Twenty-one years he spent within the walls of Pabna Mental Hospital (PMH), but patient Mahabub Anwar could not go home even though he was well enough to go home. He could not be sent home even after his death.

He was admitted to the hospital as a psychiatric patient of 33 years age on October 9, 1994. He passed away on August 7 this year.

"The hospital authority could not send him to his family because he was admitted here with a fake address. So when he became cured, the hospital took care of the patient until his death and even buried him with the help of the social welfare department of the hospital," Gazi Saiful Alam Chowdhury, superintendent of PMH, toldThe Daily Star.

When asked why he was never taken back by his family, his younger sister Kaniz Fatima became emotional while talking to The Daily Star over the phone. She said there was nobody in the family to take up the "burden".

"My father and elder brother had died. I am just a housewife so I could not look after him but I used to visit him at the hospital," Kaniz claimed, adding that the hospital did not inform her of his death.

Kaniz's name was not in the hospital register as Mahabub's guardian.

Mahabub is not the only one in PMH to be abandoned by their families.

Forty-seven-year-old Sakina Begum too died in the hospital the day after Mahabub passed away. She waited 12 years to go home, hospital sources said.

Sakina was admitted to PMH with reference from the then Pabna municipality mayor on August 5, 2003. Her address could not be found even after her death, said Abdul Bari, ward master of PMH.

There were 21 more patients who were well enough to stay with their families but were at the hospital since their families refuse to take them back.

“Most of these patients were admitted during the early 90's and they had fake addresses. At that time, certificates issued by union parishad chairmen or the municipality were accepted as legal documents during admission," Bari claimed, adding that nowadays voter ID cards are used.

Visiting the wards last week, The Daily Star correspondent found Nazma Nilufa, now 54. She came to PMH in 1989 when she was 28. Her mental health improved within a few years but none from her family took herback.

Weak and unwell physically, she could hardly speak.

"There is no need of me in this world," Nilufa lamented.

Md Akramuzzaman, 54, son of Kazi Golam Gaous of House-113, Road-4, Mirpur-12/A, Pallabi, Dhaka, as per hospital register, has been in PMH for the last 21 years.

He became well many years ago but the hospital authority could not send him back to his address as it was found to be fake, said Bari, adding that Akramuzzaman has been staying in the general ward since 2003.

Bari said according to hospital rules, they could not rely on the addresses given by the patients themselves and thus the addresses in the register were the only way.

"We cannot send them back to their fake address, that's why these longterm patients have been causing extra burden on the hospital for years." Tonmoy Prokash, director of PMH, told The Daily Star.

Prokash feels the government should open an asylum for these patients within the PMH so that they could stay there.

Keeping patients well enough to go home in the hospital occupies beds which new patients need. They cannot admit new ones as they don't have vacant beds, he said.

A stigma surrounds mental patients and even new patients of the hospital are neglected by their family members.

"I am suffering from a trivial mental trouble but my family members sent me here to save the cost of medicine. They never came to visit after my admission on August 25," said Muktar Pramanik, a newly admitted patient.

However, doctors said medicine was not enough to help psychiatric patients recover.

"Community support, including family, is essential for the recovery of patients with mental disorders but the people in our country often depend on doctors instead of community support ...," said the superintendent of PMH.

In developed countries too families abandon members suffering from psychiatric problems, said Anika Hossain, residential counsellor of a private company in the USA that works to rehabilitate mental patients.

She said these companies with licence provide a home-like environment to patients who learn basic living skills such as cleaning, basic hygiene, attending doctor's appointments, socialising, cooking, learning to self- medicate, pursue interests, and vocational training.

The residential counsellors work with each client's healthcare providers, case managers, and guardians in order to come up with treatment plans that would help the client become more independent, find employment if possible and eventually re-integrate into society, Anika said.