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PRESIDENTIAL ADDRESS
Year : 2008  |  Volume : 30  |  Issue : 2  |  Page : 68-69 Table of Contents   

Indian Psychiatric Society - South Zone


Department of Psychiatry, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, India

Correspondence Address:
S Jayaram
Ananthapuri Hospitals and Research Institute, Thiruvananthapuram
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7176.48475

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How to cite this article:
Jayaram S. Indian Psychiatric Society - South Zone. Indian J Psychol Med 2008;30:68-9

How to cite this URL:
Jayaram S. Indian Psychiatric Society - South Zone. Indian J Psychol Med [serial online] 2008 [cited 2019 Sep 16];30:68-9. Available from: http://www.ijpm.info/text.asp?2008/30/2/68/48475


   The Story Told by Mr.Fulford Top


Simon was a Latin American lawyer hailing from a religious orthodox family. Simon was not bothered of religious rituals or prayers. He was a blossoming young talent in the beginning of a successful career. This incurred professional jealousy from others. They put him into various troubles. The problems created by colleagues stressed him. One night he opened the Bible and kept two candles lit on both sides. He read the holy book and continued to read late in the night. He plunged into sleep without his knowledge… When he woke up he saw the melted candle wax was in such a shape as if it were pointing toward a line. Simon found a special meaning to that line. He thought it is a special message exclusively for him directly from the God. He believed in this special meaning and acted upon it. Every day he prayed with candles. The wax gave him special messages through the letters. Is Mr. Simon mentally ill? What is the diagnosis? Is it psychosis? He became very successful in his profession. His relationship with his family members improved. Is he mentally ill? No. Simon had a religious experience that is all.


   Person-Centered Psychiatry Top


Biological, psychological, and social sciences are for the service of the person and his values and aspirations.

It is psychiatry

  • For the person
  • Of the person
  • With the person
  • By the person


Antipsychiatry movement may be one of the reasons for the development of person-centered psychiatry.


   Antipsychiatry Top


In Prague during WPA Congress 2008, I witnessed the demonstrations of antipsychiatry movement people. They had arranged an exhibition in a nearby hotel. Plenty of posters and presentations were arranged for the viewers. I could learn some aspects of the history of psychiatry. They project the evils, but forget the merits.

Antipsychiatry is antipatient and antiperson, because it

  • Enhances stigma toward mentally ill persons
  • Prevents treatment
  • Prevents improvement
  • Prevents rehabilitation


What is needed is

  • Mental health education
  • Destigmatizing
  • Facilitating adequate treatment
  • Improving the self-esteem of the person
  • Utilizing the differently abled persons
  • Community based rehabilitation (CBR)



   Community Based Rehabilitation Top


How far the mental health professionals are involved in CBR?

Does the District Mental Health Program (DMHP) promote CBR?

Community based rehabilitation should become a priority in DMHP.


   District Mental Health Program Top


DMHP is a welcome initiative from the Government of India, but how many districts are covered? All the districts should be under the umbrella of DMHP. What about the sustainability of the program?

How many DMHP's are limping due to lack of funds? Do they have sufficient trained and motivated professionals? The program is a boon to the weaker sections of the society.

The Government should have budgetary provisions to start and maintain DMHP in all the districts of India.


   Budgetory Provisions Top


In Central and State Government budgets,

  • Mental health is a low priority
  • Meager amounts are earmarked for buildings and equipments
  • Less money is allocated for manpower


Mental health should get priority.

Australian experience - while I was in Melbourne, years ago, it was general election in the state of Victoria. I was surprised to see in the front page newspaper advertisement of a contesting party their proposal of hiking the budgetary provisions for mental health if they come into power.

How can we implement Mental Health Act (MHA) without adequate funding?


   Mental Health Act - 1987 Top


Positive features

  • Incorporates scientific knowledge
  • Mental disorder is considered at par with physical illness
  • Treatability - mental retardation and dementia excluded
  • Formation of MHAs
  • Outpatient departments insisted
  • Admission procedures simplified
  • Any private person can report to the magistrate
  • Discharge procedures made easier
  • Separate hospitals for under-16, addicts, and psychopaths
  • Provision of punishment for cruelty to MIP


Criticisms

  • Community care, aftercare, treatment other than hospitalcare and rehabilitation not addressed
  • Psychiatrists running private nursing homes discouraged
  • Licensing
  • Control of Board of Visitors
  • Medical Board for day-to-day activities
  • Inspecting officer
  • Patients compelled to undergo further examinations by medical/nonmedical visitors
  • Consent and competence not adequately addressed
  • Involuntary admissions - not necessarily imply incompetence
  • Treatment without informed consent?
  • Statutory criteria for competence?
  • Who will judge competence?
  • Presumption of availability of hospital beds
  • "Mental Hospital Act" or "Mental Health Act"
  • No provision for treatment >90 days in case of involuntary admissions. Has to obtain reception order from the magistrate
  • Penalty to doctors


Penalty to doctors

Annie went to her psychiatrist and divulged that she had a homosexual relationship and extra marital relationship while seeking treatment for depressive disorder.

  • Should he report to the police?
  • Will he be punished for not reporting the crime?
  • Will he get the protection of privileged communication?


Privilaged communication

Is the communication between a psychiatrist and his patient a privileged communication?

If not, the law should be amended.

Caring the caregivers

Caregivers are usually overstressed.

  • How to care them?
  • What benefit we are going to provide for them?


Work and mental health

  • A physically and psychologically healthy person can give maximum output
  • Job stress produces psychological illness
  • Persons recovered from mental disorders can perform
  • The quality and quantity of work shall be person centered and then the person will be healthy





 

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