The families living through the toll of a loved one’s mental illness

Fourteen-year-old Shahida used to spend the entire day on her smartphone. She struggled to concentrate on anything else and was slow to respond when someone called her. Concerned, her parents took the phone away. But it only made things worse — Shahida became completely mute.

One day, she suddenly began screaming, "Where are you all? They've married me off. Please save me!" She kept repeating the words over and over again. She stopped sleeping at night, constantly crying out the same plea. She lost all interest in eating and drinking.

After about a month, when her condition deteriorated further, her family realised they could no longer sit back and hope it would improve on its own. It was through a neighbour that they first heard about the National Institute of Mental Health and Hospital at Dhaka's Sher-e-Bangla Nagar area.

Shahida was admitted there by her father and elder sister, Farida. Two days later, her father returned home to harvest the family's paddy, leaving Farida to stay by her sister's side. Over the next seven days, Shahida showed encouraging signs of improvement, although doctors say her recovery will take more time.

Asked whether people would accept Shahida as they had before once she returned home, Farida said, "Shahida's situation can wait. Right now, it's my own marriage that's likely to become a problem. Families who had sent marriage proposals will think twice now. But that doesn't mean I can abandon my sister. Whatever is written in my fate will happen."

Shahida had no close friends. She rarely spoke, even to her cousins, and showed little interest in her appearance or the clothes she wore. Instead, she spent her days scrolling through short videos on her mobile phone or reading posts on Facebook. 

Over time, she became increasingly detached from the world around her. Farida believes this growing isolation was what ultimately contributed to her illness.

Family's sole breadwinner

Siddiq was brought from Narsingdi by his father, younger sister and brother-in-law, his hands tied with a rope. A bus conductor initially refused to let him board, but the family could not afford a minibus.

He first developed symptoms six or seven years ago. After treatment, he recovered and returned to work as a mason's helper — the sole breadwinner for his elderly father and three sisters.

Before this latest episode, Siddiq became fixated on marriage and even assaulted his father. The family eventually arranged the wedding, but just three days later, his condition worsened. They were forced to keep him tied in a separate room because he became violent, smashing household items and attacking relatives.

His aunt pleaded, "Please spare a thought for us. We were already poor, and now we've become even poorer. Help us in whatever way you can."

'High-level connections'

Satyendranath is from Netrakona, where his family has fished for generations. Married with a young daughter, he was brought to the hospital by his parents.

Though not violent, he often mutters to himself, has little interest in work, spends much of his time searching for drugs, and wanders through forests and fields. His parents hope treatment can help.

When I spoke to him, Satyendranath claimed he was in direct contact with world leaders, including Donald Trump, Narendra Modi and Kim Jong Un. He raised his hand to his ear, murmured into an imaginary device, then turned to me and said with complete confidence, "Your work will be done by tomorrow morning."

Patients gather in the men’s ward, where families often spend weeks with their loved ones undergoing treatment.

A helpless teacher

Sabuj was brought from Chattogram by his father, a respected schoolteacher who had worked hard to educate all his sons. Now, he was helpless.

A swelling above his right eye marked a recent assault. Sabuj had hit him with a mobile phone.

Once a bright and gifted student, Sabuj had grown increasingly paranoid. He believed his relatives were spies and that surveillance devices were hidden in his room. He often tore the house apart searching for them and sometimes turned violent towards family members.

At the hospital, Sabuj was assigned the first bed behind the iron bars of the emergency psychiatric ward. He had brought his books with him. Every so often, he lunged at the locked gate, shouting at his father, "You're a hypocrite. Why have you brought me here? I haven't done anything wrong. You'll be severely punished."

'The topper obsession is part of the problem'

The hospital has 400 beds, about 70% of them non-paying. According to a 2019 national survey, around 18% of Bangladesh's population lives with a mental health condition, including 12% of children and adolescents.

Dr Niaz Mohammad Khan, head of the Child, Adolescent and Family Psychiatry Department, said conduct disorder is common among children and teenagers. It is characterised by repeated violations of social norms, including lying, stealing and, in some cases, arson. Family conflict and physical or psychological abuse significantly increase the risk, he said.

Dr Khan believes many parents overlook their children's emotional needs, impose decisions without considering their feelings, and expose them to frequent parental conflict. Some even use children to hurt or influence the other parent.

"All of this creates immense psychological pressure," he said. "When children lose trust in their families, they look elsewhere for role models. They may idolise older youths who appear powerful, contributing to the rise of juvenile gangs."

He also criticised the education system's emphasis on producing toppers, arguing, "Excessive competition harms children's wellbeing. Instead, children need safe spaces to express their emotions. When distress is suppressed for years, it can lead to severe psychological problems, including conversion disorders."

72 decimals of land mortgaged

For the past 15 days, Chhamiruddin Molla from Lakshmipur has been sleeping under a mosquito net in the corridor outside the hospital's non-paying ward while caring for his daughter.

Around 30 years old, she developed severe anger issues, quarrelling constantly with her husband. After her father scolded her one day, her behaviour changed dramatically. She became restless, wandered from home and verbally abused strangers. Unable to cope, the family brought her to the hospital.

"One of the biggest misconceptions in Bangladesh is equating all mental illness with 'madness'. Not every person with a mental illness is 'mad'. Only about 1% of patients experience severe, complete loss of contact with reality. Because of stigma, many families hide mental illness or stop medication as soon as symptoms improve, increasing the risk of relapse."

Dr Shuddha Deb Sarkar, Assistant Registrar, National Institute of Mental Health and Hospital

Her four-year-old daughter, who had been raised mainly by her grandparents, is now staying at the hospital as well.

Before coming here, the family spent nearly Tk2 lakh on traditional healers, faith healers and village practitioners. To raise the money, Chhamiruddin mortgaged 72 decimals of farmland.

He arrived at the hospital with Tk13,000 sent by a nephew working in Italy. While the hospital feeds his daughter, he must cover his own meals and care for his granddaughter. The money is nearly gone.

"This is the kind of illness that can ruin an entire family," Chhamiruddin said. "You lose money, but more than that, you lose your dignity and your standing in society."

Kulsuma's never-ending battle 

Kulsuma Begum, a domestic worker living in a low-income colony in Mohammadpur, spends almost all of her income on treating her 15-year-old son, Abdullah.

Abdullah began showing behavioural problems at six or seven, becoming violent, destructive and prone to sudden outbursts. Kulsuma brought him to the National Institute of Mental Health and Hospital, but while medication brings temporary improvement, his symptoms often return. During these episodes, he has assaulted neighbours, passers-by and even children.

Kulsuma says her husband has shown little interest in their son's condition, leaving her to earn a living, care for Abdullah and manage his treatment alone.

His behaviour has forced the family to move repeatedly, as landlords refuse to rent to them.

"Everyone calls my son 'mad' just to provoke him," Kulsuma said. "They call me 'the mad boy's mother'. No one wants to rent us a home. Life has become incredibly difficult."

Years of caring for Abdullah while struggling financially have left Kulsuma physically and emotionally exhausted. Though she suffers from several health problems herself, she has little time to think about her own wellbeing.

'Sohel might have become a doctor'

By the age of 32, Sohel Ahmed had been married six times.

Tall and handsome, Sohel was, according to his mother, undone by one thing, "The problem is in his mind. He has an uncontrollable temper. Once he wants something, he won't let anyone have peace until he gets it."

Many parents overlook their children’s emotional needs and impose decisions which creates immense psychological pressure.

An excellent student, Sohel had once dreamed of studying medicine. But after higher secondary school, his behaviour changed. He began wandering into bamboo groves at night, insisting someone was calling him. He eventually abandoned his studies, learned tailoring and became obsessed with getting married.

Finding brides was never difficult, but each marriage ended within weeks. As news of his condition spread, the family sought brides from distant areas. "We knew it wasn't right," his mother admitted. "But sometimes he becomes completely normal, and we forget he's ill. Then the illness returns and life becomes unbearable."

His condition has torn the family apart. They have sold land to pay for treatment, his siblings want him permanently hospitalised, and his grandchildren are afraid of him.

But his mother cannot accept that. "I'm his mother," she said softly. "How can I leave him there forever?"

Mohona stays by her mother's side

Five-year-old Mohona has been living at the hospital with her mother. By day, she wanders the grounds with her father, who sleeps outside the paying ward. At night, she insists on sleeping beside her mother.

One night, another patient's shouting woke her in terror. Crying, she asked her father, "When are we going home? What's wrong with Mum?" Unable to answer, he walked the streets with her for more than an hour until she calmed down.

"Only those who have lived through this understand the suffering mental illness brings," he said. "People call my daughter 'the mad woman's child'. More than anything, I worry about how I'm going to raise her."

Dr Shuddha Deb Sarkar, Assistant Registrar at the National Institute of Mental Health and Hospital, said one of the biggest misconceptions in Bangladesh is equating all mental illness with 'madness'.

"Not every person with a mental illness is 'mad'," he said. "Only about 1% of patients experience severe, complete loss of contact with reality."

Because of stigma, many families hide mental illness or stop medication as soon as symptoms improve, increasing the risk of relapse. While many conditions cannot be cured completely, Dr Sarkar said they can often be managed effectively with treatment and strong family support, helping patients regain confidence and reintegrate into society.

Disclaimer: With the exception of the doctors quoted in this report, all names have been changed to protect the identities of the patients and their families.