I always know what the reaction will be before I answer the question.
Random person anywhere on the island – “Where do you work?”
Me – “The National Institute of Mental Health”
Random – “Huh?”
Me – “Oh, um, the Angoda Mental Hospital”
Random – “Oh, really? (giggling)….Why? You are a doctor?
From there it goes into a confusing explanation about media relations, stigma and websites. No one really understands, including me.
The point is that everyone laughs at that word – “Angoda”. No matter what they’re background, where they’re from or what level of education they have. If your Sri Lankan, you inherently know that this place is where the ‘crazy’ people have always been sent and it’s to be avoided like a spitting cobra by everyone else.
Once someone has been admitted to this hospital and it becomes known in the community, that person is forever labelled as ‘pissu’ (crazy) and shoved to the outskirts of society – even when they are discharged and have made a full recovery. The laughs and jeers also extend to the staff, as many people have told me how ashamed they are when telling people where they work.
Also, when families don’t know what to do next and have run out of all options, Angoda is the absolute last resort. In fact, the idea of coming here is so terrifying to many people that they will simply decide to not get their family member any help. Suffering with untreated symptoms of a mental illness is seen to be the far better option compared to coming to this place.
You don’t change an attitude that entrenched in a society.
The hospital can make all the improvements to facilities and care as possible. They can change their name and have all sorts of events, trainings and media promotion – but the only real option to end that stigma is closing this place down.
Not only does a 1,000-plus-bed psychiatric hospital instantly become the brunt of everyone’s jokes, it’s also universally been proven to be an extremely ineffective way of treating mental illness.
The way forward is clear and the Sri Lankan government has started to show they know the way based on their national mental health policy, which calls for care at the village and community level – and less and less at the large institution level. Of course, that’s easier said than done and making that change takes a long time, especially when hundreds of Angoda patients have no place else to go. This is their home.
My only hope is that they’re on the right path and Angoda will one day just exist in the punchline of a joke.
Having said all that, the hospital is far from a scary place. The fact is it’s a rather peaceful institution filled with nice gardens, sleepy (often times very bored) patients and staff, and a nice big tree in the middle of the entrance.
There are also many dedicated staff who work here that are really trying to improve things for the patients, while always being forced to managed their way through ridiculous approvals and stifling hierarchy.
For those of you in the Colombo area, I invite you down to check it out for yourself during the Open Days on October 12, 13 and 14 as part of World Mental Health Day events. There will be a craft sale, art exhibition and butterfly making with many bits of Sri Lankan hilarity mixed in.
Come on down and see the infamous hospital for yourself – before it (hopefully) disappears forever.