Saturday, November 5, 2005

Stamped Impressions

A holistic approach to mental health

Reeta Sharma on the Chandigarh chapter of the Athma Shakti Vidyalaya, which treats the mentally challenged

Col A K Mehndiratta
Col A K Mehndiratta recommends early treatment of mental ailments

THE world over, mental illness is a serious problem. Asia is no exception, where by 2020, depression and schizophrenia will be a health burden bigger than even cancer. Also, one-quarter of all Indians currently suffer from some sort of mental illness.

These facts were first highlighted in Time, November 2003, based on a study commissioned jointly by WHO and Harvard University and conducted by the Global Burden of Disease.

It is estimated that as many as 20 million Indians out of a population of 1 billion suffer from some mental illness. Chandigarh is estimated to have around 65,000 people suffering from one or the other mental illness.

And, there are only 3,500 psychiatrists to attend to the 20 million mentally ill in the country. There are 36 mental hospitals in 16 states. These hospitals are short of staff by 35 per cent. The meagre budget allocation to these hospitals is most of the times enough only for salaries. Given the alarming situation, the Union Health Ministry had recently decided to give Rs 3 crore to each of the 36 mental hospitals and Rs 50 lakh each to the medical colleges to strengthen their psychiatric departments. From an allocation of Rs 28 crore for the national mental health programme in 2002, it has now been jacked up to Rs 190 crore. Now some short-duration "capsule" courses have also been started. Besides, a palliative cure course has been introduced in six institutions.

The problem of shortage of psychiatrists is further aggravated by mass migration of trained doctors to the UK. It is estimated that over 8,000 trained Indian psychiatrists are working in the West. Dr D S Goel, national consultant on mental health to the Union Ministry of Health and Family Welfare, says India needs at least 10,000 psychiatrists for its one billion population.

Union Health Minister A Ramadoss has felt the need for putting a cap on migration of these doctors by making it mandatory that they must put in five years’ service in India before being permitted to go broad. The move, however, did not materialise due to legal complications.

The question now is what do we do to tackle this serious problem afflicting thousands of homes across the country? At the NGO level, a beginning was made way back in 1979, when Father Hank Nunn founded the Bangalore-based Athma Shakti Vidyalaya Society, as part of the worldwide organisation, Community of Communities, run by the London-based Royal College of Psychiatrists Research Unit in collaboration with the Association of Therapeutic Communities.

This network of Therapeutic Communities has now made its presence felt in Chandigarh, where Col. A K Mehndiratta (Retd) is representative of the Athma Shakti Vidyalaya. He reels off frightening statistics to underline the seriousness of the problem of mental illness.

He’s concerned about the neglect mentally ill patients face at the hands of their families because of the social stigma attached to such persons," says Colonel Mehndiratta. "Our therapeutic communities are homes away from homes, or ‘halfway homes’, where therapeutic treatment is given to patients over a period of time. What, however, precipitates the mental illness of the patients is the delay in getting them proper, professional treatment. Therapeutic communities or homes are approached only when there has been a delay of five to seven years in the treatment, he adds.

Those families or individuals who need care for such persons can contact Colonel Mehndiratta (98728-69211). He says the Athma Shakti network has been the first to take up work in the field of psycho-social rehabilitation. What, however, hurts the Colonel most is the fact that it is the "beautiful brain" that enables man to create marvels. Yet, when there is some dysfunction or disorder in the brain, patients are neglected with impunity due to social taboos or fear of social stigma.

Therapeutic Communities provide the right environment to patients. Colonel Mehndiratta, who has been closely associated with this movement, says that "unique" methodology used by the therapeutic centres has stood the test of time. Qualified psychiatrists took nearly 25 years before they accepted and admitted to the "usefulness and effectiveness" of therapeutic communities, he reveals.

The holistic approach to the problem at Therapeutic Communities, says Colonel Mehndiratta, includes psychotropic medication, individual or group psychotherapy, yoga, neuro-linguistic programming, transactional analysis, gestalt therapy, regressive therapy, cognitive re-training, psycho-physical exercises, music, art and dance movement theory. Treatment for chronic cases stretches from three to five years.

Colonel Mehndiratta says mental illness strikes young people between 15 and 25 years. This is the most valuable and productive period of their lives, thus there is need to pay utmost attention immediately. "Since signs of illness usually surface during teenage years, if therapeutic communities were given a chance to treat at that point of time, the duration of treatment could be much lower, between four and six months," adds the Colonel.