Ideas and Action for a Better India
Lecture on “Mental Illnesses – A Global Public Health Challenge. What India Should Learn from the West and How India Can Help the West” Given by Dr. Meera Narasimhan at ORF Mumbai
A timely messenger arrived in Mumbai to present a talk on the challenge of mental illnesses in India at the Observer Research Foundation on Monday, 11 January. The newspapers currently rife with stories about college students, sales executives and even labourers committing suicides owing to mental pressures of not meeting their ambitions, paint a grim picture. As we approach the end of the school year and final exams there needs to be a lot more awareness and action to prevent any more lives from being taken unnecessarily.
Dr Meera Narasimhan (MD) is a Professor of Psychiatry and the Vice Chair of Research and Scientific Initiatives in the Department of Neuropsychiatry and Behavioural Sciences at the University of South Carolina School of Medicine. She also serves as the Director of Research Initiatives for the South Carolina Department of Mental Health and sits on the Council of the American Foundation of Suicide Prevention.
Dr Narasimhan highlighted a number of shocking statistics* about the diseases of the mind, including:
(*as based on the available data)
Her presentation also illustrated how there are a large proportion of psychiatric patients in Asia, whereas the number of mental health providers are comparatively insufficient to serve the population affected. “For a country with over a billion (100 crore) population, there are just 4,000 psychiatrists available”, she said. There are also social taboos associated with mental illness which deter a number of families from seeking help as well as the efficacy of sustained
Most importantly, her lecture highlighted the close interrelation between mental illnesses and various other accentuating factors such as cardiovascular diseases, cancer etc. stressing the importance of mental wellbeing for overall physical health.
Her studies have recounted good responses to depression and mood related disorders through various techniques including yoga, meditation, exercise, which also have positive health benefits in reducing physical stresses and risks of cardiovascular complications.
Results from clinical trials conducted at NIMHANS, Bangalore, have shown that regular practise of Sudarshan Kriya Yoga (SKY) – as promoted by Sri Sri Ravishankar, founder of the Art of Living Foundation – reduces symptoms of mental depression. The researchers claim that SKY is as effective a treatment as some of the established allopathic anti-depressant drugs. Such findings further support the case for exploring alternative methods of dealing with mental illnesses.
Dr. Narasimhan’s talk focused on the advancements that have been made in the field of neurobiology and pharmacology, particularly in relation to mood and anxiety disorders, schizophrenia, bi-polar disorder and substance use disorders. Her research in these areas has had a direct impact on health policy in South Carolina.
She outlined that further efforts will need to be made to meet presently un-served needs including reducing stigma, increasing access to care, increasing affordability of care, improving adherence to treatment, and facilitating response, remission and recovery.
Relating to this, the formation of “State Policy Labs” would help to bridge the gap between policy, practice and research, addressing mental health and medical issues. These could bring about improvements in general medical practice an healthcare. Furthermore, as Dr. Narasimhan explained ‘telepsychiatry’ initiatives as being developed in the state of South Carolina could be used to provide psychiatric care with fewer physical infrastructure investments. Finally, she also suggested that providing relevant training to school teachers on spotting students who might be suffering from depression etc. would help in identification and case referral to professionals who then provide relevant treatment.
A number of practitioners from KEM Hospital including Dr Padmaja Samant, Dr Kamaxi Bhate, Dr Vasant Murthy, Dr Shubanghi Parkar and Dr Bushra Shaikh participated in the event, and Dr Supreeta Arya from the Tata Memorial Hospital was also present at the lecture.
Dr Santosh Dhadambe from the Barwalia Foundation gave an overview of the successes that the organisation has had in treating mental illnesses using homeopathy, with impressive results even in chronic cases, demonstrating the efficacy of alternative treatments and natural therapies.
The discussion initiated by participants raised very interesting issues, such as the moral and practical dilemmas of Psychiatric Health workers who face refusal of treatment by caregivers or legal guardians of mental health patients, as well as more general debates calling for cultural changes in education, diet and various other aspects, particularly relating to urban living.
It was made clear that more attention, investment and communication are needed in raising awareness about mental health issues in India. The solutions to these and more challenges are already present within our society in the ancient traditions of Yoga, Meditation, Ayurveda etc., all we need to do is unlock their potential and use them more widely to cope with the travails of modern life in this age of ‘High Globalisation’.
Furthermore, where exercise and outdoor pursuits have shown to have positive impacts on mental health, we should endeavour to make more public spaces available for physical activity. The ORF will be holding a brainstorming session on how to “Create open spaces and opportunities for a vibrant Youth Culture” on Saturday, 16 January.
Mr Sudheendra Kulkarni, Chairman of ORF Mumbai, gave a short series of readings from “The Nature writings of C. G. Jung” (eds. Meredith Sabani) in his introduction to the talk, which included the following quotes:
“Not famine, not earthquakes, not cancer… but we [who] are the great danger [to humanity].” (Jung in Sabani, 2002, p.163)
“We know how to protect ourselves from physical contagion, but do not yet bother about psychic contagion, even though we witness regularly its destructive effects.” (Sabani, 2002, p.163)
“As a psychologist I am deeply interested in mental disturbances, particularly when they infect whole nations… I am a neutral Swiss and even in my own country I am uninterested in politics, because I am convinced that 99 percent of politics are mere symptoms and anything but a cure for social evils. About 50 percent of politics is definitely obnoxious inasmuch s it poisons the utterly incompetent mind of the masses. We are on our guard against contagious diseases of the body, but we are exasperatingly careless when it comes to the even more dangerous collective diseases of the mind.” (Jung in Sabani, 2002, p.166-7)
“Anxiously we look around for collective measures, thereby reinforcing the very mass-mindedness we want to fight against. There is only one remedy for the levelling effect of all collective measures, and that is to emphasize and increase the value of the individual. A fundamental changes of attitude (mentanoia) is required, a real recognition of the whole man. This can only be the business of the individual and it must begin with the individual in order to be real.” (Jung in Sabani, 2002, p.167)
In his concluding remarks Mr Kulkarni stressed the importance of getting back to nature, quoting Carl Jung again, he said, “People get dirty through too much civilization. Whenever we touch Nature, we get clean.”
Finally, as Dan Ariely put it in his TED lecture last year, “When it comes to building the physical world we understand our limitations and we build around them, but somehow when it comes to the mental world when we design things like healthcare, pensions and stock markets, we forget the idea that we have limitations. If we could understand our cognitive limitations in the same way we understand our physical limitations we could design a much better world.” (Dan Ariely, 2002, TED)