The mysterious death of 11 in a Delhi family proves how little we know about recognising mental illness, writes Nichola Pais
“To follow instructions where you know you are going to kill yourself is really very frightening and that is exactly what has happened,” avers Dr Kersi Chawda, Consultant Psychiatrist, P D Hinduja hospital. Sounding shaken by the recent mysterious death of 11 of a family in Delhi, he explains the Folie à Famille or Shared Psychotic Disorder in layman’s terms. “Basically what happens is that usually there is a very dominant person in the family who also has a psychological issue, a mental illness. Everyone around him is so much in awe of him that they follow whatever he says. Very often they themselves have a few psychological issues. They listen and follow instructions because that gives them a feeling of security. The others simply follow what has been said…”
Eleven members of the Bhatia family decimated, apparently by their own volition. What could have prompted 77-year-old Narayan Devi, her children and grandchildren to embrace what appears to be a mass suicide at their home in Burari, north Delhi? At the centre of the vortex is evidently Narayan Devi’s youngest son, Lalit Bhatia. Investigations focused on the notes found in the house indicate that Lalit had been planning the deaths, to the extent of predicting doom and advising the family that they would be saved.
Lalit, who had taken a vow of silence some years ago and was known to communicate even with customers at his grocer’s shop via scribbled notes, has left behind a glimpse into his twisted world via a series of chilling notes. One entry reads: “In your last hours, while your last wish is fulfilled, the sky will open up and the earth will shake, don’t panic but start chanting the mantra louder. I will come to save you and others.” He believed this to be a message from his father, who had passed away 10 years ago, to the family.
The notes are crucial evidence of the shared psychosis that went on to rip apart this family, including two 15-year-old boys and a young lady soon to be wed. Filling two thick notebooks, Lalit Bhatia’s diary reveals disturbing details about the case. Real life played out much like was described in the pages… The matriarch served all the members rotis as was instructed in the diary. Everyone evidently tied their hands for the ritual. And then real life deviates from the written word… “When the kriya (ritual) is done then everyone will help each other untie their hands.” None survived to complete the ritual. They were found faces covered, mouths taped and hands tied behind their backs, hanging from an iron grill in the ceiling of their hallway, hanging close and minus any signs of struggle.
Shared Psychotic Disorder
The Bhatias were evidently victims of Folie à Famille, a shared psychosis within a family involving more than two members. In this psychiatric syndrome, symptoms of a delusional belief and sometimes hallucinations are transmitted from one individual to another. The delusions are first manifested in the dominant personality, who influences the weaker personalities and suggestible and less intelligent people. Members involved have an unusually close relationship and are generally isolated from others.
Lalit Bhatia would credit all the ritualistic activities to ‘upar se aadesh’ or the orders from the higher power. He claimed to communicate with his father, taking instructions about property, business and family responsibilities from him. Such was the strength of their shared fears and beliefs, that the family members apparently even rehearsed the steps to get it right for the actual ritual.
Treatment and Cure
According to Dr Chawda, “The treatment by a mental health professional would actually involve separating everybody from the dominating person and allowing them to live their own lives. While the mentally ill person needs medication, the family members too need proper individual attention and therapy. That is what should happen but did not… and in a sheep-like fashion they apparently followed the instructions of one member; absolutely and incredibly.”
Unfortunately, in the case of the Bhatia family, any warning signs went unnoticed. In a country notorious for being highly judgemental of people perceived as having a mental illness – this despite an estimated 56 million people suffering from depression and 38 million from anxiety disorders – it is really no surprise that the Bhatia family evidently remained locked in their private world of fear, in life and in death.
Mental Hai Kya?
This happens to be the title of an upcoming film starring Kangana Ranaut and Rajkummar Rao, which attempts to break the stigma around mental illness. About time! A 2011 World Health Organisation-sponsored study had found that 36% of Indians suffered from a Major Depressive Episode (MDE) within their lifetime. It follows that India, as a country, has the highest number of people in the world who suffer from some form of depression at some point in their lives.
Even more disturbing is the treatment gap for all mental health disorders in India. A mere 10% of patients get treated, compared to 44% in the USA and 82% in South Korea. Admittedly there is a severe dearth of experts in India, where there are just three psychiatrists for every one million people. Compare this with the UK, which has over 14,000 psychiatrists for every one million.
Last year, President Kovind pointed out that the number of people affected by mental health issues in India is larger than the population of Japan, even as he expressed concern over the shortage of mental health professionals which needs to be addressed on priority.
Equally depressing is the fact that mental healthcare accounts for a miniscule 0.06% of the health budget; even Bangladesh is marginally better off at 0.44%.
In both rural and urban areas in India, access to mental healthcare is poor. Nuanced professional training is missing and excessive medication is common. What’s more, insurance does not help make mental healthcare affordable either. Many do not even comprehend the difference between psychological attention and psychiatric care.
However, the overriding problem continues to be the mindset. A ‘cocktail of stigma and ignorance’ continues to hold people back from seeking professional help. The pressure to appear ‘normal’ and avoid all so-called judgement and gossip, results in a silent veil of shame being dropped over mental health issues, as thousands continue to suffer in silence.