Bula was not happy at being offered a bath and fresh clothes. Food, she would gladly take – but for that she had to scrounge through leftovers in the bins. Staying dirty was her only protection from the roving eyes of men on the streets. She was afraid they would come after her if she looked clean, like they had for the other woman who had lived some metres away from her. After all, Bula lived on the streets herself – a homeless woman with psychosocial disability on the streets of Kolkata.
Gopal is a homeless man with psychosocial disability, but is cared for and looked after by the community in which he lives. The chaiwallah lets him sleep next to his stall every night. He also gives him some money every day for bringing water. But that particular night was not like the others; there was a stranger, a man. He was stronger than Gopal was. Try as he did, Gopal couldn’t fight him.
Sakhi has taken refuge in a shelter. It is a special shelter for urban homeless women with psychosocial disability. She has been here for a few months now. The baby she gave birth to here did not survive more than a month. She is an active participant in the shelter’s activities, but on some days she feels low. She misses the sense of touch terribly on those days. Some of the women she seeks out in the shelter don’t always respond to her.
There are many more stories, mostly unspoken, only lived and relived through memories, trauma, and longing – the words secretly being whispered by the winds, and lost forever in the sands of time. These are stories from a section of the population forgotten by most and abandoned by the rest – persons with psychosocial disability.
What is psychosocial disability? It is a term increasingly being used by professionals, carers and activists in the field of mental health to describe disability experienced by persons as a result of their mental health conditions, leading to restrictions in the persons’ participation in the activities of daily life. It may mean inability to manage social and emotional aspects of life, reduced ability to function effectively, and difficulty in achieving goals.
Its usage in India and other developing nations is not very widespread – but is not completely absent either. Its focus lies on going beyond the mental illness to understand the disability and consequently the quality of life led by a person affected by mental health conditions. Often dumped in shelter homes and hospitals across the country, or, in aggravated cases, having wandered off to find themselves on the streets – this is a highly vulnerable group which is at the margins of society.
The majority of these persons are out of the fold of any interventions thanks to the pitiful state of public mental health services in the country and the extremely expensive and elite private practices in the city. The mostly misunderstood nature of psychosocial disability is experienced through the rampant magico-religious beliefs in communities across the country. Rural as well as urban communities often believe that mental illnesses are due to the presence of a demonic spirit in the person, or because a person ate or drank something given by a practitioner of ‘black magic’.
Few private and non-profit organisations are involved in working with psychosocial disability issues, and public services are largely poorly funded, overcrowded and operating on an asylum-based approach, where persons with mental illness are incarcerated in mental hospitals. Most of those who do work in this area tend to focus on what is called a biomedical model of treatment, which focuses on only the biological factors in order to understand a person’s illness, and hence treatment is limited to pharmacological intervention. This model of treatment excludes the social and psychological factors that contribute to a person’s mental health condition, leaving little scope for rehabilitation activities or holistic development of the individual.
Given this state of affairs, the sexual needs of a person with psychosocial disability are the last thing on any stakeholder’s mind. Bula, Gopal and Sakhi are not isolated bits of flotsam in the vast ocean – there are looming questions around physical appearance, body image and attractiveness, consent, sexual needs, and overall intimacy issues faced by these individuals.
Such a person, otherwise shunned by their so-called sane compatriots, is often taken into account only as a body – a body to be used and discarded. Their complaints of any sexual assault are often met by labels of ‘mad’ and ‘liar’ – with others believing that this is a manifestation of the person’s mental illness. They are also labelled as ‘dirty’ at being ‘caught’ pleasuring themselves by the family or others, with the women alleged to be ‘of loose character’ and the men as ‘weak’. People around them often believe that these persons are incapable of consent and hence use their bodies for their own pleasure, stripping them of dignity and agency. Persons with psychosocial disability are stuck in a no man’s land with no real ownership over their sexual rights.
Consider now in this population of persons with psychosocial disability, women in particular. Women are a marginalised population who face everyday stigma and discrimination due to their gender alone. Women with mental health conditions, however, are recipients of the same ‘second-class citizen’ status with the added stigma and discrimination of their disability.
Bula may be picked up by the Vagrancy department for being on the streets and dumped at a mental hospital, or worse, at a Vagrants’ home with no available mental health services. She may be subject to unwanted sexual advances or even assault. Sakhi may be forced to take a bath, even have her hair shorn off, but her wish for intimacy and touch is met by beatings and being locked up.
This absence of consent further goes to imply an absence of any bodily need – the need for warmth, the need for touch, the need for intimacy, the need to play. This absence of play can be said to inform the absence of sex-positivity for the woman. The absence of permitted sexuality almost bereaves her of her humanness: having all her body parts in place but with no real power over them.
Mental health professionals, activists, NGOs, and other public-private bodies often focus on symptom reduction and relapse prevention; the humanity of the person gets lost in the pills being consumed. The focus has to become broader; the approach has to challenge the stigma and prejudice that lie even within their work, and to become more inclusive – thinking of the woman as a woman like any other with a disability which needs support. For the disabled woman, the fight is to regain ownership of her body – to take it back from the hospital authorities, spouses, family members, caregivers and even activists. The fight is to find her voice, to assert her agency as a sexual being, and to find acceptance for it.
The fight for feminism is to ask uncomfortable questions and attempt answers. Only then can we hope to include disability within the array of feminism and sexuality. Only then can we hope to not let these women continue to be nowhere persons, marginalised doubly by disability and by being a woman. Only then can we hope for a real and inclusive feminist movement.
Image courtesy: Wikipedia