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,Gujarat,India

  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(Gujarat), India. We gave them a semi-structured questionnaire of socio-demographic details and also gave General Health Questionnaire-28.We also interviewed them personally to diagnose the psychiatric illness and to know their begging patterns.We found that 38.8 per cent of inmates were suffering from one or other types of psychiatric disorders. The study also revealed the high scores on GHQ among the beggars suffering from the psychiatric illness.

 

 


 

INTRODUCTION:

A ‘beggar’ or a ‘cadger’ (Oxford Dictionary, 2001) is, a person who lives by asking people for money or food. It is now roughly estimated that there are about 2 million beggars of all category in India (Planning Commission, 1963). A Beggar Home is a statutory organization that functions in collaboration of State Government and Municipal Corporation of that particular city. It works under 'The Bombay Prevention of Begging Act', 1959. The beggar’s home provides shelter, protection, and training of vocational skills to the inmates. Thus, Beggar Home is a good source of sample when beggars are to be studied.  This study was aimed to assess psychiatric distress and morbidity and also to study socio-demographic variables of beggars among the inmates of beggar home in Vadodara. In this study we have tried to find any significant association among presence of psychiatric illness, distress, begging patterns and socio-demographic variables.


METHODS:

Data collection

The subjects were 49 inmates of Beggar’s Home, Vadodara, Gujarat. After receiving permission from The Superintendent of Beggar Home, we interviewed the inmates of beggar home on one to one basis, using DSM-IV criteria, to diagnose any mental illness. We also prepared a semi-structured questionnaire that included questions about socio-demographic details and begging patterns of beggars. We used General Health Questionnaire-28 (Goldberg, 1978) and translated it in Gujarati language to find out distress among inmates of beggar home.

 

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

ADDICTION

DISORDER PRESENT

DISORDER ABSENT

SMOKING

7 (36.8)

15 (50)

TOBACCO CHEWING

7 (36.8)

14 (46.7)

ALCOHOL

3 (15.8)

6 (20)

OTHERS

0 (0)

0 (0)

D.N.A.

8 (42.1)

6 (20)

TOTAL

19

30

 

 

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, Washington DC.

Dean Hartley, Ed. (1999) Begging Questions: Street-level economic activity and social policy failure, (The Policy Press; Bristol)

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; Bristol)

Fitzpatrick Susan & Kennedy Catherine (2000) 'Getting by: Begging, rough sleeping and The Big Issue in Glasgow and Edinburgh, (The Policy Press; Bristol)

Goldberg DP, Hillier VF 'A scaled version of the General Health Questionnaire', Psychol Med 1979;9:139-45

Oxford dictionary 2001: beggar, pg 73, edition 9, Catherine Soanes (Ed.), Oxford University Press.

Planning commission (Planning commission, plans & prospective of social welfare in India, 1963)

Simon Walk on by… Begging, street drinking and the giving age (Crisis: London)

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

    



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