The International Journal of
Psychosocial Rehabilitation
Psychiatry Morbidity Among Inmates of the 'Beggar Home’
Dr Yogesh Thakker
Dr Zindadil
Gandhi
Dr Hitesh Sheth
Dr G.K.Vankar
Dr Sudeep Shroff
Citation:
Thakker Y., Gandhi Z., Sheth H., Vankar G.K., & Shroff S. (2007).
Psychiatry Morbidity Among
Inmates of the 'Beggar Home’ International Journal of Psychosocial
Rehabilitation. 11 (2), 31-36
Contact: Dr Hitesh C Sheth
202,Aashrayadeep Apartment,
Gautamnagar Society,Alwa Naka
Manjalpur,Vadodara,
Pin Code No 390011
Email: hiteshcsheth@rediffmail.com
drdivinescorpio@yahoo.co.in
ABSTRACT:
With
aim to know prevalence of psychiatry morbidity
among the beggars, we study socio-demographic variables and assessed the
psychiatric morbidity and distress
among the inmates
of 'Beggar Home'. The Subjects were 49 inmates of Beggar Home situated in
Vadodara(
INTRODUCTION:
A ‘beggar’ or a ‘cadger’ (Oxford
Dictionary, 2001) is, a person who lives by asking people for money or food. It
is roughly estimated that
there are about 2 million beggars of all category in
METHODS:
Data collection
The
subjects were 49 inmates of Beggar’s Home, Vadodara,
Data analysis
We
analyzed all the data by using SPSS (Statistical Package for the Social
Sciences, Version 8.0). We collected the data along a nominal level, and then we
used chi-square test for the main statistical analysis. The demographic
variables we studied were age, sex, geographic distribution, residence
(rural/urban), education, marital status, family (nuclear/joint), and family
income.
RESULTS:
The sample
consisted of 49 inmate beggars from ’Beggars Home', Vadodara.
Their Age ranged from 16 to 60 years (mean= 35.14, SD=11.02). Among forty- nine
inmates, age of 11 beggars ranged from 16-25 years; 16 were from 26-35 years
age group; 14 were from 36-45 years age group and remaining 8 were of
more than 45 years of age. Their duration of begging in months ranged from zero
to 48 months (mean=3.82, SD=1.13).
Of 49
beggars we studied, 41 beggars were male and only 8 were females. There
was no significant association between, gender and presence of psychiatric
illness. Twenty beggars were from urban locality whereas 29 were from
rural locality. When asked about literacy level, 23 beggars
did not answer anything; 1 beggar said he was illiterate; 15 beggars had
studied up to primary education level and 10 had studied up to secondary
education level. While replying about their marital status, 28 beggars said
they were married and 21 said they were unmarried. Among 21 inmates
with distress, 14 were unmarried (p =0.009).
Seventeen
beggars were begging for less then month duration. Thirty-one were begging by
there own wish while forty-four attributed their begging to unemployment or
financial crisis. Thirty-three were farmers or laborers earlier. Fifteen
beggars reported guilt feeling related to begging, while 15 inmates denied
having any guilt because of begging. Twenty-eight beggars wished to quit
begging if given any opportunity to earn. Of forty- nine inmates, 28
of the inmates were feeling happy in Beggar’s Home. When inquired about earning,
17 beggars said that ‘they earned just sufficient to have their two meals’,
while 32 beggars declined to reply. The income of these beggars varied in
between zero to 9000 rupees (0 to100 pounds) per annum (mean=1706.12,
SD=1973.1).
Thirty-five
beggars reported addiction to one or other substances, mainly chewing or
smoking tobacco (65 per cent) and alcohol (13.6 per cent). Association of act
of begging and history of addiction of a substance was statistically
significant (p=0.04). Twenty beggars had some relative with history of
substance abuse in their home; distress was present in eight among these 20
beggars. It was statistically significant that distress was present more in the
beggars who had positive family history of substance abuse (p=0.017). Two
beggars had attempted suicide at least once in their lifetime. Four beggars had
tried theft before and among them two had positive GHQ findings. Beggars who
had tried theft before, had distress present in them (p=0.001).
Twenty-three
beggars came from joint family, 21 from nuclear family and 5 were separated
from their family. Family members of 28 beggars were unaware of their begging.
Forty-two beggars reported overall good attitude of family members towards
them. Out of thirty-two beggars who answered very good or good family attitude,
10 had distress present in them. Nine out of twelve beggars who answered
somewhat good, bad or very bad attitude of family members towards them, had
distress present in them. When we studied association between psychiatric
illness and family attitude, we found that there was significant association in
between them. Seven beggars had someone with physical disability in their home;
distress was present in 3 among these 7 beggars (p=0.05). Ten beggars had one
or other permanent physical disability; whereas 37 beggars did not have any
permanent physical disability. Six beggars accepted having homosexuality.
When we
applied DSM-IV criteria to find out any psychiatric illness in the
beggars, we found 19 (38.8 percent) beggars among 49 were suffering
from one or other psychiatric illness. Exact number of different
illnesses present in beggars is described in TABLE-1. We observed
significant association in positive family history of psychiatric illness and
presence of psychiatric illness in beggars (p=0.04). Distress was also present
significantly in the beggars who were suffering from psychiatric illness
(p=0.05)
TABLE-1: Psychiatric illnesses present among
inmates.
|
Psychiatric illnesses |
No. Of beggars |
% Of sample |
|
Psychosis |
11 |
22.4 |
|
Mental retardation |
3 |
6.1 |
|
Adjustment disorder |
2 |
4 |
|
Bipolar I mood disorder |
1 |
2 |
|
Major depressive disorder |
1 |
2 |
|
Dementia |
1 |
2 |
|
Total |
19 |
38.8 |
DISCUSSION:
We were
unable to find any study done on beggars, especially the one that assesses
psychiatric co-morbidity and distress among them. In our study we tried
to find out any association present among socio-demographic variables and
psychiatric co-morbidity; socio-demographic variables and distress; and
psychiatric co-morbidity and distress. We found significant association between
marital status and presence of distress in beggars, whereas association between
marital status and presence of psychiatric illness in beggars was
non-significant. Association of act of begging and history of addiction of a
substance was statistically significant. It was statistically significant that
distress was present more in the beggars who had positive family history of
substance abuse (p=0.017). Beggars, who had tried theft before, also had
distress present. Nine out of 12 beggars who answered somewhat good, bad or
very bad attitude of family members towards them, had distress present in them
(p=0.009). When we studied association between psychiatric illness and family
attitude, we found that there was significant association in between them
(p=0.04). Seven beggars had someone with physical disability in their home;
distress was present in 3 of these 7 beggars (p=0.05). We observed significant
association in positive family history of psychiatric illness and presence of
psychiatric illness in beggars (p=0.04). Distress was also present
significantly more in the beggars who were suffering from psychiatric illness
(p=0.05). Dean et al in 2000 also observed that 74 per cent of subjects
had troubled family background.
The beggars
with psychiatric illness had high prevalence of addiction, family history of
psychiatric illness, poor attitude of family members towards them and high
score of GHQ (TABLE-2). In our study, we found that 35 beggars reported
addiction problem in other words 71% of the inmates agreed to have addiction of
some kind (TABLE-3). The result were similar to the cross-sectional study
done by Dean and Melrose in 2000, in which 68 per cent of subjects admitted
current or past involvement with drugs and/or alcohol. In other comparative
study done by Danczuk (2000), 45 per cent reported
having addiction problem. In our study 13 per cent beggars admitted
alcohol dependency, while in Fitzpatrick study in 2000, 33 per cent reported
alcohol dependency. The high prevalence of psychiatric morbidity among beggars is
not a startling revelation if we examine the findings in light of testimony
given by Congressman Ted Strickland in front of 'House Judiciary Committee’ on crime
(Strickland, 2000). He said, ‘deinstitutionalization movement’ in which large
number of mentally ill patients were released in society, was well
intended. But it is not deinstitutionalization but trans-institutionalization
because large number patients have shifted form mental hospital to jails,
prisons and homeless shelters.
TABLE-2
|
GHQ |
DISORDER
PRESENT |
DISORDER
ABSENT |
|
POSITIVE |
13 (68.4) |
12 (40) |
|
NEGATIVE |
6
(31.6) |
18 (60) |
|
TOTAL |
19 |
30 |
|
TABLE-3
|
There
was significant association between female sex and distress in inmates of Beggar
Home, which might be because of the lack of privacy in beggar home. There was
no female servant or caretaker in the Beggar home.
Majority of the inmates had
started begging because of unemployment and financial crisis in the family.
Sixty three percent had started begging by their own wish. Sixty Eight per cent
of beggars felt badly about begging and also reported feeling of shame and a
loss of pride and dignity. In one previous study done by Dean and others
(2000), they found that 63 percent did not start begging out of choice. In one study, Simon Walk mentioned that only 6 per cent of
beggars started begging because of
homelessness.
This data suggests that it is
necessary to facilitate de-addiction and other educational programs for beggar
inmates. We found that occupational guidance and training would help beggars to
regain confidence to earn bread. They required access to appropriate
accommodation and work opportunities. Fitzpatrick (2000) also recommended
individualized, flexible support provided through key workers as one way of
promoting a holistic approach at service delivery level. The most inmates also
required help to overcome drug and alcohol misuse, social isolation, mental and
physical health problems, and deep-seated low esteem. These needs can only be
met in an integrated way through effective policy co-ordination at both
national and local levels, with responsibilities accepted by all the key
players and the necessary resources attached.
SUGGESTIONS:
- Criteria for admission to be reconsidered
- Periodic visit by a psychiatrist
- Adequate number of staff members to be recruited
- Awareness and education of staff members regarding
psychiatric illnesses
- Vocational training for beggars.
- Female attendants and staff for the female inmates of beggar
home.
- The policy of a deinstitutionalization and releasing
mentally patients in society without making alternate arrangement needs
rethinking.
LIMITATIONS:
Interpretation of the findings in this study is limited by
the small size of the sample. Nevertheless, analysis reported in this article
reached the standard accepted levels of statistical significance. This is a
cross sectional study. It provided an idea about the condition of inmates of
the Beggar Home. A prospective study is required to get more information about
any improvement or worsening in the condition of the beggars till they stay in
the Beggar Home. A prospective study can also help in the follow up of the
beggars who had psychiatric illness or distress present at the time of our
study. We have faced language problem while communicating with the beggars who
could not understand Gujarati or Hindi. There was no relative or informant
present while interviewing the beggars, so information given by the beggars
could not be verified. The sample we studied was of inmates of the Beggar Home,
so the results of this study cannot be generalized to the whole beggar
community. We performed this study at Beggar Home in Vadodara
city; the findings may differ if the same study is performed in the Beggar Home
somewhere else.
References
American
Psychiatric Association’s (1994) Diagnostic and Statistical Manual of Mental
Disorders. 4th
edition. American Psychiatric Press,
Dean Hartley, Ed. (1999) Begging
Questions: Street-level economic activity and social policy failure, (The
Policy Press;
Dean Hartley
& Melrose Margaret (2000), Easy pickings or hard profession? Begging as an economic activity, in Begging Questions:
Street-level economic activity and social policy failure, (The Policy Press;
Fitzpatrick Susan & Kennedy
Catherine (2000) 'Getting by: Begging, rough sleeping and The Big Issue in
Glasgow and Edinburgh, (The Policy Press;
Goldberg DP, Hillier VF 'A
scaled version of the General Health Questionnaire', Psychol
Med 1979;9:139-45
Planning commission (Planning
commission, plans & prospective of social welfare in India, 1963)
Simon Walk on by… Begging,
street drinking and the giving age (Crisis:
Strickland Ted(2000),
'The Impact of the Mentally ill on the Criminal Justice System , 'Testimoney of Congressman Ted Strickland';
http://www.globalsecurity.org/wmd/library/congress/2000_h/stri0921.htm
Copyright © 2007
Hampstead Psychological Associates, Ltd - A Subsidiary of Southern Development
Group, SA.
All
Rights Reserved. A Private Non-Profit Agency for the good of all,
published in the UK & Honduras