कोठल्याही दहा कैद्यांना निवडून त्यांना मृत्युमुखी दिले जायचे, आणि असे करण्याचे कारण कॅम्प मधील अपुरी जागा. हाना दुर्बल व्यक्तींना निवडून, त्यांच्याकडून ती पुस्तके वाचवून घेत असे. तिच्या विरुद्ध आणखी एक आरोप असा असतो. मित्र देशांकडून युद्धात चुकून एका चर्चवर बॉम्ब पडून, लागलेल्या आगीत, आत असलेल्या, वर नमूद केल्या प्रमाणे, ३०० व्यक्ती रात्रीच्या वेळेस, बाहेर पडण्यासाठी दरवाजे न उघडल्याने, मृत्युमुखी पडतात. आरोप असा असतो की एक सुरक्षा रक्षक म्हणून हाना त्यांना बाहेर जाऊन देऊन वाचवू शकली असती. दरवाजे न उघडण्यासंबधित आदेशावर तिची सही असते असा पुरावा असतो. ती त्याचा इन्कार करते, पण स्वतःची नमुना सही देण्यासी नकार देते(इथे परत ती आपला अशिक्षितपणा ती लपवते). तिच्या ओळखीच्या तरुणाला हे कोर्टात हानाबद्दल आणि तिच्यावरील आरोपांबद्दल   समजते आणि त्याला धक्का बसतो.

ह्या नाझी अत्याचारामधून बचावलेल्या त्या तरुण ज्यु मुलीची साक्ष निर्णायक ठरून हानाला जन्मठेपेची शिक्षा जाहीर केली जाते. त्यावेळेस ही खटल्याचा वेळेस ती आपला अशिक्षितपणा जाहीर न होऊ देता, आपला बचाव न करता, ती शिक्षा स्वीकारते. हा तरुण हानाला ती तुरुंगात असताना वाचायला शिकण्यासाठी मदत करतो, ती तसे शिकते देखील. पुढे कित्येक वर्षे तुरुंगात राहून, पुस्तके वाचल्यामुळे की काय, तीला आपल्या कृत्याची जाणीव होते, आणि त्यामुळेच की काय हाना आत्महत्या करते. लिहिता वाचता येत नसल्यामुळे हानाची होणारी मनाची घालमेल, न्यूनगंड इत्यादी गोष्टी ह्या भूमिकेत केट विन्स्लेट हिने हे सर्व छान अभिनित केले आहेत. हा सिनेमा अर्थात नाझी अत्याचाराच्या प्रत्यक्ष अनुभव कथनाचे चित्रण करत नाही अथवा त्यावर आधारित नाही. तो त्याचा विषय नाही, पण तो काळ, त्याची पार्श्वभूमी नक्कीच, त्यातून गेलेल्या, संबंधित व्यक्तींच्या मनात खोलवर काय होते आहे याचे चित्रण नक्कीच. त्याकाळातील एका महिलेच्या मानसिकतेचे, मनाचे, आपल्या अशिक्षित असणाबाद्द्लचे न्यूनगंड, त्यामुळे होणारी मानसिक आंदोलने, वर्तवणूक समस्या दर्शवणारा हा चित्रपट आहे. ह्या सर्वातून बचावलेल्या, अमेरिकेत रहात असलेल्या, आणि त्या अनुभवांवर पुस्तक लिहिणाऱ्या महिलेबद्दल देखील आपल्याला समजते. असे असले तरी आपल्याला दुसरे महायुद्ध, १९४५ च्या आसपासचे जर्मनी, तेथील concentration camps, युद्धानंतरची court trials ह्याचे चित्रण दिसते. हा असा गुंतागुंतीचा चित्रपट बऱ्याच अश्या मोठा कालपटावर घडतो. Flashback सारखी विविध तंत्रे वापरली गेली आहेत. मी अमेरिकेत भेट दिलेल्या आणि पाहिलेल्या ज्यु लोकांच्या इतिहासाबद्दलचे एक संग्रहालयाबद्दल पूर्वी लिहिले होते.

Man’s Search for Meaning हे पुस्तक तर प्रत्यक्ष ह्या अत्याचारांच्या अनुभवातून गेलेल्या एका व्यक्तीचे अनुभव कथन आहे. तेही वर उल्लेख केलेल्या Auschwitz Concentration Camp चे अनुभव. त्यातच लेखक मानसोपचार तज्ञ आहेत. आणि त्यामुळे हे पुस्तक अत्याचारांच्या अनुभवाहून बरेच अधिक आहे. त्याबद्दल नंतर कधीतरी.

Lifeboat and Psycho

Lifeboat आणि Psycho! ही दोन्ही आल्फ्रेड हिचकॉकच्या चित्रपटांची नावे आहेत, हे तुमच्या लक्षात आलेच असेल. मी इतक्यातच हा Psycho चित्रपट पाहिल्यांदच पहिला. आणि त्यानंतर काही दिवसातच मी पुण्यात झालेल्या चित्रपट रसास्वाद शिबिरात जाऊन आलो होतो, आणि माझे brain-washing झाले होते! मी खरे तर आल्फ्रेड हिचकॉकचे हे दोनच सिनेमे पहिले आहेत. आल्फ्रेड हिचकॉक हा आपल्याला माहितीच आहे की रहस्य/भय चित्रपट बनवण्यात माहीर होता. त्यातही काहीतरी मानसशास्त्रीय दृष्टीने असतेच असते. हा ब्लॉग म्हणजे काही त्या दोन चित्रपटांची तुलना करणारा नाही, कारण दोघांची जातकुळी वेगळीच आहे. पण दोन्ही बद्दलचे माझे अनुभव कथन आहे.

Lifeboat हा सिनेमा मी खूप पूर्वी अमेरिकेत असताना पहिला होता. १९९५ चे साल. त्यावेळेस अजूनही विडियो कॅसेट आणून लोकं आणून घरी सिनेमे पाहत. त्यावेळेस विडियो कॅसेट भाड्याने देणाऱ्या Blockbuster सारख्या कंपन्या होत्या, आणि जोरात होत्या. शनिवारी, रविवारी असे मित्रांचे कोणाच्या तरी घरी अड्डे जमत, आणि असे सिनेमे पाहण्याचे कार्यक्रम, इतर गोष्टीबरोबर होत असत. त्या १९९५ मधील विकेंडला आम्ही तेच केले. Blockbuster मधून आम्ही Lifeboat हा आणि अजून एक The Last Detail नावाचा सिनेमा त्या रात्री आणला. सुरुवात Lifeboat पाहून केली. तर हा सिनेमा १९४४ मध्ये आलेला, अर्थातच श्वेतधवल चित्रपट. हा पहिल्यानंतर मला तरी असा हा सिनेमा एका नाटकासारखा वाटला होता. कथा काय तर समुद्रात जहाज बुडाल्यामुळे जहाजातील खलाशी/प्रवासी एका आपत्कालीन जीवरक्षक बोटीत जाऊन आपला जीव वाचवतात, पण जेव्हा विविध प्रकारची, विविध स्वभावाची माणसे एका छोट्याश्या बोटीत काही काळ एकत्र व्यतीत करतात, तेव्हा काय काय होते, ह्याचे चित्रण म्हणजे हा सिनेमा. विपरीत परिस्थितीत माणसे एकमेकांशी कसे वागतात, यांचे मानसशास्त्रीय विश्लेषण पाहायला मिळते. त्यातच परत दुसऱ्या महायुद्धाची पार्श्वभूमी. वाचलेल्या माणसांमध्ये एक जर्मन देखील असतो, बाकीचे ब्रिटीश आणि अमेरिकन नागरिक असतात. हा काही हिचकॉकचा टिपिकल भयपट नाही, पण रहस्यपट नक्कीच आहे. तसे हे नाटक म्हणून देखील चालले असते, कारण यात बोटीत अडकलेल्या माणसांमधील संवाद, चर्चा, संशय, भय, ताणतणाव, पदोपदी मृत्यूचे भय या सर्वांचे काही काळात झालेले दर्शन आहे. चित्रपटात संगीत असे नाहीच, फक्त समुद्रातील लाटांचा, वाऱ्याचा आवाज, त्यामुळे एक वेगळा परिणाम होतो.


Lifeboat movie poster, courtesy Internet

जेव्हा इंटरनेट, युट्युब वगैरे गोष्टी आल्यापासून, Blockbuster ही कंपनी नामशेष झाली आहे असे वाटले होते मला. पण अजूनही काही स्टोर्स आहेत असे समजले.


Blockbuster store image, courtesy Wikipedia

त्यांची एक स्लोगन असे, Be kind, rewind ती अजूनही मला आठवते. म्हणजे काय तर, सिनेमा पाहून झाल्यानंतर, विडियो कॅसेट परत rewind करून ग्राहकांनी परत द्यावी आणि सौजन्य दाखवावे, म्हणजे नंतर ती घेण्याऱ्या ग्राहकाला ती करावी लागू नये. काहीही असो, पण  Blockbuster मुळे तयार एका जीवन पद्धतीचा लय झाला. Blockbusterच्या स्टोर मध्ये, शुकवारी संध्याकाळी जाऊन आपल्याला हव्या त्या विडियो कॅसेट्स घरी घेऊन येऊन पाहणे ही वेगळी मजा होती. आणि सोमवारी ऑफिसला जाता जाता Blockbusterच्या स्टोर मध्ये विडियो कॅसेट्स परत करण्यासाठी असलेल्या खिडकीत विडियो कॅसेट्स परत देणे, यात वेगळी मजा होती.

आता Psycho या चित्रपटाबद्दल. हा १९६० मधील चित्रपट, भयपट तर आहेच, रहस्य आहे, आणि मनोविकार झालेल्या व्यक्तीचे चित्रण आहे. अमेरिकेतील हमरस्त्यावरील मोटेल(motel) मध्ये एका स्त्रीचा खून होतो. त्यावर हा सिनेमा आहे. का होतो, कोण करतो ह्याचा उलगडा म्हणजे हा सिनेमा आहे. भयपटाचे सारे घटक यात आहे, काही सूचक प्रतिमा वापरल्या आहेत. खून करणाऱ्या व्यक्तीच्या दुभंग व्यक्तिमत्वाचे(schizophrenia) चित्रण येते. हा मनोविकार का त्या व्यक्तीला झाला असावा, याची चर्चा करणारे काही संवाद आहेत. सिनेमाच्या पहिल्या भागात, ती स्त्री पैसे चोरी करून दुसऱ्या गावी मोटारीतून जाते, आणि शेवटी एका मोटेलमध्ये रात्रीच्या मुक्कामासाठी येते. ती स्त्री काही सराईत चोर नाही. त्यामुळे तिचा मोटेलपर्यंतचा प्रवास आल्फ्रेड हिचकॉक ती कश्या भेदरलेल्या मनःस्थितीमध्ये करते हे दाखवतो. पोलीस दिसले की तिची कशी भंबेरी उडते, हे दाखवतो. त्यामुळे त्या स्त्रीची एक प्रकारची प्रतिमा प्रेक्षकांच्या मनात निर्माण होते. त्याचा फायदा पुढे त्या स्त्रीचा खून झाल्यावार प्रेक्षकांच्या शंकेला वाव राहतो.


Psycho movie poster, courtesy Pinterest

मी वर उल्लेख केलेल्या चित्रपट रसास्वाद शिबिराच्या अंतर्गत चित्रपट संकलन कसे होते याबद्दल एक सत्र होते. त्यात Psycho चा उल्लेख झाला. स्त्रीचा खून हा मोटेलमधील बाथरूममध्ये होतो असे दाखवले आहे. त्या २-३ मिनिटांच्या दृश्यासाठी आल्फ्रेड हिचकॉकने म्हणे ९० वेगवेगळे शॉट्स घेतले होते, आणि एडिटिंगच्या वेळेस त्याला हवे ते जोडून अंगावर काटा आणणारा दृश्यपरिणाम त्याने साधला. भयपट म्हणजे ध्वनी आलाच, आणि तोही येथे अतिशय छान वापरला गेला आहे. यात ज्या पद्धतीने मनोविकाराचे स्पष्टीकरण आले आहे, आणि एकूणच जे चित्र प्रेक्षकांसमोर येते, हे कितपत बरोबर आहे, यावर तज्ञांमध्ये मतभेद आहेत. मी मध्ये ह्या ब्लॉगवरच सिनेमा मधील मनोविकारांचे चित्रण यावरील एक मराठी लेख मी इंग्रजीत भाषांतरीत केला होता

आल्फ्रेड हिचकॉकच्या चित्रपटांचा, त्याचा चित्रपट रचनेच्या, कथन शैलीचा बराच अभ्यास झाला आहे. त्याच्या एका पुस्तकाचा उल्लेख शिबिरात झाला. त्याचे नाव Hitchcock on Hitchcock. आल्फ्रेड हिचकॉकचे अंतरंग जाणून घ्यायचे असेल तर ते पाहिले पाहिजे.


Chatbots and rest of us!

Couple of years back I was looking for some property in Bengaluru. During the search I bumped on website of popular builder in that city.  The website popped out a window from the right hand corner of the screen and the question “How may I help?” This appeared as a regular chat window on the bottom on the page. I instantly realized that is might be a chatbot, than a real person talking to me. How? As chatbot windows appear on certain interactions with websites, certain clicks, and probably time you spent on the it, or if you are about to leave it. These are the signs.  I remembered the brief interaction I had way back in 2009 with an early stage startup working on similar technologies.

I had interacted to real person at famous hard disk manufacturing company, on the chat window, for my hard disk problem on my personal laptop long time back. So using real chat windows for customer support is very common, versus phone based support and also is faster than email based support, as many of us would have experienced. With advent of big data, and artificial intelligence, natural language processing technologies and their maturity has lead to many such interesting life-changing experiences for end consumers like us. The word ‘bot’ in chatbot, obviously has come out of word robot. The word robot, of course, when it was first coined, had a different connotation which is related to a man made intelligent machine. Of course, this technology is also has been advancing. So applying the same concept, a bot is a software program which works in the background, without end users’ knowledge most of the time, analyzing user interactions, text exchanged, and engages the user, or many times take certain decisions or provides information, to the source beneficiary. The key thing they do this automatically, with users’ knowledge.

I have been having a particular interest in natural language processing(NLP), specifically in the Indian language domain. Indian language domain poses a particular challenge not necessarily be solved best by existing NLP techniques. I also had done some work on the sentiment analysis on the social media for particular domain. This also was kind of a bot, for a social media, like Twitter. Some of these bots can even post dummy, fake items on Twitter or Facebook. I am sure you have experienced this, like me, especially on Twitter. Every now and then I see some socialbot adding followers, posting relevant content on my page. It becomes, of course, a task to clean it up. As it is with any technology, there are those who would it for malicious purposes. But other wise many consumer facing companies such as telephone, mobile operators, banks, travel(bus, airline, car rental), property and real estate dealers, are using this technology-either in-house developed or bought from other vendors. Another interesting application of chatbots I can is in the health domain. Since I work in mental health awareness domain, I have talked of technology and mental health in the past here. People with mental health issues and/or their care takers can use mobile apps which are equipped with chatbots types facilities to allow people to interact with them and talk through their emotions, seeks standard help, alarm or alert care taker or doctor or a counsellor on certain patterns derived out of interaction.

We also have been seeing voice based bots too. Many examples are in front of us, such as Apple Siri or Google Talk are any very generic examples. I use Slack at work. So Slack also few chatbot-alike features such as /giphy command which is famous. Their bot directory can give you various options to incorporate bots of your interest in the system. Same is true with other bots such as ChatOps from Atlassian. They take operations activity, which is backend end activity for any service provider company to automatically trigger, its internal workflows such creating a ticket in ServiceNow, by deciphering a certain text on the ChatOps window. Even cloud service providers such as Amazon AWS has service called Lex which allows to bots for their application using their ecosystem.

Some time back science fiction writers and experts had anticipated that robots will be every where. While it has happened to some extent, in the manufacturing industry, we are still far from seeing robots on the streets. But a silent revolution is already on, for sure, where we can encounter a chatbot or similar bot, whenever you are doing something on the web or mobile apps, at home or at work. This where innovation on automation is going on( I had talked of innovation aspects in my earlier blog here).

What is your experience on bots in general, chatbots specifically? Feel free to share!

PS: A news on Twitterbots I read today(Oct 22, 2107). It seems that Rahul Gandhi’s popularity on Twitter is due to Twitterbots…Check out it here

The Green Mile

Last week there was a news which said authorities at jails and prisons in India, are starting jail tourism. This is certainly not a bad idea, at least from the revenue generation perspective. Everyone is curious about life inside a prison. There is a mysterious circle around it. The only thing amused me is that, the tourism plan they have, is to allow tourists to stay inside a cell, and experience it from within. Now this is novel. I have been, in the past, as a tourist, to couple of prisons, which are not active anymore. For example, famous prison called Alcatraz Federal Penitentiary near San Francisco, on an island of Alcatraz; Eastern State Penitentiary, in Philadelphia. And it was a great experience, but now, visiting a live prison, staying inside it and experiencing it from within is something different!

The reason I remembered all this is, that I happened to watch, a famous jail movie The Green Mile recently. I have been hearing about it at many occasions, being one of the best movies. There are couple of famous jail movies such as The Shawshank Redemption and Clint Eastwood’s Escape from Alcatraz, both of which I had watched in the past. There is another one called Dead Man Walking starring Susan Sarandon and Sean Penn. All of them are very gripping movies, and the last two are based on real events.


Image courtesy: Internet

The Green Mile is a movie based on Stephan King’s novel, starring Tom Hanks. He is hell of an actor. It is period movie, particularly references to 1930 time USA, the great depression era. The movie takes place inside of a prison called Cold Mountain Penitentiary. It tells stories of personalities of wardens, and inmates of the prison. Particularly, these inmates are on a death penalty. It seems they used to use electricity then to execute the criminals in the prison. The film portrays this execution by electrocution in detail and is a gruesome to watch even in a film. It was also interesting to watch that, while execution is carried out, the audience is allowed to view it, during those times. In India, of course, there is procedure of hanging criminals. I remember lot of discussion about famous hangmen of India, who executed infamous criminals such as Ajmal Kasab etc. A quick search on Internet found a interesting link to details on hangmen of India.

The movie is lengthy, for sure, almost 3 hours. I remember the old days of Hindi movies, which used to be 3 hours movies. The reason why this is a lengthy movie is because it depicts relation of each of 3 inmates with wardens, in detail before they are executed. Each of them bring different personality. It is interesting to note that couple of them suffer from mental disorder, and also one of wardens displays personality disorder of sadism. It is also interesting to see inmates ethnicity-one of them is black(played by Michael Clarke Duncan), another one is a native American.

This a not an easy movie to watch. So be prepared for some torturous experience which will leave you spellbound, if you happen to watch it. In India, I don’t think we have had any notable prison movies. May be a movie on Kasab’s life in prison, could be a good story, to depict what goes behind the bars in the Indian prisons. One interesting side note on depiction of movies in Indian films. The famous Hindi film Do Aankhen Barah Haath(दो आंखे बारह हाथ)), directed by V Shantaram and written by famous Marathi writer/poet G D Madgulkar, had depiction an interesting experiment where inmates are allowed in open. The story was inspired by idea put forward by Polish engineer named Morris Friedman. It was using prison inmates to help build watershed for drought by then princely state of Aundh in 1939. This is similar to concept which existed in the USA where prisons were called penitentiaries. I have written about one such named Eastern State Penitentiary in Philadelphia



Good Will Hunting

मी मानसिक आजाराच्या क्षेत्रात काम करत असल्यामुळे, मला मानसिक आजार, त्यावरील उपचार, किंवा समाज त्या कडे असा पाहतो, त्याचे चित्रपटातून, नाटकातून कसे होते, यात मला रस असतो. ह्या पूर्वी देखील मी त्याबद्दल Movies and Mental Illness ह्या ब्लॉग मध्ये लिहिले आहे. त्यामुळे, जेव्हा Good Will Hunting हा चित्रपट प्रसारित केला जाणार आहे हे कळल्यानंतर तो मी पाहायला बसलो, आणि तो संपेपर्यंत उठलोच नाही. असे क्वचितच होते.

कथा घडते ती अमेरीकीतील बोस्टन ह्या शहरात. नायक गणित विषयात अतिशय बुद्धीमान आहे(प्रसिद्ध भारतीय गणिती रामानुजनसारखी प्रतिभा आहे, असेच त्यात दाखवले आहे). पण हा नायक हार्वर्ड विद्यापीठात शिकत नसतो तर, तेथे साफ-सफाई कामगार म्हणून काम करतो. विद्यापीठातील एका नामांकित गणित प्राध्यापकाला त्याची प्रतिभा उमजते. पण त्याला हेही समजते की हा काही मानसिक आजाराने ग्रासला आहे(लहानपणीच्या काही अनुभवांमुळे), आणि त्याला समुदेशन देऊन, त्याच्या प्रतिभेच्या लायकीचे त्याला काम करण्यास उद्युक्त करावे अश्या नेक विचाराने, त्याला समुदेशनासाठी वेगवेगळया ठिकाणी घेवून जातो. पण आपला नायक काही त्यांची डाळ शिजून देत नाही. त्याला एकदा तर संमोहन तज्ञाकडे देखील घेवून जातो. तेथेही नायक धमाल करतो. मग शेवटी तो त्याला त्याचा वर्गमित्र असलेल्या प्रसिद्ध समुपदेशकाकडे घेवून जातो. आणि त्यानंतर जे काही घडते ते चित्रपटात पाहायला हवे.  चित्रपटात बोस्टन शहराचे छान चित्रीकरण आहे. मी कधी तेथे गेलो नाही.  रॉबिन विलियम्सने त्या समुपदेशकाची भूमिका यात केली आहे. त्यासाठी त्याला ऑस्कर देखील मिळाले होते. साधारण दोन वर्षांपूर्वी  रॉबिन विलियम्सचे निधन झाले. अतिशय मनस्वी असलेल्या हा कलाकाराने आत्महत्या केली होती असे नंतर समजले. हा चित्रपट पाहिल्यानंतर, आणि विशेषतः त्याची ह्या चित्रपटातील असलेली भूमिका पाहताना, त्याने आत्महत्या केली असेल यावर कसा विश्वास बसावा, नाही का?

मी मानसिक आजार क्षेत्रात Schizophrenia Awareness Association(SAA) या संस्थेतर्फे शुभांकरांचा स्वमदत गट चालवतो. त्यात सामान्य समुपदेशक(lay counselor, facilitator) म्हणून, गटाचा समन्वयक म्हणून काम करतो. येथे आमच्या स्वमदत गटाची महिन्यातून दोनदा भेट होते. त्यावेळेस वेगवेगळ्या अनुभवातून जावे लागते. या चित्रपटातून जसे दाखवले आहे, तसे, अनुभव येत असतात. आपल्याला काही झाले नाही, आपण ठिक आहोत अशी समजूत असते. कोणी तसे दाखवून दिल्यावर, किंवा समुपदेशनाची, उपचाराची गरज आहे असे सांगितल्यास, आगपाखड करणे अश्या गोष्टी घडतात. तसेच, व्यवसाईक समुपदेशकाकडे गेल्यानंतर, समुपदेशनाचा तथाकथित(?) डाव समुपदेशकावरच उलटवणे वगैरे असे प्रकार घडतात. ह्या चित्रपटाच्या निमित्ताने हे सर्व आठवले. आमच्या संस्थेच्या विविध कार्यशाळांत संमोहन, किंवा इतर तत्सम प्रकार मानसिक आजारांत कितीपत उपयोगी पडतात याची चर्चा घडत असते, आणि सर्वसाधारण मत असे असतो की त्याने विशेष फरक पडत नाही. ह्या चित्रपटातून, नायकाला मानसिक आजाराची वेगवेगळी लक्षणे जसे की mood disorder, stress, inferiority complexity, post-traumatic stress disorder इत्यादी संयत पद्धतीने दाखवली गेली आहेत. पण चित्रपटात ह्या पद्धतीने सामुदेशन करताना दाखवले आहे, ते थोडेसे फिल्मी आहे असे म्हणावे लागेल. प्रत्यक्षात, समुपदेशकाने शुभार्थीला धमकावणे, गळा पकडणे इत्यादी प्रकार कसे काय होतील, असा विचार येतो. समुपदेशक आणि शुभार्थी यांचे नाते किती वेगवेगळया पदारांवर असू शकते हे हा चित्रपट नक्कीच दाखवतो.

चित्रपटाच्या नायकाबद्दल थोडेसे. तो आहे प्रसिद्ध अभिनेता Matt Damon. ह्या चित्रपटासंदर्भात असलेल्या विकिपीडिया वर असे लिहिले आहे की Matt Damon नाट्यलेखनाचा अभ्यास करत असताना ह्या चित्रपटाची पटकथा लिहायला सुरुवात केली होती. त्याने ह्या चित्रपटात छान भूमिका केली आहे. त्याने बऱ्याच चित्रपटातून काम केले आहे. नुकतेच असे वाचनात आले की त्याचा नवीन चित्रपट Jason Bourne चीनमध्ये वेगळ्याच कारणाने चर्चेत आहे. ते कारण म्हणजे, तो 3-D चित्रपट ज्या पद्धतीने चित्रित केला आहे, त्याने प्रेक्षकांना डोकेदुखी सुरु होते म्हणे. तर ते असो. मानसिक आजार, व्यक्ती, उपचार अशा गोष्टी असलेल्या अजून बरेच चांगले(तसेच वाईटही आहेत) चित्रपट आहेत. तेही पाहायचेत केव्हातरी.


Mental Health Care Bill

Last week parliament passed GST bill amidst much hype and publicity. At the same time, Rajya Sabha passed Mental Health Care Bill as well, which hardly anyone noticed. This is major milestone for the bill which was formulated in 2013.

I am associated with Schizophrenia Awareness Association(SAA) which works in the area of mental health area. The president of SAA, Amrit Bakshey has been championing this bill and has keenly following its journey. He has written an articles on its journey which I am reproducing it below:

Stake holders’ wait for it become a law will end soon! Much to the joy of the mental health community, the Rajya Sabha passed the Mental Health Care Bill 2013 with a voice vote on Monday the 8th August 2016. As the news spread that the Bill is listed on the business of the day, thousands of stake holders left their other engagement and were glued to the TV channels, sending minute to minute reports to their groups. The Bill should have an easy passage in the Lok Sabha and President’s assent should come soon.

For those of us who have been following the passage of the Bill from day one, it was a great historic moment. Six years back, with a view to harmonize the Mental Health Act 1987 (MHA 1987) with the United Nations Convention on Rights of Persons with Disability (UNCRPD) which India had signed and ratified on 30th March 2007 and 1st October 2007 respectively, the Ministry of Health and Family Welfare (MHFW) decided in the National Consultation Meet held on 22nd January 2010 to amend or replace the MHA 1987. The work was assigned to a senior and a highly qualified psychiatrist with vast experience in drafting mental health laws of several nations on WHO assignments and a legal expert from a reputed law college of the country.

After a rigorous participative process stretching over 3 years, consisting of regional and national consultations with stake holders, including psychiatrists, family care-givers, user survivors and NGOs and consultations with states and various ministries and after 3 drafts ( the first two were amendments to Mental Health Act 1987), the 4th and final draft bill, repealing the MHA 1987, was cleared by the Cabinet on 13th June 2013 and was introduced in the Rajya Sabha on 19th August 2013 as Mental Health Care Bill 2013 (MHCB 2013). On 20th August 2013, the Chairman Rajya Sabha referred the Bill to the all-party Parliamentary Standing Committee on Health and Family Welfare. The Parliamentary Committee after due deliberations and consultations with experts signed its favourable report on 11th November 2013 and presented to the Chairman Rajya Sabha and Speaker Lok Sabha on the 20th November 2013. The Cabinet approved the recommendations of the Parliament Committee on 30th January 2014.

The Bill cleared by the all-party Parliament Committee fell in the category of consensus bills and not much debate as such was required to pass it. The Bill, a property of the House, however, awaited an agonizing 3 years for Parliament’s time to discuss and pass to become a law.

MHCB 2013 is a highly progressive and beneficial legislation in offing. Right to access mental health care facilities, community living, protection from cruelty, inhuman treatment and right to equality and non-discrimination in treatment are some of the most laudable features of the Bill.

This chapter V of the Bill provides far reaching rights and elaborate benefits to the persons with mental illness (PWMI). The benefits provided as rights are unparalleled in the history of Indian legislation. What is offered is comparable to the best in the World. Section 18 makes mental health care and treatment at affordable cost and nearer home as a right and free for those below poverty line. Section 19 gives PWMI the right to live in the community rather than languish in institutions. This will reduce stigma. Sections 20 to 28 protect the basic human rights of PWMI including the right to equality and non-discrimination, to know about their illness, the treatment being given, the confidentiality and free legal advice. It enables the PWMIs admitted in mental health establishments (MHE) to enjoy basic amenities as are available to patients in other hospitals. Section 21 (2) provides for medical insurance policies for PWMIs by insurance companies the same way as for physical illness.

Sections 29 to 32 of Chapter VI cast responsibilities on State to promote mental health, launch preventive programmes, create awareness, reduce stigma and develop human resource. Sections 94 to 108 of Chapter XII regarding admission to, treatment  in and discharge from mental health establishments protect human rights fully without diluting the need for appropriate treatment. Sub Sections (4), (5) and (6) of Section 96 take adequate care to prevent molestation of minors in a MHE especially of minor girls. Section 103 on Emergency Treatment is a highly practical and helpful provision. Section 104 prohibiting certain treatments, such as unmodified ECT and sterilization and restrain on chaining are highly desirable pro human right provisions. Section 105 provides safeguards in regard to psychosurgery. Section 106 is a human right provision curbing physical restraint and seclusion, to be used only to prevent harm to self or others.

The Bill in its 4 year journey was debated and discussed and changes made after due process of consultation with all stake holders. Consultative process at the regional and at national level was all inclusive. Psychiatrists as well as other stake holders were invited and they participated. IPS Representatives also sought and got exclusive meetings with the Ministry Officials.

During this period of 4 years, there were several controversies and acrimonies. Some Human Right Activists criticized the Bill vehemently as in their view the Bill did not protect the human rights of persons with mental illness adequately. Some families felt that the provisions in regard to nominative representatives and advance directives would pose practical problems in caregiving. The Indian Psychiatrists Society (IPS) seemed unhappy that they were denied their due role in the drafting of the MHCB 2013. The MHA 1987 was drafted by IPS.

Their demurrals were banning of unmodified ECT which was for the attending psychiatrist to decide, the high cost of modified ECT, risk due to anesthesia and also non-availability of anesthetists for modified ECT. The IPS was also opposed to the registration of general hospitals with psychiatric beds.

The counter view of the framers and the supporters of the Bill was that ECT without anesthesia and muscle relaxant caused suffering and could cause injuries and therefore it was violative of human rights. It had been shunned by lot many nations. The country had over 16000 anesthetists against some 4500 psychiatrists. As a surgeon would not perform a surgery without an anesthetist, a psychiatrist should not administer ECT without an anesthetist. One time simple registration of mental health care establishments (where PWMI were kept overnight) including General Hospitals with psychiatric beds was required for statistical purposes and also to ensure that minimum standards were maintained and incidents like Erawadi, (28 chained inmates with mental illness died in a fire) did not occur again and patients were not exposed to abuse and neglect in ill-equipped mental health facilities both in the private and public sector. If a mental health establishment was registered under Clinical Establishments Act, (which was to be the case with general hospitals), registration under the proposed MHCA would have been waived.

Some IPS members also took cudgels on behalf of caregivers and said that the Bill was modelled after the western concept of institutional psychiatric care and would marginalize the families. It was also said that the nominated representatives would dupe the patients, taking major decisions on their behalf in regard to care and property.

Those associated with the drafting of the Bill quoted clause 17.c of the Bill and stated that a nominated representative had no role in regard to the property. His/Her role was limited to providing support to PWMI in making treatment decisions only. The Bill complied with the UNCRPD. The concept of mental health care and protection of human rights related thereto, was universal and not a country or region specific. It was a Mental Health Care Bill to provide mental health care to PWMIs. What was good for the PWMIs was also good for their families.

MHA 1987 which was a robust act when it was enacted had outlived its utility and needed to be replaced with a new law which inter alia protected human rights of PWMI. Its provisions had become outdated and were prone to struck down if challenged in a court of law leading to a vacuum which would have been dangerous.

The Caregivers and the PWMI are thrilled at the prospect of getting a beneficial law for them in a few months’ time and look forward to the passing of the sister Bill ‘’Rights of Persons with Disability Bill’’.  One hopes that all stake holders including senior and well respected members of psychiatric community and human right activists will also welcome the Mental Health Care Act 2016 which should soon become a reality and which is in the interest of the entire mental health community. The battle is half won as an equally important part would be the implementation of the new act. Many salutary provisions remain on paper only for want of proper implementation. State authorities, judiciary and mental health activists will have to be on their toes.

Indian Express also had article on this explaining various topics in this bill. Please find the link here. Hope this bill, once passed in Lok Sabha, with proper implementation, will change the lives and plight of persons with mental illness.