INDIAN PSYCHOSOCIAL FOUNDATION
 
   INDIAN PSYCHOSOCIAL FOUNDATION
         
IJPS >
IJPS April 2011
IJPS October 2011
IJPS April 2012
IJPS October 2012
IJPS April 2013
IJPS October 2013
IJPS Apirl 2014
IJPS October 2014
IJPS Apirl 2015
IJPS Apirl 2016
IJPS October 2016
IJPS Apirl 2017
 
 
 

STATUS OF PSYCHIATRY IN MORDEN ERA


 


Nowadays we are very happy to discuss about psychiatry of the modern era and itís bright Future, past two decades were golden periods of emerging psychiatry when newer neuroleptics, psychometric tools, up gradation of psychology taken role in patient care in specialties. Newer neuroleptic and tools not only reduces the side effect in patients but improved the quality of life. Nowadays we have different option to choose the specific therapy for specific patient. The awareness of society to this specialty markedly increases and they developed new hope that psychiatric disorders are treatable and they consulting to psychiatrists, psychologist and other allied professions without barrier of stigma.

The belief in faith healer and causes of disorder due to curse of past life, bhoot, prÍt, devil etc. of decreases, and people used to leave psychiatric patient either in forest or tie him isolated places. Faith healers treat them by inhuman methods and exploit differently. These journey of new erawas not so easy but we thanks to media, professionals, scientists and governmental organization those did untierable efforts to achieve this level. If we see the past before independence we will found that there were limited numbers of institute and research centres, the asylum meant for long hospitalised psychiatric patient and very limited number of asylum used to run OPD services and training programs.On new initiation of human right, ethics and government changes old schinario, now psychiatric patient have their own right to take treatment, will to takeout from treatment and hospitalizations. There are certain guidelines for detention of involuntary and voluntary patient those protects their rights. Government developed many plan to empower the psychiatric services and Issue order for conversion of all mental hospitals to teaching and training centers, Since independence, the numbers of mental hospitals in India have increased from 31 to 59 (NHRC Report).There are something like 43 mental hospitals in the public sector in the country, with a total of around 30,000 beds. Psychiatric beds per 10000 populations in mental hospitals are 0.2 compared to 0.05 bed per 10000 population in general hospitals (WHO-AIMSREPORT OF MENTAL HEALTH SYSTEM INDIA, 2008). The NMHP was re-strategized in the year 2003 (in X Five Year Plan) with the following components:Extension of DMHP to 100 districts and up gradation of Psychiatry wings of Government Medical Colleges/ General Hospitals

In the XI Five Year Plan, the NMHP has components/schemes of District Mental Health Programme (DMHP), Manpower Development Schemes, centre Of Excellence and Setting Up/ Strengthening PG Training Departments of Mental Health Specialties, Modernization of State Run Mental Hospitals from custodial care to comprehensive management. The DMHP envisages a community based approach with integration of mental health with General health services through decentralization of treatment from Specialized Mental Hospital based care to primary health care services.

Under Scheme for Manpower Development in Mental Health, 10 more mental hospitals with the aim of constructing modern buildings as well as strengthening staffs. Qualitative as well as quantitative improvements will be introduced in the areas of research, training and IEC, with more focused attention on epidemiological catchment area surveys on a larger scale. 20 mental hospitals will be taken up for reconstruction later on. Non-viable mental hospitals will be closed down or merged with general hospitals to create GHPUs. In modernisation of mental hospitals these developed into tertiary care centres and for physically ill mental patients Separate ward in various mental hospitals. Most of the mental hospitals run child mental health services and Geriatric mental health services and Psychiatrists also visiting the Central Jails of nearby district, remand home and District Hospital periodically. Most of the hospitals are affiliated to Universities and have post graduate training courses (MD and DPM), clinical psychology, social work and psychiatric nursing. Special clinics like Sex Clinic, Headache Clinic, OCD Clinic, epilepsy clinic, lithium clinics, Clinic for homeless persons, mental retardation clinic, child guidance clinic, tobacco cessation clinic, drug addiction treatment and rehabilitation clinic, marital and psycho sexual clinic, movement disorder clinic and neuro-behaviour clinic.Many separate clinics offer services like group therapy, family counseling, occupational and industrial therapy for psychiatric patients. Many psychiatry hospitals also have community psychiatry programs and run satellite clinics in nearby districts and regular camps, awareness programs, workshops with patients and parents are also conducted at these extension clinics. The Mental hospitals are actively involved in organizing workshops for developing linkage and networking with NGOs working in the field of mental health. The other major contribution of mental hospitals has been in mental health research and developing models involving schools, primary healthcare and general practitioners, as well as working with families. Mental health care bill 2013 reviewed the shortcoming in mental health act 1987 and focuses more on psychiatric patientís rights and health insurance.

Though for future development of this specialty it needs greater administrative autonomy and budgetary provisions, as steps to take improve functioning of mental hospitals by reducing bureaucratic and procedural delays. The publicĖprivate partnership needs to be improved and enhanced. They must share the information on their clinical work so that the state/country statistics reflect the total picture and not that of the public sector alone. Mental hospitals need to take a more expanded role in the community - not only as treatment centers, but also as facilitators of social awareness and training of personnel to meet community mental health needs. There has also been a parallel growth in interdisciplinary linkages, which support integrated socially and culturally appropriate approaches to mental health interventions and mental hospitals should not lag behind. This should evolve strategies to offer diagnostic and therapeutic facilities to all corners of India in the field of Mental Health and Neurosciences utilizing the advances in information technology. Establish training facilities and impart knowledge in the field of mental health and Neurosciences to all the developing countries by Institutional and distance Learning. The services also need to develop strategies for disaster management and psychological rehabilitation. Integrate physical and metaphysical aspects of neuroscience research.