'Indian mental health professionals' role significant'

By Ramya Kannan

CHENNAI, SEPT. 26. As Director of the Mental Health wing of the World Health Organisation, Dr. Benedetto Saraceno has a hectic term. With the WHO calling for international action to wipe out the stigma attached to mental illness, the issue is in the limelight.

The WHO slogan, `Stop Exclusion: dare to care', proved that the World Health Organisation was indeed taking the issue seriously. Fighting to remove the stigma shrouding mental illness and the ignorance that it is `untreatable' is on the prime agenda. The World Health report, ready for release on October 4, is entirely devoted to mental health.

The editor of this year's mental health report is Dr. Srinivasa Moorthy of the NIMHANS, Bangalore, and a number of team members are Indians, says Dr. Saraceno, ``It is not by chance that the contribution from the Indian mental health profession is significant and substantial''.

Acknowledging that India can provide the developing world a `model' with its remarkable experience in family involvement and community psychiatry, he says the situation in mental health can vary vastly from State to State. The global approach to mental health care has shifted to the community and the family. The family has been recognised as an `important ally' though, he concedes, it could be an equally powerful opponent.

But in India, there is an acute problem in terms of access to psychotropic drugs. `` How many persons are recognised as patients and how many of them get treatment, or access to psychotropic drugs in India, '' asks Dr. Saraceno.

There is an urgent need to bridge the gap between those who are treated and those who are not. To this effect, he calls for improving the public health system of the country, to ensure that facilities reach those who are in need.

Once again, it is this factor which seems to take people to faith healing centres.

Because of the inability of the public health system to offer solutions, which are decent, effective, human, affordable and sensitive, people are searching for magical or mystical cures, Dr. Saraceno says.

``Mental illness ahoulsd be treated like any other disease, say, diabetes. Add to that, rationality, science, social commitment, compassion.''He said, with a note of warning at the same time: ``It is very dangerous to confuse what needs rational treatment with other things.'' However, he believes, like most good psychiatrists, that spirituality can be a powerful ally for cure, though it cannot replace treatment.

``We must shift to the community, train primary health care professionals to handle mental health issues,'' Dr. Saraceno says. In addition, it is important to retain the support structure the family offers.

The expertise in this part of the world in dealing with community is more substantial than in developed nations.

The need creates the function and in countries where resources are not so many, people naturally find workable alternatives.

It is perhaps because of this unshakeable belief in the power of family supported cure, that the director of the WHO's Mental Health programme prophesies, `` the north of the world will learn a lot from the south about community mental health''. The models framed in `poor' psychiatry can teach the `rich' nations a few lessons, he says.

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