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Historically, the treatment of abnormal behavior in the Indian subcontinent has deep cultural roots, often blending spiritual beliefs and indigenous healing practices. Ancient texts, such as the "Charaka Samhita" and "Sushruta Samhita," recognized mental disorders like mania and depression, illustrating an early understanding of psychological conditions. These texts described symptoms and suggested interventions, indicating an approach to mental health long before the advent of modern psychology.

Traditional treatments included herbal remedies, yoga, and meditation, aimed at restoring balance to the mind and body. Psychological concepts such as the balance of the three doshas (Vata, Pitta, and Kapha) in Ayurveda highlight a holistic view of health. Imbalances among these doshas were believed to lead to physical and mental ailments, prompting treatments that integrated lifestyle changes, dietary adjustments, and mindfulness practices.

One unique indigenous practice is the use of “Sidh,” a form of spiritual healing performed by local shamans or healers. They employed rituals, chanting, and offerings to spirits, believing that mental illnesses could result from spiritual disturbances. This reflects an understanding of the psychological impact of societal and environmental factors on mental health.

Moreover, concepts like "Prana" (life force) and "Chitta" (mind) in ancient Indian philosophy illustrate an awareness of the complexities of mental processes. The integration of these spiritual and psychological frameworks laid the groundwork for contemporary mental health care, emphasizing the interconnectedness of mind, body, and spirit. This rich tapestry of understanding demonstrates how traditional wisdom and practices continue to influence modern psychology and mental health treatments in the region today.

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Reducing prejudicial attitudes towards the mentally ill requires a multifaceted approach. First, education plays a crucial role; by increasing awareness about mental health, we can dispel myths and stereotypes. Schools, workplaces, and communities should implement programs that focus on mental health literacy, emphasizing that mental illnesses are medical conditions deserving compassion and treatment.

Second, promoting open dialogues can help destigmatize mental health issues. Encouraging individuals to share their experiences can foster understanding and empathy. Media representation also matters; responsible portrayal of mental illness in films and news can shape public perceptions positively.

Lastly, legislative measures are essential. Governments should enforce laws that protect the rights of individuals with mental health issues and ensure access to mental health services. By creating an inclusive society, we can cultivate acceptance and reduce prejudicial attitudes.

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Reducing prejudicial attitudes and behaviors towards individuals with mental illness, several strategies can be employed:

1. Education and Awareness: Conduct awareness programs that highlight the realities of mental illness, dispelling myths and misconceptions. Providing accurate information can help people understand that mental health conditions are not a result of personal weakness but medical conditions that require empathy and support.

2. Positive Media Representation: Media plays a critical role in shaping public perception. Encouraging responsible and respectful representation of mental illness in television, films, and news can challenge harmful stereotypes and foster understanding.

3. Open Conversations: Create safe spaces for people to share their experiences with mental illness. Open dialogues can humanize individuals affected by mental health challenges and break down the barriers of stigma.

4. Community Engagement: Involve local communities in mental health initiatives through workshops, campaigns, or public discussions. Engaging the community helps normalize mental health conversations and promote inclusivity.

5. Legislation and Policy: Advocate for laws and policies that protect the rights of individuals with mental illness. Anti-discrimination laws and inclusive workplace policies can ensure that people with mental health conditions receive fair treatment in all areas of life.

6. Peer Support Networks: Encourage the development of peer support groups, where individuals with similar experiences can offer mutual support. These networks can empower people with mental illness and reduce feelings of isolation.

Implementing these strategies can create a more inclusive society, reduce prejudice, and foster a supportive environment for people with mental heal

th challenges.

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The historical origins and treatments of mental disorders (MD) in India are deeply rooted in traditional, colonial, and contemporary frameworks of understanding mental health. Over the centuries, India has adopted and evolved various approaches, from spiritual and holistic systems like Ayurveda to modern psychiatric practices.  A detailed overview of the origins and treatments of MD in India.

1. Ancient Indian Systems and Spiritual Understanding

Ayurveda: This ancient medical system, dating back over 3,000 years, emphasized a holistic approach to health. Mental disorders were classified as "Manas Roga" or diseases of the mind, and were attributed to imbalances in the three doshas (Vata, Pitta, and Kapha) and disturbances in the three gunas (Sattva, Rajas, and Tamas). Depression, anxiety, and other mental conditions were often associated with an excess of the Tamas guna, symbolizing inertia, confusion, and emotional pain. Treatments involved herbal medicines, dietary changes, yoga, and meditation to restore balance.

Unani: Similar to Ayurveda, Unani medicine treated mental illness through balancing the four humors in the body: blood, phlegm, yellow bile, and black bile. The imbalance in black bile was believed to cause melancholia, a condition similar to depression.

Spiritual and Religious Interpretations: In ancient Indian culture, mental illnesses were also attributed to spiritual causes such as karma or possession by evil spirits. Ritualistic practices like prayers, temple offerings, and exorcisms were often the primary modes of treatment. Mental illness was often seen as a punishment or spiritual imbalance rather than a medical condition.

2. Colonial Period and the Introduction of Western Psychiatry

During British rule in India, mental health treatment underwent significant transformation with the introduction of Western psychiatric practices.

Colonial Psychiatry: The British established the first mental asylums in India, such as the Lunatic Asylum in Bombay (now Mumbai) in 1745. These institutions were primarily custodial, offering little active treatment and were often places of isolation and confinement. The Western understanding of mental illness as a medical issue, rather than a spiritual or moral failing, began to take root. However, the emphasis during this period was on control and containment rather than rehabilitation.

Electroconvulsive Therapy (ECT): In the early to mid-20th century, treatments like Electroconvulsive Therapy (ECT) were introduced in India, following global psychiatric trends. ECT was widely used for severe mental disorders like schizophrenia and major depression, although it was controversial due to its invasive nature and the lack of anesthesia in early use.

3. Post-Colonial and Contemporary Approaches

After India gained independence in 1947, mental health care began to evolve with a focus on medical treatment, psychoanalysis, and community mental health initiatives.

Rise of Modern Psychiatry: By the 1950s, psychiatry had developed into a more established field in India, with the introduction of psychotropic drugs such as antidepressants and antipsychotics. These medicines revolutionized the treatment of mental disorders like schizophrenia, bipolar disorder, and depression.

Integration of Modern and Traditional Medicine: Modern psychiatry in India often integrates traditional practices like Ayurveda and yoga, especially in cases of depression and anxiety. Many practitioners believe that a combination of medication, therapy, and holistic approaches leads to better outcomes for patients.

Cognitive Behavioral Therapy (CBT): Psychotherapy, especially Cognitive Behavioral Therapy (CBT), has gained prominence in treating disorders like depression and anxiety. This form of therapy focuses on changing negative patterns of thought and behavior, offering long-term relief without the need for medication.

Mindfulness and Yoga: As awareness of the benefits of mindfulness and yoga has grown, these practices have become a popular part of mental health treatment in India. Mindfulness-based cognitive therapy (MBCT) and yoga have been particularly effective for treating mood disorders, stress, and depression.

4. Challenges in Mental Health Treatment in India

Despite advancements, India continues to face several challenges in treating mental disorders:

Stigma: Mental health disorders still carry a significant stigma in India. Many people view conditions like depression and anxiety as personal weaknesses or moral failings, rather than medical conditions that require treatment. This often prevents individuals from seeking timely help.

Access to Care: Mental health services are primarily concentrated in urban areas, leaving much of the rural population without access to professional care. While community-based programs like the District Mental Health Programme (DMHP) aim to make mental health care more accessible, there remains a significant treatment gap.

Underreporting: Due to the stigma and lack of awareness, many cases of mental illness, particularly depression, go unreported or are misdiagnosed. Many individuals seek help from traditional healers or religious figures instead of mental health professionals.

5. Current Government Initiatives and Mental Health Legislation

The Indian government has made several efforts to address mental health challenges, including:

National Mental Health Programme (NMHP): Launched in 1982, the NMHP aims to provide accessible mental health services to all sections of society, particularly in rural areas. It focuses on integrating mental health care with general health services at the community level.

Mental Healthcare Act, 2017: This landmark legislation seeks to protect the rights of individuals with mental illnesses, ensuring that they receive appropriate care without facing discrimination or abuse. The Act also guarantees that every person has a right to access mental health services and makes provisions for the protection of human rights within psychiatric institutions.

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Reducing prejudicial attitudes towards the mentally ill is crucial for fostering understanding and support within communities. There are several effective strategies based on research and practice:

1. Increasing public knowledge about mental health conditions can dispel myths and reduce stigma. Programs that provide accurate information about the prevalence, causes, and treatment of mental illnesses help challenge stereotypes and misconceptions. For instance, campaigns like “Time to Change” in the UK aim to educate the public and reduce stigma associated with mental health issues .

2. Personal interactions with individuals who have mental health conditions can significantly reduce prejudice. Programs that facilitate contact between the public and those living with mental illness—such as peer support groups or community events—help humanize the issue and promote empathy. This approach is supported by social psychology theories that suggest that direct contact can reduce prejudice .

3. Advocating for more accurate and compassionate portrayals of mental illness in media can shift societal attitudes. Positive stories that highlight recovery, resilience, and the everyday experiences of individuals with mental health conditions can combat negative stereotypes .

4. Creating safe spaces for dialogue about mental health in schools, workplaces, and communities encourages individuals to share their experiences and feelings. This openness can foster understanding and decrease the fear associated with mental illness .

5. Advocating for policies that support mental health care access and anti-discrimination protections can also help combat stigma. Policies that improve mental health services can lead to better public understanding and acceptance of mental health issues .

6. Implementing mental health literacy programs for professionals, such as teachers, healthcare providers, and employers, can help them recognise mental health issues and respond appropriately, thereby promoting a more supportive environment .

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HISTORICAL ORIGINS AND TREATMENT OF ABNORMAL BEHAVIOR IN THE INDIAN SUBCONTINENT- Anusherly

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HISTORICAL ORIGINS AND TREATMENT OF ABNORMAL BEHAVIOR IN THE INDIAN SUBCONTINENT- Anusherly

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In Ancient Indian scriptures like Atharva-Veda has many references to mental disorders which seems to attribute to supernatural causes like possession by spirits and divine curses. It mentions like divine curses can lead to mental illnesses which includes the conditions resembling about schizophrenia. It involves charms, prayers and temple rituals, these seems to help for neutralizing supernatural influences. They included substances like rock salt, ghee and gurjo which was prescribed to remove the curses. These methods helped as a treatment in ancient times. They also included Samkhya and yoga, Samkhya describe the components of human psyche, while yoga describes about the practices for mental discipline and balance. The Sage Agasthiyar has written many Tamil medicinal books and astrological literature which has involved Agasthiyar kirigar nool. In which he has included about mental illness. It describes eighteen psychiatric disorders with detailed symptoms and appropriate treatment methods, in which the conditions are similar to schizophrenia, depression and anxiety. They involved herbal medicines, dietary recommendations, rituals and spiritual practices, astrological remedies and physical therapies like yoga and specific exercises which were recommended to improve their mental well-being. Abnormal behavior was largely seen as resulting from supernatural causes. The mentally ill were often isolated and treated as cured, which led to avoid social situations and worsened their conditions.

British influenced mental hospitals in India, they view it as a physical issue and not by spiritual. They viewed mental disorders were often attributed to brain pathology or other psychological causes. They established asylums to contain and manage people who are mentally ill, these asylums were primarily custodial rather than therapeutic. There were often housed in poorly maintained buildings. The treatments were very rude and harsh including extreme hot or cold baths, application of leeches, beatings and even lobotomics. The local population largely avoided them due to the stigma associated with mental illness and harsh treatment methods. Many middle-class people preferred traditional Indian medicine, including ayurveda and unani, often seeking care from temples and ashram healers. These traditional methods were not always effective but were seen as more acceptable than the colonial institutions.

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PSYCHIATRY IN INDIA AFTER INDEPENDENCE. BY THULASI P R

After India's independence in 1947, the prioritization for General Hospital Psychiatric Units (GHPUs) was more than new mental hospitals, enhancing existing ones and fostering outpatient care. Notable additions included mental hospitals in Delhi, Jaipur, Kottayam, and Bengal. Dutta Ray initiated a psychiatric outpatient service in 1957 at Irwin Hospital, New Delhi. N.N. Wig launched the first GHPU in 1958 at Medical College, Lucknow, followed by Neki at Medical College, Amritsar. The 1960s saw specialized services in traditional institutions like CIP Ranchi and Madras Mental Hospital,  the introduction of day hospitals,  and community mental health services.

The All India Institute of Mental Health was established in 1954, which later became NIMHANS in 1974. The 1970s witnessed the first psychiatric mental health camps in India and the start of training programs for mental health professionals.  In 1982, The National Mental Health Program was initiated, which aimed for “health for all by 2000”, fostering direct mental health programs and training materials.

The Mental Health Act of 1987 stemmed from efforts beginning in 1949 but gained traction only in the 1980s.  The Erwadi tragedy in 2001, where 26 mentally ill individuals perished in a fire, prompted widespread reforms and heightened attention to mental health services.

With the Indian Journal of Neurology and Psychiatry debuting in 1949, research in psychiatry evolved, followed by the Indian Journal of Psychiatry in 1958. Initial research focused on psychopathology,  transitioning to societal interactions and group behavior by the 1960s. Epidemiological studies emerged,  which highlighted the community's mental health issues. The Mudaliar Committee recommended expanding mental health training,  leading to programs for clinical psychologists and increased research collaborations with Indian and global health organizations.

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146221/

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Fierarchy for ornithophobia - V.S.Shivani

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Fierarchy for ornithophobia - V.S.Shivani

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GOWRI MAHESWARI- feararchy for fear of people 

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How can we reduce Prejudicial Attitudes towards the mentally ill?- Vibha Kothari

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How can we reduce Prejudicial Attitudes towards the mentally ill?- Vibha Kothari

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A Prejudice is a negative attitude toward another person or group formed in advance of any experience with that person or group. Prejudice towards the mentally ill stems from rooted stigma and the history of negative association. In turn, this causes discrimination, unfair treatments and greater disadvantage towards the individuals with mental illness.

To resolve this, education and awareness regarding the disorders can help reduce social stigma and encourage individuals to seek treatment. Inclusivity in normal lives and day to day activities normalizes and allows integration into society. In a word of the growing pace of media, movies and other such forms hold great influence. Hence, representation and positive information may help reduce prejudicial attitudes. Acknowledging that individuals are not defined or limited to their mental illnesses allows thinking and dealing with it as objectively as possible while not separating them as a separate group.

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How can we reduce Prejudicial Attitudes towards the mentally ill? By Priyanka Prakash

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How can we reduce Prejudicial Attitudes towards the mentally ill? By Priyanka Prakash

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Prejudicial attitudes are something that’s very common and multifaceted with regards to mental illness across the world, many day to day strategies can be taken to reduce stigma and prejudice and misconceptions towards mentally ill people.

The first and foremost answer to any misconception is awareness through education. Mental health is a wide and fast growing field of importance and needs education to back it up. Education can be provided in two different ways, one is from the root by incorporating it in school curriculum so children are made to know about the importance of mental well being from a young age. The second form of education is by increasing awareness through campaigning, media announcements, articles on daily news etc.

Movies are the current maker and breaker of views amongst public, mental illnesses have half the misconceptions due to wrong and scary portrayals in movies, hence accurate and respectful portrayal in movies and shows create awareness and reduce misconceptions! Making morally fulfilling movies by showcasing stories of people with mental Health highs and lows who ended up living a good life despite the challenges and highlighting their experience and the experience of the people around them challenges negative stereotypes.

We are always an amalgamation of the people around us, having a supportive environment both legally in aspects to work and having supportive peers matters a great deal. Some examples of work place initiatives are flexible work arrangements and celebration of mental health days promoting awareness and fostering inclusivity. Creating inclusive environments in schools and universities giving space for open discussion of mental health and making accommodation for those suffering with mental problems make people feel supported.

Anti discrimination laws must be enforced so that individuals are protected from discrimination when it comes to aspects like education , employment and housing struggles.

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Acceptance significantly contributes to reducing prejudicial attitudes toward individuals with mental illness over time. By promoting understanding, empathy, and inclusivity, acceptance can help challenge stereotypes and diminish the stigma associated with mental health conditions.

Acceptance of individuals with mental illnesses is vital for reducing prejudicial attitudes over the long term. When society welcomes and integrates people with mental health conditions, it creates an environment where stereotypes and misconceptions can be effectively challenged and dismantled. According to Contact Theory, increased interpersonal interactions between different groups can lead to reduced prejudice, as such contact allows individuals to look beyond stereotypes and see the person rather than the illness (Pettigrew & Tropp, 2006). This interaction fosters empathy and diminishes fear-based attitudes, which often stem from ignorance (Corrigan & Penn, 1999).

Programs focused on education and awareness that emphasize acceptance can also help mitigate stigma by dispelling false beliefs and highlighting the universality of mental health challenges. Research indicates that when people are informed about the biological and psychological aspects of mental illnesses, their attitudes shift toward greater acceptance (Corrigan & Watson, 2002). Acceptance motivates individuals to advocate for fair treatment and inclusion in community settings, thereby reducing the "us vs. them" mentality that often underlies prejudice (Thornicroft, 2006). As acceptance increases, it leads to policy changes and societal norms that prioritize mental health equity, creating a positive feedback loop that continuously diminishes stigma and encourages inclusive attitudes toward mental illness.

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Rakshita-How can we reduce prejudicial attitudes towards mentally ill. 

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Rakshita-How can we reduce prejudicial attitudes towards mentally ill. 

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Prejudice against individuals with mental illness is pervasive and can significantly impact their lives negatively. This prejudice often arises from misunderstandings, fear, and a lack of knowledge about mental health conditions. Research indicates that such stigma not only impedes social inclusion but also discourages those affected from seeking the necessary treatment and support (Corrigan & Watson, 2002). Addressing these prejudices is essential for creating a more inclusive and supportive society.

1. Education and Awareness Campaigns:

- Public education initiatives that provide accurate information about mental illnesses can reduce misconceptions and fear (Corrigan & O'Shaughnessy, 2007). These campaigns can dispel myths and highlight the realities of living with a mental health condition, thereby promoting empathy and understanding.

2. Contact-Based Interventions:

- Facilitating interactions between the public and individuals with mental illness can also reduce stigma. Contact-based strategies, which involve people hearing personal stories and engaging in dialogue with those who have mental health issues, have been shown to decrease prejudicial attitudes (Thornicroft et al., 2016).

3. Media Representation:

- Positive and accurate portrayals of individuals with mental illnesses in the media can change public perceptions. Media that depicts people with mental health conditions leading fulfilling lives or making positive contributions to society can counteract negative stereotypes (Pescosolido et al., 2008).

4. Legislation and Policy:

- The implementation and enforcement of anti-discrimination laws that protect the rights of individuals with mental health conditions can help reduce societal stigma. Policies that promote equal opportunities and combat discrimination in workplaces and communities can have a broader impact on societal attitudes (Corrigan et al., 2014).

5. Mental Health Literacy in Schools:

- Incorporating mental health education into school curriculums can foster understanding from a young age. Educating students about mental health, its challenges, and how to support peers with mental health issues can lay the groundwork for a more accepting future generation (Kutcher, Wei, & Coniglio, 2016).

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Nayna Surana - how can we reduce prejudicial attitudes towards the mentally ill ?

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Nayna Surana - how can we reduce prejudicial attitudes towards the mentally ill ?

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To reduce prejudicial attitudes towards mentally ill individuals, we must address the root causes of stigma. One key factor is the way mental illness is portrayed in the media. Often, mental illness is sensationalized or used as a plot device, perpetuating harmful stereotypes. By promoting responsible media representation and accurate portrayals of mental illness, we can begin to shift public perception.

Another important step is to increase access to mental health education and resources. When people are informed about mental health, they are better equipped to understand and support individuals struggling with mental illness. Additionally, we must work to create a culture of inclusivity and respect, where individuals feel comfortable disclosing their mental health status without fear of judgment or rejection.

Furthermore, we must recognize the intersectionality of mental illness and other social identities, such as race, gender, and sexuality. By acknowledging and addressing these intersections, we can provide more effective support and advocacy for marginalized communities. Finally, we must prioritize mental health in the workplace and educational settings, promoting accommodations and support for individuals with mental illness. By taking these steps, we can work towards a society that values and supports mental health.

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Neha - How can we reduce prejudicial attitude towards the mentally ill 

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Neha - How can we reduce prejudicial attitude towards the mentally ill 

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Reducing prejudice against individuals with mental illnesses requires a multifaceted approach that begins with education and awareness. Incorporating comprehensive mental health education into school curricula is essential for teaching children the importance of empathy, understanding, and inclusivity. Policies and curricula should address mental health as a natural part of human experience, rather than stigmatizing it. Media representation also plays a significant role in shaping our perceptions, and portraying people with mental illnesses in a respectful and empathetic manner can help dismantle stigmatizing attitudes. Additionally, training mental health professionals, teachers, and staff to recognize and respond to mental health concerns is crucial. Promoting inclusive language, encouraging open discussions, and providing resources and support for individuals struggling with mental health issues are other vital strategies. Community-based initiatives, such as mental health awareness campaigns and support groups, can further promote acceptance and understanding. Moreover, advocating for policy changes that support mental health services and accessibility can help reduce barriers to care. By working together to educate, empathize, and advocate, we can create a society that values and supports mental health, reducing prejudice and promoting inclusivity for all.

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Krishi jain - how can we reduce prejudice against mentally ill

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Krishi jain - how can we reduce prejudice against mentally ill

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Many people with serious mental illness face a double challenge. They not only struggle with their symptoms and disabilities but also deal with stereotypes and prejudice from misconceptions about mental illness. These challenges prevent them from accessing opportunities that define a quality life, such as good jobs, safe housing, satisfactory healthcare, and social connections with diverse people.

Education is a key strategy to reduce stigma by providing accurate information. Research shows that better understanding leads to less stigma and discrimination. Participation in education programs improves attitudes across different groups, including students, community members, and individuals with mental illness. These programs effectively dispel negative stereotypes and foster positive attitudes, making education a powerful tool in fighting mental health stigma. (Corrigan, P. W., & Watson, A. C. (2002)

Contact strategies reduce stigma by encouraging interaction between the public and individuals with mental illness.  Positive examples, like individuals with mental illness holding jobs or being good neighbors, help diminish prejudice. Regular interaction fosters understanding and empathy, making contact essential in reducing mental health stigma. (Corrigan, P. W., & Watson, A. C. 2002)

Protesting inaccurate and hostile representations of mental illness in the media sends a clear message to stop spreading negative views. These efforts can lead to the removal of stigmatizing images and stories. (Wahl, O. F. (1999)

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Purvi Agarwal

Before diving into the reducing the prejudicial attitudes towards the mentally ill let's first understand what is prejudicial attitudes?

Prejudicial attitudes refer to preconceived opinions or judgments about individuals or groups that are not based on reason, experience, or actual knowledge. These attitudes often lead to unfair treatment, discrimination, and stereotyping of people based on characteristics such as race, gender, ethnicity, age, disability, or mental health status (Allport, 1954).

So, Prejudices against people with mental illnesses can be lessened by taking a multidimensional approach that includes social integration, regulatory changes, and education. These are a few tactics backed by studies and professional advice.

Education and Campaigns: Dispelling misunderstandings and lowering stigma are two benefits of educating the public about mental illness. Campaigns that dispel myths and advance awareness can do this by accurately describing mental health illnesses and how common they are.
The "Time to Change" campaign in the UK has been effective in reducing stigma and discrimination through public education, social contact events, and media engagement (Henderson & Thornicroft, 2009).

Personal contact: Personal contact with individuals who have mental illnesses can reduce prejudice. These interactions humanize mental illness and reduce fear and misconceptions.

Studies have shown that structured interactions between the general public and individuals with mental illness can significantly reduce stigmatizing attitudes (Corrigan et al., 2001).

Mental Health Education in Schools: Including mental health education in school curriculum can help children develop empathy and understanding at an early age. Information about coping mechanisms, peer support, and mental health might all fall under this category.

Programs like "Mental Health Literacy" have been shown to improve knowledge and attitudes about mental health among adolescents (Kutcher, Wei, & Coniglio, 2016).

Media representation: Positive and accurate representations of mental illness in the media can influence public perceptions. Encouraging responsible media reporting and showcasing stories of recovery and resilience can counteract negative stereotypes.

Policy and Legislation: Discrimination can be decreased by putting laws, protecting the rights of people with mental illness into place and upholding them. It is imperative to have anti-discrimination legislation, employment accommodations, and mental health treatments accessible.

The Americans with Disabilities Act (ADA) in the United States prohibits discrimination against individuals with disabilities, including mental illness, in employment, public services, and accommodations (ADA National Network, n.d.).

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Ishrath Fathima: How can we reduce prejudicial attitudes towards the mentally ill? 

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Ishrath Fathima: How can we reduce prejudicial attitudes towards the mentally ill? 

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Prejudice is a disease that plagues almost everything in life: from people, to places and even illnesses. All prejudice is ugly. But those associated with the mentally ill are particularly nasty.

Prejudicial attitudes towards the mentally ill are an added torment. In addition to having to live and cope with a mental health condition, the mentally ill are forced to muddle through the wicked prejudice that has been tagged onto them, and for no fault of their own.

In order to reduce prejudicial attitudes towards the mentally ill, we must reform our journalism and our entertainment. These are the media that have the power to send very compelling messages to its viewers. And these are also the media that we tune into almost everyday.

Over the years, irresponsible reporting on mental disorders and an atrociously incorrect representation of people with mental illnesses in films and television have popularized themselves among the masses, almost effortlessly.

Humans can be violent and reckless. And mental illness is not a prerequisite for these behaviors. Contrary to popular belief, patients with mental illnesses are not inherently violent. And not all mental illnesses are characterized by violence. Yet, where did this unscientific prejudice stem from? It does not come as a surprise that the Indian media has helped disseminate and perpetuate these beliefs.

This calls for better representation of mental disorders in films and television and cracking down on the sensationalization of news on mental illnesses. The overdramatization of the mentally ill has done more harm than good.

It's about time that the media takes responsibility for its actions and works towards a prejudice-free space for the mentally ill. Sick people deserve compassion not prejudice.

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Rithika Rajathi L- How can we reduce prejudicial attitudes towards the mentally ill?

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Rithika Rajathi L- How can we reduce prejudicial attitudes towards the mentally ill?

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Prejudice towards the mentally ill can be reduced in many ways such as through positive media portrayal, education, campaigns, and language.

Positive media portrayal: Shows, movies, and even social media can reflect positive stories about characters living with mental illness. I believe that this gives viewers a new perspective on how they see things.

Education: Educating both the general public and people with mental illness can significantly reduce prejudicial attitudes. We can also make one paper on mental health or mental illness compulsory in every program at the college level.

Campaigns: Effective campaigns can break the myths and improve the facts in society. Reaching a wider audience with the help of campaigns can also bring various research scholars together which would in turn provide some other way to improve the lives of people with mental illness.

Language: Instead of using "depressive", we could rather use words like " people with depression" which will make a drastic change.

Apart from this, we could also show empathy to people with mental illness and show inspirational stories about people who fought those illnesses before them.

There is a huge positive difference between how people see mental illness 5 or 10 years back to now. Even though there are various other factors for this change, I also believe that change in society's perception towards people with mental illness is also a crucial factor. If we continue to strive on that path, we can someday in the future fully eradicate prejudicial attitudes towards people with mental illness.

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Gayathri S,  How can we reduce Prejudicial Attitudes towards the mentally ill?

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Gayathri S,  How can we reduce Prejudicial Attitudes towards the mentally ill?

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We can talk about it openly on social medias, to spread more knowledge about mental illness. It helps to break the stigma and proper understanding. Social media helps to spread positivity, awareness and support.

Education on mental illness is very important. Educating ourself and others will help to change the opinion about mental illness. Sharing personal experience might help other to learn more.

Equalize both physical and mental health. Mental health is as equal as physical health, individuals should take care of both. So both physical and mental health should be encouraged.

Open up about the treatment, in a honest way. Mental health treatment should be normalized, like other health treatments. Therapies, medications and other interventions should be discussed openly. It will help people to encourage and seek help and it can reduce stigma as well.

To create a supportive and understanding community, it is crucial to show compassion those with metal illness. Kindness and empathy can make a difference. It might help them to feel less isolated and feel valued. Listening ear and non - judgemental support should be offered.

To choose empowerment over shame, which might help people to come out with their experience and seek help confidently. Self advocacy , encouraging people to take care or control over their mental health. Culture of support and understanding, we can replace shame with strength and hope.

Reference: Reducing stigma. (n.d.). https://www.tn.gov/behavioral-health/stigma.html#:~:text=Be%20conscious%20of%20language%20%E2%80%93%20remind,like%20other%20health%20care%20treatment.

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POTHIYA P- HOW CAN WE REDUCE PREJUDICIAL ATTITUDES TOWARDS MENTALLY ILL?

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POTHIYA P- HOW CAN WE REDUCE PREJUDICIAL ATTITUDES TOWARDS MENTALLY ILL?

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We can include them socially and give opportunity to them in many ways rather than neglecting them for their illness. First we have to start educating about mental health and illness , making awareness of it in overall places. Including it in schooling as a subject will create a new perspective on growing students who will be the next generation will have a positive impact in reducing prejudice attitudes. Not letting them be socially isolated will also help them.

Making dramas and role plays on the topic of mental illness will help to understand the problem and the discrimination that are going through by the people with mental illness.

Creating awareness camps will make others understand how we have to treat and deal with the people suffering with mental illness.

Establishing real or sharing stories of the people with mental illness will help other people to relate and to think that it is only an illness like physical illness not lesser or greater than that and it is not any curse or something. By some of these ideas the stigmas can't be erased but it can be reduced. It takes time to understand by the people around them and about their illness. Inclusion is the main key to reduce the prejudice attitude towards the people who are mentally ill. Starting from us is a great thing spreading across will help in reducing these judgements over the people with mental illness.

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Throughout history psychiatry and psychology have been viewed from the lens of Western sciences that Eastern sciences are being disadvantaged. However, the history of psychiatry is heterogeneous and consists of many different scientific and cultural traditions which vary between populations. hence the Indian concept of “unmada” can’t be compared or conformed to “schizophrenia” without addressing its cultural and historical contexts.

Vedanta philosophy describes “Atman” as the core of one's personality that controls mind, body and intellect and describes “Vasanas” as determining nature and nature and activities originating from them. This concept was later understood in the West through Freud, Jung, and Adler as the reality of the unconscious. Rigveda describes Sattva (goodness, harmonious), rajas (passion, activity), and tamas (ignorance, laziness) as the components of one’s personality. It also identified mental illness as separate from physical illnesses. Atharvaveda describes “manas” as the instrument of hypnotism and describes in detail willpower, emotion, and consciousness.

Vedas describe treatment for mental disorders ranging from psychosis, epilepsy, sleep disorder and aggression in the form of “Bheshaj” (medicine) and prayers to God (psychotherapy) along with “Yam” and “Niyam” (behavioural control) and “Asan” and “Pranayan” (physical activities.

Bhagavad Gita even mentions one of the earliest depictions of anxiety and depression. Charak Samhita and Sushrut Samhita, the two classics of Ayurveda also describe mental disorders based on Tridoshas (humours in the body vat, pitta, kapha), which can be seen in Hippocrates's work.

Furthermore, developments were noticed until the 2nd AD, after which conceptualization and management of mental illnesses from an Indian perspective slowed down and following the arrival of the British empire, we became a part of modern psychiatry.

Citation: Mishra, A., Mathai, T., & Ram, D. (2018). History of psychiatry: An Indian perspective. Industrial psychiatry journal, 27(1), 21–26. https://doi.org/10.4103/ipj.ipj_69_16

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 How can we reduce Prejudicial Attitudes towards the mentally ill?

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 How can we reduce Prejudicial Attitudes towards the mentally ill?

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I remember the first time I encountered someone with a mental illness. One of my classmates was cornered because he was "different" when I was in third standard. He had the habit of not being able to walk, talk, or write properly, nor could he make proper eye contact. He was given the designation of Slow Learner. He displayed signs of mental health problems, which his parents and teachers had neglected. When there was essentially no awareness of these kinds of topics at the time. In addition, he was bullied by his male classmates, who used physical harm as a way to assert their dominance over him. He had to be taken out of school because he could not pick things up quickly, and I haven't seen him since.

This experience suddenly jumped to mind when I saw the question, and I believe we can make these small but important changes to reduce the stigma associated with mental illness.

Instead of IGNORING certain symptoms or indicators, one can always TAKE ACTION. Due to stigma or labeling associated with mental illness, people generally typically disregard all of these indications. The fear that society holds of this stigmatization needs to go.

We, as a Society can always EMBRACE and ENCOURAGE people going through mental health issues by fostering Empathy. I believe Empathy brings in strength with one another.

One should always educate oneself before making judgments about others, rather than calling people who are struggling with mental health issues "psycho," "mental," or "crazy." Our views are greatly influenced by language. Making an effort to be kind to others as this reduces the amount of hurtful comments said might really improve one's process.

Positive changes in prejudicial attitudes are always possible when there is open communication and support regarding this subject.

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There are many people today unable to acquire the effective therapies available because of the stereotypes and discrimination associated with mental illness. Traditionally, a psychiatric diagnosis often became a disabling label that led to worsening of the patient’s mental and social well-being. Nevertheless, recent scientific/technological breakthroughs in our field have greatly advanced our understanding about these aspects. Most psychiatrists take pride in the fact that people suffering from mental disorders can be successfully treated as well as reintegrated back into their social and family networks and get to live normal lives.

Adequate policies, mental health programs, reorganisation of health services, inclusion of scientific/technological advancements; new therapeutic approaches (including new medications); modern psychoeducational and psychosocial rehabilitation techniques; multiple evaluations by peers and consumers can contribute to obtaining ‘good quality of life’ for patients.

In order to achieve this, we follow the content of “Psychosocial Rehabilitation – Consensus Statement” by WHO and WRAP. Psychosocial rehabilitation is described as a process that enables people with mental disorders to reach an optimal level of independent functioning, improves their competence and makes environmental changes that will help improve their quality of life.

The goals of psychosocial rehabilitation are symptomatology reduction, iatrogenesis minimization, social competence improvement, stigmatization decrease and discrimination avoidance, family support provision, social support delivery as well as consumer empowerment. At different levels the document suggests various action strategies. Such recommendations include improving relevant legislation at a social level empowering the consumer and enhancing public opinion/attitude towards mental disorders.

To reduce prejudiced thinking against the insane, education, personal contact and a change in media are needed. By this I mean that during school days, programs of education have been shown to effectively derogate discrimination by creating an emotional reaction towards victims. For example, Corrigan and Penn’s surveys justify the fact that continuous meetings with people facing mental disorders helps to debunk myths as well as enhance empathy.

According to Pettigrew and Tropp, further research reveals that one-on-one contacts with mentally ill persons serve humanising function and encourage empathy among those unaffected. This argument suggests the need for mental health in schools’ curriculum along with community initiatives for personal interaction.

Additionally, media representation plays a crucial role. Accurate and positive representations of mental illness found in movies or television can help to reshape public perceptions about it negatively. This requires putting together educational programs, direct contact between individuals and cautious media approaches so as to breed societies that understand mental illness more compassionately.

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Awareness and Actual Attitudes:

Bridging the gap between awareness and attitudes involves not just educating people about mental health terms but also fostering empathy and understanding. This can reduce stigma by helping individuals see beyond the labels and recognize the humanity of those with mental illnesses.

Approach: Encouraging people to learn about the lived experiences of those with mental illnesses can build empathy and reduce fear and misunderstanding.

Role of Education:

Teaching school students about mental health and how to interact compassionately with those who have mental illnesses can instill understanding and reduce prejudice from a young age.

Approach: Incorporating mental health education into school curriculums helps children learn that mental illnesses are medical conditions, not character flaws. This early education promotes respectful attitudes and reduces the likelihood of stigmatizing behavior.

Media Influence:

The media's portrayal of mental illness significantly shapes public perception. Positive and accurate portrayals can reduce stigma by normalizing mental health issues and showing that individuals with mental illnesses can lead fulfilling lives.

Approach: Campaigns that promote accurate representations of mental illness in media can correct misconceptions and reduce fear. Encouraging media outlets to consult mental health professionals can ensure portrayals are respectful and accurate.

Parental Awareness:

Educating parents about the importance of addressing mental health issues early can prevent the development of severe conditions and reduce stigma by normalizing mental health care.

Approach: Providing parents with resources and information about early signs of mental illness and how to seek help can reduce stigma associated with mental health treatment. Parents who understand mental health can also model positive attitudes for their children

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Sanchana Muthusamy

In order to bring about any kind of change, I believe spreading awareness is key to success. We all need to come together as a society to bring about this change. First, we need a good understanding. To reach all sorts of people, we need to be heard and understood. Whether something is right or wrong is another matter, but people will only be willing to participate if they feel heard. By doing this, we can also learn about the majority's thoughts and points of view. Based on this information, we can address and reach the audience in a language they understand. For example, we can conduct surveys, interviews, and create anonymous public spaces for people to share their thoughts.

While this approach could partially work with adults, it is wiser to educate young minds. This way, children can educate their parents as well. By engaging with children and helping them understand, we can normalize these ideas for the next generation. Teens and young adults in their 20s will need to put in maximum effort to bridge the gap. They are the most important group as they hold the power to bring about change. To help children learn, it is crucial for them to observe good behavior in social activities.

To reach the elderly population, the youth must take a strong stand together, using their strength to shape society positively. However, the youth first need to be educated. I suggest incorporating a small program on these topics, regardless of the field of study. Many STEM courses and other fields lack an understanding of the importance of humanities. This disconnect can lead to innovations that do not consider people's well-being.

For example, IIT students receive significant funding from the government for their projects. They proposed using drones to carry hearts for transplant treatments and designed a machine to stop manual scavenging but just to manufacture one machine it costed alot. While these are creative and intelligent solutions, they are expensive and may not be practical for everyone. This shows a disconnect with the real world.

I strongly suggest incorporating humanities and its importance into every curriculum. Understanding humans better will lead to a better world in every aspect.

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Ancient india thought emphasised in the foundation of body and the soul and also explained how to deal with health and mental health problems in a psychosomatic way. Two well known ayurvedic manuscripts that have established the roots of modern Indian medicine namely are  the charaka Samhita by charaka has described various attributes for a hospital including its location,details of equipment’s,food and model code of conduct for physicians,nursing staff and ward attendants.and the Sushruta samhita by Sushruta.

ATHARVA VEDA mentions that mental illness may result from Divine curses.There has been seen descriptions of conditions similar to that of schizophrenia and bipolar disorder in the VEDIC TEXTS.Vivid description of schizophrenia can also be found in ATHARVA VEDA.SIDDHA a traditional medical system flourished in Southern India  has recognised various types of mental disorders.

The BHAGAVAD GITA is a classic example of crisis intervention psychotherapy.Close to the roots of the HINDU MYTHOLOGY,Najabuddin Unhammad(1222AD) an Indian physician propagated the UNANI system of medicine as he described seven types of mental disorders:Sauda-a-tabee(schizophrenia),Muree-Sauda(depression),Ishq(delusion of love),Nisyan(Organic mental disorder),Haziyan(Paranoid state) and Malikholia-a-maraki(delirium).Psychotherapy was well known as Ilaj -I-Nafsani in unani medicine.The great saga”AGASTYA” formulated a treatise on mental diseases called as ‘Agastiyar Kirigai Nool’ in which treatment methods were described for 18 psychiatry disorders.

REFERENCE:

Nizamie, S. H., & Goyal, N. (2010). History of psychiatry in India. Indian journal of psychiatry, 52(Suppl 1), S7–S12. https://doi.org/10.4103/0019-5545.69195

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D. Leka - How can we reduce Prejudicial Attitudes towards the mentally ill?

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D. Leka - How can we reduce Prejudicial Attitudes towards the mentally ill?

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Research has shown that having a direct contact or to say facilitating interactions and relationships between the general public and individuals with mental illnesses has more effect on reducing Prejudicial Attitudes towards them (Corrigan,2012).

Incorporating the importance of mental health, myths and misconceptions and accurate information about mental health conditions in the curriculum of students helps people to gain knowledge regarding this, this may have higher chances of people to change their prejudicial attitudes towards mentally ill.

Encourage individuals with mental illness to share their personal stories on social media platforms. This can provide valuable insights into their struggles and resilience, helping to humanize their experiences.  This approach is particularly beneficial for older people, who might gain a better understanding of mental health challenges and stop labelling individuals, thereby reducing prejudicial attitudes.

Implement community programs that highlight the struggles faced by individuals with mental illnesses due to prejudicial attitudes, stigma, and labeling. Showcasing these challenges can foster empathy and understanding among community members. This approach is effective in reducing stigma and changing negative attitudes, promote supportive environment to those people with mental illness

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K Pachiammal - How can we reduce prejudicial attitudes towards the mental illness? 

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K Pachiammal - How can we reduce prejudicial attitudes towards the mental illness? 

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To reduce the prejudiced attitude towards mental illness, we can start with role-play scenarios. By doing role play regarding mental illness like what exactly a mentally ill person struggles with and the pain they go through every day. It differs across the mental illness they have. So doing a role play about mental illness may be more effective in reducing prejudice and also in increasing empathy. Another way is educating others about mental health conditions including manifestation, misunderstanding, misconceptions, etc... that knowledge helps foster empathy and correct misconceptions about mental health challenges. Another way is sharing personal stories. A person who has experienced mental illness can share their personal experiences of living with a mental health condition can be a powerful tool in reducing stigma. By sharing stories, individuals can educate others about the realities of mental health challenges, fostering empathy and reducing judgment and misunderstanding. The final way is community-based awareness. We all know that people in local communities are less aware of mental health than others. To remove the stigma associated with these groups, we may raise awareness by establishing community health centers that provide accessible counseling, crisis intervention, and educational programs customized to their specific needs. Raising awareness about mental illness can reduce stigma among these individuals. By combining role-play scenarios, education, personal stories, and community-based awareness initiatives, we can create a comprehensive approach to reducing prejudice and fostering empathy towards mental illness. This multifaceted strategy will help us build a more inclusive and understanding society for everyone.

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In ancient India, The Vedas consist of prayer verses that helps an individual to cultivate noble thoughts and cultivate their brain. They also seem to incorporate various techniques for the treatment of mental disorders ranging from aggression to psychosis. During the ancient days only, the scholars were able to understand the verses return in the Upanishads and Vedas, a simplified version of this was the Bhagavad Gita. This book consists of written descriptions of anxiety and depression observed in one of its characters – Arjuna.

Two classics of Ayurveda - “Charak Samhita” and the “Sushrut Samitha” describe mental disorders and a few causative factors which include immorality, weak mind, stress, anxiety etc.

Buddhism explains psychosis as a breakdown on one’s view point of the world due to the insufficient emotional support from within.

During the period of the Delhi Sultanate, Unani medicine gained popularity. Unhammad was a prominent practitioner during that time, he described seven types of mental disorders.

Post this period there wasn’t much development in the field of mental disorders. After the advent of the British Empire, India became a part of the modern psychiatry.

During the mid-18th and 19th centuries, mental asylums were established in Kilpauk, Calcutta and Monghyr. These asylums aimed at separating mentally ill patients from the society. In the mid-19th century new asylums were built in Patna, Dacca, Calcutta, Pune and Agra. As the institutions became overcrowded there were difficulties in maintaining health and hygiene.

Today the quality of mental health institutions are being improved.

Ref article : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198594/

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Abstract

A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. Modern psychiatry and its history has always been observed through the prism of western science which has its own evolutionary line in which the eastern sciences can't fit and are always at a disadvantage. Especially the colonial bid to prove its legitimacy as a civilizing mission led to representation of European medicine as morally superior to the eastern practices resulting in a biased history. Though in reality, the history of psychiatry is heterogeneous and consists of many different scientific and cultural traditions which vary between populations. hence the Indian concept of "unmada" can't be compared or conformed to "schizophrenia" without addressing its cultural and historical contexts. Many suggest that in case of Indian patients, an understanding of illness through a Vedantic model of psych seems more appealing in comparison to the western constructs, as such an attitude has been transferred over generations. Therefore, a knowledge of history of psychiatry, especially from an Indian perspective becomes important.

Keywords: History, India, psychiatry

History of psychiatry might be interesting but most psychiatrist still do not consider it as a core topic and many consider it at best, nonrelevant.[ 1] But owing to the close analogy between the neurobiological paradigms and the concepts of old authors like Kraepelin[ 1] and Bleuler,[ 2] that has come up with advanced researches of the past few decades, interest in the history of psychiatry has renewed from the academic point of view.

A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. It helps in detecting and preventing different understandings of mental illness (biological, psychological, cultural, etc.) from becoming dogmas or myths. Psychiatry might be the only specialty in which admission can be a legal issue which calls for the perspective of personal autonomy,[ 3] and hence, precedence becomes important. Several other factors also bring psychiatry into a close and complex relationship with jurisprudence which makes the historical perspective important.

Overall the study in history of psychiatry can broadly be divided into three main domains - conceptual history (how core concepts developed), institutional history (asylums, societies, etc.), and biographical history (important figures).[ 4]

WHY AN INDIAN HISTORY OF PSYCHIATRY?

In early part of 19 th century, Dr. James Esdaile, a surgeon working in Kolkata under the East India Company, with the help of his native assistant, experimented with mesmerism.[ 5] He utilized it as a pain relieving technique during the surgeries he performed and also in some cases of mental problems.[ 6] Due to favorable reviews of his peers, he also received official support for the establishment of an experimental mesmeric hospital near Kolkata (Report of the Committee Appointed by Government to Observe and Report upon Surgical Operations by Dr. J. Esdaile...., 1846). Instead of being recognized as one of the first Europeans who performed painless surgeries, he invited much controversy[ 7] and was compared to tricksters and performers by the scientific communities in France and England, who were sceptic about mesmeric practices.[ 8]

Dr. Esdaile was undoubtedly one of the myriads of casualty which the rich history of "nonwestern psychiatry" suffered at the hands of the positivistic and reductionism approach of Western science in an age influenced by the law-governed paradigms of enlightenment.[ 9]

Modern psychiatry and its history have always been observed through the prism of Western science which has its own evolutionary line in which the eastern sciences cannot fit and are always at a disadvantage.[ 10] Especially, the colonial bid to prove its legitimacy as a civilizing mission[ 11, 12] led to representation of European medicine as morally superior to the eastern practices[ 5] resulting in a biased history. Although in reality, the history of psychiatry is heterogeneous and consists of many different scientific and cultural traditions[ 4] which vary between populations. For example, in stark contrast to the reliance of western history of psychiatry on the history of institutions in general, Sharma pointed out the fact that there were no institutions for insane before the arrival of the East India Company as family used to support the mentally ill.[ 13] In addition, a universal conceptualization of psychiatry is difficult,[ 14] and hence, the Indian concept of "unmada" cannot be compared or conformed to "schizophrenia" without addressing its cultural and historical contexts.[ 15] Thus, knowing the history of psychiatry with an Indian perspective becomes pertinent in conceptualizing major issues in phenomenology and management specific to the Indian context.

CONCEPTUALIZING MENTAL ILLNESS-AN INDIAN WAY

Chronology is the hard problem of history when it comes to ancient India. The controversy surrounding the precise age of Vedas and other related scriptures which has been estimated from a few million years to a few thousand years by various Eastern and Western researchers,[ 16] makes precise historicizing a difficult task.

Vedanta philosophy conceptualizes Atman as the core of personality which is the prime control of the mind, body, and intellect, but "Vasanas" (inherent tendencies) determine nature and activities originating from them.[ 16] This difference between the mind and Atman has always confused the Western philosophers, till the researches of Freud, Jung, and Adler recognized the reality of unconscious. Cartesian dualism differentiating mind from matter is very recent to the Western thought while the Indian philosophy, particularly the Upanishads understood the mind "more from within than from without."[ 17]

Vedas mention mantras for prayers to bring noble thoughts to mind and purify it.[ 16] Rigveda describes sattva, raja, and tama as personality traits and also identifies mental illness independent of physical illness. Yajurveda conceptualized mind as the inner flame of knowledge.

Atharvaveda describes "Manas" as an instrument of hypnotism and talks in details about will power, emotion, inspiration, and consciousness. "Unmad" (psychosis) has been mentioned as a deluded state of mind in Vedas with etiology suggestive of both organic (worms/microorganisms, fever, etc.) and functional (sins toward Gods) origin. Vedas also mention treatment for mental disorders ranging from psychosis, epilepsy, sleep disorder, and aggression in the form of "Bheshaj" (medicine) and prayers to God (psychotherapy), along with preventive methods such as "Yam" and "Niyam" (behavioral control) and "Asan" and "Pranayam" (physical activities).

Upanishads describe the various states of mind (Jagrat, Svapana, Sushupti, and Samadhi), theories of perception, thought, and memory. Ichchha Shakti (will) Kriya Shakti (Action) and Jnana-Shakti (Knowledge) were described by them as the three mental potencies,[ 18] and the psychopathology was understood by Trigunas and Tridosas.

Considering the difficulty in understanding the teachings of Vedas and Upanishads, it became necessary to simplify them for the nonscholars.[ 19] Bhagavad Gita is considered to be the simplified and condensed form of the Vedas and Upanishads. It has one of the earliest written descriptions of anxiety and depression as seen in Arjuna and also describes the several aspects of psychotherapy.

Contrary to popular notion, Ayurveda, our traditional medicine system is not confined to physical health alone. Mira Roy in her commentary on Ayurveda for the voluminous cultural heritage of India series published by Ramakrishna mission, clearly mentions its holistic role in promoting physical, mental, and spiritual health in context to a man's environment.[ 20] In contrast to modern psychiatry where diagnosis is based on phenomenology in Ayurveda, it is based on etiology (the Tridoshas).

Charak Samhita and Sushrut Samhita, the two classics of Ayurveda describe mental disorders according to trigunas (sattva, raja, and tam) and tridoshas (three humors in the body vat, pitta, kapha). They also describe 14 causative factors which include immoral behavior, weak mind, stress, anxiety, and substance to name a few. They also classify mental disorders as "Nijmanas rog" (endogenous) and "Agantujmanas rog" (exogenous) with further subdivision of "Nijmanas rog" into "manas dosh" (psychological) and "Sharir Doshanubandh" (physical) causation types. In Ayurveda, over 200 herbal medicines have been described and categorized into various categories such as memory enhancer, intoxicating, antipsychotics, and anticonvulsants.

Earliest evidence of attribution of mental illness to demons and treatment by magic and occult practices was note in the Indus valley period (around 1500 BCE). This conceptualization was possibly imported from the contemporary civilizations in Mesopotamia, Egypt, and Crete during those times.[ 21]

Buddhism and Jainism (around 6 th century AD) brought in the philosophical systems (Nyaya, Vaiseshika, Samkhya, Yoga, and Vedanta) following which medicine separated from the magicoreligious tradition and entered into an alliance with these philosophical systems. Buddhist conceptualization of psychosis as the "breakdown of one's worldview with insufficient emotional support from within" and severe mental illness as a result of pursuing a lifestyle that is different from inherent disposition and spiritual destiny, appears to be the bridging gap between the religious certainties and rationality during those times.[ 22] Supernatural gave way to rationalism and psychiatry benefited a lot from Vaiseshika, Nyaya, Samkhya and Yoga systems.[ 21] Buddhism stressed on specific meditational practices which aimed at direct restructuring of the consciousness in contrast to the Western psychotherapy which tends to be indirect and aims at removing blockages in the way of awareness.[ 22]

With the advent of the Delhi sultanate and the Mughal dynasty which followed it, Unani medicine gained prominence.[ 23] Najabuddin Unhammad (1222 AD), a prominent Unani practitioner of his time, described seven types of mental disorders; Sauda-a-Tabee (Schizophrenia); Muree-Sauda (depression); Ishk (delusion of love); Nisyan (Organic mental disorder); Haziyan (paranoid state), and Malikholia-a-maraki (delirium).[ 24]

Overall, after the classical era (maybe till 2 nd century AD), there has not been much development in the conceptualization and management of mental illnesses from an Indian perspective[ 21] and following the arrival of the British empire, we became a part of the modern psychiatry, and as we will discuss in the following sections, our contribution has mostly been about institutions and increasing their accommodation.

A HISTORY OF INSTITUTIONS AND INSTITUTIONALIZATION IN INDIA:

As mentioned before, mental asylums were mostly a British concept. Except for a few institutions (or "collection of curious humanity" as referred to by a few authors) scattered in time across various parts of India, the institutions and institutionalization were introduced to India in the colonial era. It seems that the institutions were initially started for European soldiers only but later went on to treat the local population too.[ 13]

Sharma in his book on the development of mental hospitals in India, went on to describe the five phases of development which were influenced by the dominant geopolitical predicaments of their times.[ 25]

First phase (18th-mid 19th century)

Some of the first mental asylums (Calcutta (1787), Kilpauk(1794) and Monghyr (1795)) were established during this period with the sole guiding principle of separating the mentally ill patients from the society.

Second phase (Mid 19th late 19th century)

The first Lunacy Act (1858)[ 26] was promulgated which mentioned guidelines for establishment of asylums and their admission procedures. Several new asylums were built in places such as Patna, Dacca, Calcutta, poona, Agra, etc. These institutions were overloaded which led to deterioration in services along with the health and hygiene of these places.

Third phase (First quarter of 20th century)

A major change to counter the deteriorating conditions of the institutions as noticed during the 2 nd phase, was shifting the charge of asylums from Inspector general of Police to the Civil Surgeons. In addition, psychiatrists were appointed in these hospitals. The introduction of Indian Lunacy Act in 1912[ 26] further refined and systemized the admission, treatment, and discharge procedures of the mentally ill with the introduction of the provisions for voluntary boarder admissions.

Fourth phase (1920 - independence)

In a bid to promote the illness model and to reduce stigma, the "asylums" were renamed as "mental hospitals" in 1920. Occupational therapy and rehabilitation were stressed on as a core issue with respect to mentally ill. The Bhore committee[ 27] health survey for the first time surveyed and made recommendations for mental hospitals. A committee headed by Col Moore Taylor[ 28] suggested for focused training in psychiatry, promotion of occupational therapy, and separate child psychiatry units. It also recommended for the establishment of friendly relationship with the community by countering the ignorance, superstition, and suspicion associated with mental illness.

Fifth phase (postindependence)

Keeping the international trend toward deinstitutionalization and persisting poor conditions in mental hospitals, Government of India concentrated on creation of psychiatric units in general hospitals rather than building new mental hospitals. Improving the conditions of existing mental hospitals has also been stressed upon. A series of conferences were held in Agra (1960), Ranchi (1986), Bangalore (1988), Delhi (1995), and Bangalore (1999), in which the state of existing mental hospitals were reviewed and recommendation for their improvement were made. Considering the experience of the Indian Lunacy Act, 1912 as outdated, The Mental Health Act, 1987 came into force from 1993.[ 29] It stressed on the role of treatment and necessity to safeguard the interests of the mentally ill. It also has guidelines for establishing and maintaining of psychiatric hospitals and nursing homes.

With the trends toward deinstitutionalization and outpatient care, the focus on the institutions are largely decreasing, but considering the fact that the severely ill patients or patients with poor social support systems, who require chronic institutionalization are still present in a significant number in the society,[ 28] the mental hospitals are here to stay and contribute to the history for a longer period.

SOME IMPORTANT FIGURES IN INDIAN PSYCHIATRY

Considering the predominance of the scriptures over individuals from ancient India and the prevailing tone of Western philosophy and education, the prominent figures from the history of Indian psychiatry are of those who contributed to the progress and modernization of mental health care in India. Nevertheless, there also have been a few names who tried to address the phenomenological and treatment aspects of mental illnesses.

With the emergence of Indian doctors trained in western medicine by mid-19 th century, the prevailing conditions started getting incorporated into the Western paradigms.[ 30] Pandurang et al.[ 31] gave one of the earliest descriptions of hysteria and unlike Briquet,[ 32] did not see it as a disorder of brain. Indian doctors in 19 th century were reporting on biomarkers and debating on genetic causes of mental illnesses.[ 30] W. B. O'Shaughnessy from Kolkata in 1839 reported on the use of cannabis indica in treating illnesses such as rheumatism, cholera, and delirium tremens.[ 33] Dr. Fraser a psychiatrist posted in British Army during World War II wrote an article in the British Medical Journal on ganja psychosis.[ 34]

Owen Berkeley-Hill as medical superintendent of European Mental Hospital, Ranchi, was instrumental in changing the word asylum to mental hospital by a government notification in 1920. He also founded that the Indian Association for Mental Hygiene, which was affiliated to National Council for Mental Hygiene in Great Britain.[ 35, 36] Girindra Shekhar Bose, pioneer of psychoanalysis in the country, founded that the Indian Psychoanalytical Association in 1922 in Calcutta and got it affiliated with International Psychoanalytic Association.[ 24] He also set up the first psychiatric outpatient service at the Carmichael Medical College (now R. G. Kar Medical College), Calcutta in 1933. J. E. Dhunjibhoy, inspired by Western researchers, pioneered many a first in the country such as Sulfosin therapy, Cardiazol-induced seizure treatment for schizophrenia, subshock nitrogen gas inhalation in excited patients, glandular therapy, Soneryl as a hypnotic in excitement and insomnia, and benzedrine as a stimulant in depression, way back in the 1930s-1940s.[ 37] R. B. Davis as medical superintendent of European Mental Hospital, Ranchi (now Central Institute of Psychiatry), introduced electroencephalography (leukotomy, modified electroconvulsive therapy, and insulin coma therapy in India.[ 38]

Gananath Sen and Karthick Chander Bose were the first to report on the use of alkaloid extracts from the Rauvolfia serpentina plant in reducing psychosis.[ 39] Initially overlooked, but when rediscovered, reserpine became one of the first agents to be used in the treatment of schizophrenia.

Postindependence, there is not much of the biographical history to be mentioned. Probably because most of it is still contemporary with several distinguished figures still busy contributing to all aspects of mental illness research. In near future, as new paradigms develop, undoubtedly, they are deemed to become part of the illustrious history of modern Indian psychiatry.

THE FUTURE - WHERE FROM HERE?

Way back in the 1950s, Bhagwat had observed that for a bright future, psychiatry needs to establish itself as an independent discipline with specific stress on postgraduate training and research.[ 40] Needless to say, Indian psychiatry has come far ahead and in the right direction since then.

The District Mental Health Program started in 1996-1997[ 28] reflected a major shift in policies from the concept of custodial care to emphasis on treatment and care at the primary healthcare level. Still, a lot needs to be done proactively regarding financial allocation, training programs, etc., for the fulfillment of roles envisioned for mental hospitals in the national mental health program.[ 28]

The skills and capacity for research can be raised further through research-oriented training, providing resources, possible collaboration with ongoing projects and with help from international agencies such as WHO,[ 41] which can be influential in the further progress of Indian Psychiatry.

The acceptability of the alternative system of medicine in the masses and the cropping up of evidence-based research in their support cannot be denied. Recently, the National Rural Health Mission has recommended mainstreaming of AYUSH, the various forms of alternative medicines practiced legally in India.[ 42] By mainstreaming, they intend to integrate AYUSH with the existing healthcare system of the country at all levels to combat the existing workforce shortage. A similar bid to integrate the alternative system of medicine in psychiatric research can be contemplated upon. Especially, considering their better agreeability with the ancient and precolonial concepts, a more holistic understanding of mental illness and its management can be developed from the Indian perspective.

In the light of the mental healthcare bill, 2013, which is still in process of becoming an act and an issue of both positive and negative criticism among the mental health professionals in the country,[ 43] the future holds many exciting prospects. The effects of concepts such as judicial review and advance directives in an Indian context are difficult to be predicted in the present but for sure will have indelible impressions on the pages of history.

So far, the focus remains on a model of care which not only treats the illness but also addresses issues of self-respect and dignity, the progress will be in the right direction with a better comprehension of the complicacies of mental illness.

CONCLUSION

Based on studies[ 44, 45] of his time, which supported the fact that a significant proportion of patients with mental illness improved irrespective of the treatment type, Rao questioned if it was correct to ridicule ancient concepts on the ground of rationality.[ 21] Considering the fact that most of the outcome studies for an illness like schizophrenia[ 46] over the years have provided conflicting results, and major textbooks in psychiatry[ 47] also refrain from giving a strong opinion regarding this, Rao's question is still pertinent.

The difficulty in finding established causation and heterogeneity in presentation and prognosis were explained on the construct of "primitive", "gullible," and "superstitious" native mind during the 19 th century India as reported by Radhika et al. in their review of psychological symptom profile in colonial India.[ 30] In the same review, they go on to report how rarity of general paresis in Indian population was explained on the basis of it being a disease of civilized society and men who do brain work.

Such instances from history open not one but several questions. Who holds the authority to reject something as magic or superstition and accept other things as science and rational? What draws the line between fact and fiction? And what becomes history and what becomes story? Voltaire once rightly said that "History is a trick the living play on the dead", and the vetting which our precolonial history of psychiatry received from the zeitgeist of the colonial era, seems to prove him correct.

Colonialism brought in a dominant British flavor to Indian psychiatry when at best we could prove ourselves to be good followers. One would hardly disagree with Varma's[ 48] comment that "the history of Psychiatry in this country is the history of establishment of mental hospitals and then increasing its accommodation from time to time as the exigencies of the time demanded".

One of the greatest achievement of modern psychiatry has been its openness to inputs from other disciplines. The zeal to grow in the right direction allows us to entertain all sorts of ideas, For example-an anthropological perspective of mental illnesses, which calls for considering International Classification of Diseases and Diagnostic and Statistical Manual of Mental Disorders phenotypes as culture-bound syndromes.[ 47] In appreciation of the same argument, imposition of a particular diagnostic system on a different cultural setting has been questioned by many.[ 15] Similarly, many suggest that in case of Indian patients, an understanding of illness through a Vedantic model of psych seems more appealing in comparison to the Western constructs, as such an attitude has been transferred over generations.[ 16] Therefore, a knowledge of the history of psychiatry, especially from an Indian perspective becomes important and not just interesting, for who knows what truth the future might prove or end up agreeing upon.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Hoff P. Vol. 73. Berlin: Springer-Verlag; 2013. Emil Kraepelin und die Psychiatrie als Klinische Wissenschaft: Ein Beitrag zum Selbstverständnis Psychiatrischer Forschung. [ Google Scholar]

14. Weiss MG. Caraka Samhita on the doctrine of karma. Karma and Rebirth in Classical Indian Traditions. 1980:90-115. [ Google Scholar]

20. The Cultural Heritage of India. Ramakrishna Mission. Ramakrishna Mission, Institute of Culture; 2013 [ Google Scholar]

27. Bhore JC. Report of the Health Survey and Development Committee. 1946;3 [ Google Scholar]

33. O'Shaughnessy WB. On the preparations of the indian hemp, or Gunjah: [[ Cannabis indica their effects on the animal system in health, and their utility in the treatment of tetanus and other convulsive diseases. Prov Med J Retrosp Med Sci. 1843;5:363. PMC free article] [ PubMed] Google Scholar]

37. Ernst W, Mueller T. Cambridge: Cambridge Scholars Publishing; 2010. Transnational Psychiatries: Social and Cultural Histories of Psychiatry in Comparative Perspective c. 1800-2000. [ Google Scholar]

47. Kaplan HI, Sadock BJ. 1-2. Philadelphia: Williams & Wilkins Co; 1989. Comprehensive Textbook of Psychiatry. [ Google Scholar]

Articles from Industrial Psychiatry Journal are provided here courtesy of Wolters Kluwer -- Medknow Publications

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History of psychiatry: An Indian perspective

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A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. Modern psychiatry and its history has always been observed through the prism of western ...

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People with mental illness are belittled & discriminated against in many ways. Understanding what it's like & how to address it can help. One can talk openly about mental illness with others and sharing it on social media helps with creating Awareness about “stigma” associated with it.

An individual can educate themselves as well as others by responding to misleading information or negative comments by sharing evident facts and their personal experiences.

One can always be conscious of their words thus, it wouldn't affect other people who are dealing with a tough time.

We can try encouraging equality between physical & mental illness by drawing comparisons.

Educational programs include information about the causes and treatments of mental illness.

Promoting proper and respectful information and representing the mental illness in the media may reduce prejudice and stereotypes associated with mental illnesses.

Promoting and encouraging mental health  practices in the environment, will create a supportive safe space for people dealing with mental illness.

Organizing educational programs in schools might create awareness among students about mental health from a very young age.

Events like workshops can be organized to promote empathy and understanding of mental illness.

People dealing with mental health issues can share their experiences with their peers about the discrimination faced by them in society. Discrimination makes it hard for people to recover from their mental illness.

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The study "Learn and ACT: Changing Prejudice Towards People with Mental Illness Using Stigma Reduction Interventions" (2016) by Kenny and Bizumic tested two methods to reduce prejudice towards mental illness.

1. Interventions Compared:

Education: Traditional information about mental illness.

Learn and ACT (Acceptance and Commitment Therapy): Exercises to increase psychological flexibility and acceptance.

2. Results :

Reduced Prejudice: Both methods significantly reduced prejudice compared to a control group with no intervention.

The Learn and ACT intervention was more effective than education alone, regardless of initial psychological flexibility levels.

This suggests that ACT-based interventions may be effective in reducing prejudice towards mental illness by challenging negative biases and fostering more accepting attitudes. It can address prejudice towards mental illness in different settings. Schools and workplaces can incorporate ACT-based programs to promote mental health awareness and inclusivity. Online platforms can deliver ACT interventions and educational content, using Internet platforms. Public health campaigns by government and NGO’s can also use ACT principles to change societal attitudes towards mental illness, which could make the community more accepting and understanding.

In today's world, where there is so much social media use, it offers a chance to make a positive impact. By encouraging responsible online behaviour, supporting mental health advocates, and creating educational programs, social media can work with traditional methods to reduce stigma and promote understanding. Given the high usage of social media, it's an ideal starting point for these efforts.

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Prejudicial attitudes toward the mentally ill are not only harmful to the patients but also to society as a whole. They prevent people from seeking help due to the fear of being stigmatized and alienated from society. It is not a topic that is spoken about as openly as prejudice toward the physically ill. While the physically ill are sympathized with for their disabilities, the mentally ill are often put down, which can exacerbate their illness. This makes it difficult for them to heal, seek help, and acquire adequate resources to come out of their illness and move toward well-being.
The issue of prevailing prejudice, in my opinion, is because the mentally ill are not capable of advocating for themselves due to their illness, in most cases. They are unable to combat these narrow-minded opinions and form a clinically accurate picture of their own illness and mental health as a whole. Personally, to overcome this issue, the mentally affected must also be counseled, along with their treatment, not to be ashamed of their illness (if they are cognitively capable of understanding) and to stand up for themselves against any societal hurdles they may face throughout their healing journey.
Another belief that I hold is that, the majority of the prejudice comes from the generations who were not given the opportunity to learn about mental health and it's importance. It is truly difficult to change their opinions since their brains have deteriorating fluidity and it's harder to modify their upbringing as they age. But it is not impossible. It is important for mental health professionals and social workers to target this population and provide group/individual counseling sessions to help them understand the importance and prevalence of mental health and how those affected by it are supposed to be treated.

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Amritha Chandrasekhar- How can we reduce prejudicial attitudes towards the mentally ill?

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Amritha Chandrasekhar- How can we reduce prejudicial attitudes towards the mentally ill?

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We can infer from the topic's title that prejudice towards a specific population can only be reduced and not deluged. The negative attitudes that are core schemas in the general population cannot be changed overnight. The indifference to the population that slightly deviates from what is assumed to be “normal” is ingrained, and it is also a natural reflex to pay attention to what is “unusual” or “novel”. We can also connect this to how we all use the term “disabled” to denote something or someone who cannot carry out functions in a so-called efficient way like the “normals” do. The rigorous measures to reframe the term disabled to differently-abled are just getting internalized in the public eyes. Yet the natural tendency of many is to associate someone with a wheelchair or an amputee to be destitute and needy of sympathy. Despite the illusion of progression, we still carry the images, ideas, and inclinations that media, family, friends, and teachers have imparted to us from a tender age. These influence our cognitions (stereotypes) that cause negative attitudes and emotions (prejudice) towards a certain set of people. Now coming to the solution, it purely lies on what caused it first. My take on this is that the world’s most incurable disease is a strong ingrained attitude that has been reinforced multiple times. It can be seen as a bidirectional effect, where the mentally ill population gets affected by negative attitudes toward them and the behaviors of the mentally ill reinforce these strongly embossed prejudices that were taught by the micro and macro systems of the “normals”. The only way is to inculcate alternative schemas in future generations and reframe the same in people who have flexible attitude styles. This can be done through government initiatives that termed disability as a different ability through slogans, posters in public places, legislations that give dignity to the affected people, and leveraging the power of social media to create a dopamine-induced footprint in the “brain rot” generation.

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Historical origins and treatments of MD in India - V.S.Shivani

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Historical origins and treatments of MD in India - V.S.Shivani

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The history of Indian psychiatry, is a rich blend of cultural, philosophical and colonial influences. It offers a unique perspective rooted in ancient wisdom and indigenous healing practices. Texts like Vedas and Upanishads linked mental health to physical and spiritual well-being, while ayurveda considered the mind and body as an indivisible unit. The concept of Tridoshas - Vata (space and air) governs movement, pitta (fire and water) regulates metabolism, and kapha (earth and water) manages assimilation in the body was applied to understand mental imbalances and diet, lifestyle changes, herbs and meditations were some treatments that were opted.

Indian epics and mythology provide us with great insights about the human psychology. Mythological figures like Indra (god of war, rain and thunder) and Varuna (god of sea) can be represented as extreme state of mind. Indra's impulsive behaviour shows uncontrolled passion as his realms are associated with power, action, and intense emotions. While Varuna's melancholic behaviour shows depressive tendencies as his realms are associated with depth, and emotional complexities of human emotions. Additionally, in the epic Mahabharata, the character of Arjuna was overwhelmed by doubts and despair before the kurukshetra battle depicts human struggles. Krishna's guidance to Arjuna through Bhagavad Gita can be viewed as an early adaptation of the Cognitive Behavioural Therapy. In Ramayana, Rama represents the ideal ego striving for balance, while Ravana embodies the id driven by desires.

Buddhism and Jainism cultures emphasized the significance of meditation. These philosophes proposed that mental disorder could arise from disturbances in one's spiritual path. The arrival of colonial rule introduced the establishments of asylums and institutionalization. Post independence, India shifted to community-based care by establishing psychiatric units in GHs. During this period, there were also advancements in research and policy-making. The National Mental Health Program, introduced in 1982, aimed to integrate mental health services into primary healthcare.

Referencee: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198594/

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Abstract

A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. Modern psychiatry and its history has always been observed through the prism of western science which has its own evolutionary line in which the eastern sciences can't fit and are always at a disadvantage. Especially the colonial bid to prove its legitimacy as a civilizing mission led to representation of European medicine as morally superior to the eastern practices resulting in a biased history. Though in reality, the history of psychiatry is heterogeneous and consists of many different scientific and cultural traditions which vary between populations. hence the Indian concept of "unmada" can't be compared or conformed to "schizophrenia" without addressing its cultural and historical contexts. Many suggest that in case of Indian patients, an understanding of illness through a Vedantic model of psych seems more appealing in comparison to the western constructs, as such an attitude has been transferred over generations. Therefore, a knowledge of history of psychiatry, especially from an Indian perspective becomes important.

Keywords: History, India, psychiatry

History of psychiatry might be interesting but most psychiatrist still do not consider it as a core topic and many consider it at best, nonrelevant.[ 1] But owing to the close analogy between the neurobiological paradigms and the concepts of old authors like Kraepelin[ 1] and Bleuler,[ 2] that has come up with advanced researches of the past few decades, interest in the history of psychiatry has renewed from the academic point of view.

A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. It helps in detecting and preventing different understandings of mental illness (biological, psychological, cultural, etc.) from becoming dogmas or myths. Psychiatry might be the only specialty in which admission can be a legal issue which calls for the perspective of personal autonomy,[ 3] and hence, precedence becomes important. Several other factors also bring psychiatry into a close and complex relationship with jurisprudence which makes the historical perspective important.

Overall the study in history of psychiatry can broadly be divided into three main domains - conceptual history (how core concepts developed), institutional history (asylums, societies, etc.), and biographical history (important figures).[ 4]

WHY AN INDIAN HISTORY OF PSYCHIATRY?

In early part of 19 th century, Dr. James Esdaile, a surgeon working in Kolkata under the East India Company, with the help of his native assistant, experimented with mesmerism.[ 5] He utilized it as a pain relieving technique during the surgeries he performed and also in some cases of mental problems.[ 6] Due to favorable reviews of his peers, he also received official support for the establishment of an experimental mesmeric hospital near Kolkata (Report of the Committee Appointed by Government to Observe and Report upon Surgical Operations by Dr. J. Esdaile...., 1846). Instead of being recognized as one of the first Europeans who performed painless surgeries, he invited much controversy[ 7] and was compared to tricksters and performers by the scientific communities in France and England, who were sceptic about mesmeric practices.[ 8]

Dr. Esdaile was undoubtedly one of the myriads of casualty which the rich history of "nonwestern psychiatry" suffered at the hands of the positivistic and reductionism approach of Western science in an age influenced by the law-governed paradigms of enlightenment.[ 9]

Modern psychiatry and its history have always been observed through the prism of Western science which has its own evolutionary line in which the eastern sciences cannot fit and are always at a disadvantage.[ 10] Especially, the colonial bid to prove its legitimacy as a civilizing mission[ 11, 12] led to representation of European medicine as morally superior to the eastern practices[ 5] resulting in a biased history. Although in reality, the history of psychiatry is heterogeneous and consists of many different scientific and cultural traditions[ 4] which vary between populations. For example, in stark contrast to the reliance of western history of psychiatry on the history of institutions in general, Sharma pointed out the fact that there were no institutions for insane before the arrival of the East India Company as family used to support the mentally ill.[ 13] In addition, a universal conceptualization of psychiatry is difficult,[ 14] and hence, the Indian concept of "unmada" cannot be compared or conformed to "schizophrenia" without addressing its cultural and historical contexts.[ 15] Thus, knowing the history of psychiatry with an Indian perspective becomes pertinent in conceptualizing major issues in phenomenology and management specific to the Indian context.

CONCEPTUALIZING MENTAL ILLNESS-AN INDIAN WAY

Chronology is the hard problem of history when it comes to ancient India. The controversy surrounding the precise age of Vedas and other related scriptures which has been estimated from a few million years to a few thousand years by various Eastern and Western researchers,[ 16] makes precise historicizing a difficult task.

Vedanta philosophy conceptualizes Atman as the core of personality which is the prime control of the mind, body, and intellect, but "Vasanas" (inherent tendencies) determine nature and activities originating from them.[ 16] This difference between the mind and Atman has always confused the Western philosophers, till the researches of Freud, Jung, and Adler recognized the reality of unconscious. Cartesian dualism differentiating mind from matter is very recent to the Western thought while the Indian philosophy, particularly the Upanishads understood the mind "more from within than from without."[ 17]

Vedas mention mantras for prayers to bring noble thoughts to mind and purify it.[ 16] Rigveda describes sattva, raja, and tama as personality traits and also identifies mental illness independent of physical illness. Yajurveda conceptualized mind as the inner flame of knowledge.

Atharvaveda describes "Manas" as an instrument of hypnotism and talks in details about will power, emotion, inspiration, and consciousness. "Unmad" (psychosis) has been mentioned as a deluded state of mind in Vedas with etiology suggestive of both organic (worms/microorganisms, fever, etc.) and functional (sins toward Gods) origin. Vedas also mention treatment for mental disorders ranging from psychosis, epilepsy, sleep disorder, and aggression in the form of "Bheshaj" (medicine) and prayers to God (psychotherapy), along with preventive methods such as "Yam" and "Niyam" (behavioral control) and "Asan" and "Pranayam" (physical activities).

Upanishads describe the various states of mind (Jagrat, Svapana, Sushupti, and Samadhi), theories of perception, thought, and memory. Ichchha Shakti (will) Kriya Shakti (Action) and Jnana-Shakti (Knowledge) were described by them as the three mental potencies,[ 18] and the psychopathology was understood by Trigunas and Tridosas.

Considering the difficulty in understanding the teachings of Vedas and Upanishads, it became necessary to simplify them for the nonscholars.[ 19] Bhagavad Gita is considered to be the simplified and condensed form of the Vedas and Upanishads. It has one of the earliest written descriptions of anxiety and depression as seen in Arjuna and also describes the several aspects of psychotherapy.

Contrary to popular notion, Ayurveda, our traditional medicine system is not confined to physical health alone. Mira Roy in her commentary on Ayurveda for the voluminous cultural heritage of India series published by Ramakrishna mission, clearly mentions its holistic role in promoting physical, mental, and spiritual health in context to a man's environment.[ 20] In contrast to modern psychiatry where diagnosis is based on phenomenology in Ayurveda, it is based on etiology (the Tridoshas).

Charak Samhita and Sushrut Samhita, the two classics of Ayurveda describe mental disorders according to trigunas (sattva, raja, and tam) and tridoshas (three humors in the body vat, pitta, kapha). They also describe 14 causative factors which include immoral behavior, weak mind, stress, anxiety, and substance to name a few. They also classify mental disorders as "Nijmanas rog" (endogenous) and "Agantujmanas rog" (exogenous) with further subdivision of "Nijmanas rog" into "manas dosh" (psychological) and "Sharir Doshanubandh" (physical) causation types. In Ayurveda, over 200 herbal medicines have been described and categorized into various categories such as memory enhancer, intoxicating, antipsychotics, and anticonvulsants.

Earliest evidence of attribution of mental illness to demons and treatment by magic and occult practices was note in the Indus valley period (around 1500 BCE). This conceptualization was possibly imported from the contemporary civilizations in Mesopotamia, Egypt, and Crete during those times.[ 21]

Buddhism and Jainism (around 6 th century AD) brought in the philosophical systems (Nyaya, Vaiseshika, Samkhya, Yoga, and Vedanta) following which medicine separated from the magicoreligious tradition and entered into an alliance with these philosophical systems. Buddhist conceptualization of psychosis as the "breakdown of one's worldview with insufficient emotional support from within" and severe mental illness as a result of pursuing a lifestyle that is different from inherent disposition and spiritual destiny, appears to be the bridging gap between the religious certainties and rationality during those times.[ 22] Supernatural gave way to rationalism and psychiatry benefited a lot from Vaiseshika, Nyaya, Samkhya and Yoga systems.[ 21] Buddhism stressed on specific meditational practices which aimed at direct restructuring of the consciousness in contrast to the Western psychotherapy which tends to be indirect and aims at removing blockages in the way of awareness.[ 22]

With the advent of the Delhi sultanate and the Mughal dynasty which followed it, Unani medicine gained prominence.[ 23] Najabuddin Unhammad (1222 AD), a prominent Unani practitioner of his time, described seven types of mental disorders; Sauda-a-Tabee (Schizophrenia); Muree-Sauda (depression); Ishk (delusion of love); Nisyan (Organic mental disorder); Haziyan (paranoid state), and Malikholia-a-maraki (delirium).[ 24]

Overall, after the classical era (maybe till 2 nd century AD), there has not been much development in the conceptualization and management of mental illnesses from an Indian perspective[ 21] and following the arrival of the British empire, we became a part of the modern psychiatry, and as we will discuss in the following sections, our contribution has mostly been about institutions and increasing their accommodation.

A HISTORY OF INSTITUTIONS AND INSTITUTIONALIZATION IN INDIA:

As mentioned before, mental asylums were mostly a British concept. Except for a few institutions (or "collection of curious humanity" as referred to by a few authors) scattered in time across various parts of India, the institutions and institutionalization were introduced to India in the colonial era. It seems that the institutions were initially started for European soldiers only but later went on to treat the local population too.[ 13]

Sharma in his book on the development of mental hospitals in India, went on to describe the five phases of development which were influenced by the dominant geopolitical predicaments of their times.[ 25]

First phase (18th-mid 19th century)

Some of the first mental asylums (Calcutta (1787), Kilpauk(1794) and Monghyr (1795)) were established during this period with the sole guiding principle of separating the mentally ill patients from the society.

Second phase (Mid 19th late 19th century)

The first Lunacy Act (1858)[ 26] was promulgated which mentioned guidelines for establishment of asylums and their admission procedures. Several new asylums were built in places such as Patna, Dacca, Calcutta, poona, Agra, etc. These institutions were overloaded which led to deterioration in services along with the health and hygiene of these places.

Third phase (First quarter of 20th century)

A major change to counter the deteriorating conditions of the institutions as noticed during the 2 nd phase, was shifting the charge of asylums from Inspector general of Police to the Civil Surgeons. In addition, psychiatrists were appointed in these hospitals. The introduction of Indian Lunacy Act in 1912[ 26] further refined and systemized the admission, treatment, and discharge procedures of the mentally ill with the introduction of the provisions for voluntary boarder admissions.

Fourth phase (1920 - independence)

In a bid to promote the illness model and to reduce stigma, the "asylums" were renamed as "mental hospitals" in 1920. Occupational therapy and rehabilitation were stressed on as a core issue with respect to mentally ill. The Bhore committee[ 27] health survey for the first time surveyed and made recommendations for mental hospitals. A committee headed by Col Moore Taylor[ 28] suggested for focused training in psychiatry, promotion of occupational therapy, and separate child psychiatry units. It also recommended for the establishment of friendly relationship with the community by countering the ignorance, superstition, and suspicion associated with mental illness.

Fifth phase (postindependence)

Keeping the international trend toward deinstitutionalization and persisting poor conditions in mental hospitals, Government of India concentrated on creation of psychiatric units in general hospitals rather than building new mental hospitals. Improving the conditions of existing mental hospitals has also been stressed upon. A series of conferences were held in Agra (1960), Ranchi (1986), Bangalore (1988), Delhi (1995), and Bangalore (1999), in which the state of existing mental hospitals were reviewed and recommendation for their improvement were made. Considering the experience of the Indian Lunacy Act, 1912 as outdated, The Mental Health Act, 1987 came into force from 1993.[ 29] It stressed on the role of treatment and necessity to safeguard the interests of the mentally ill. It also has guidelines for establishing and maintaining of psychiatric hospitals and nursing homes.

With the trends toward deinstitutionalization and outpatient care, the focus on the institutions are largely decreasing, but considering the fact that the severely ill patients or patients with poor social support systems, who require chronic institutionalization are still present in a significant number in the society,[ 28] the mental hospitals are here to stay and contribute to the history for a longer period.

SOME IMPORTANT FIGURES IN INDIAN PSYCHIATRY

Considering the predominance of the scriptures over individuals from ancient India and the prevailing tone of Western philosophy and education, the prominent figures from the history of Indian psychiatry are of those who contributed to the progress and modernization of mental health care in India. Nevertheless, there also have been a few names who tried to address the phenomenological and treatment aspects of mental illnesses.

With the emergence of Indian doctors trained in western medicine by mid-19 th century, the prevailing conditions started getting incorporated into the Western paradigms.[ 30] Pandurang et al.[ 31] gave one of the earliest descriptions of hysteria and unlike Briquet,[ 32] did not see it as a disorder of brain. Indian doctors in 19 th century were reporting on biomarkers and debating on genetic causes of mental illnesses.[ 30] W. B. O'Shaughnessy from Kolkata in 1839 reported on the use of cannabis indica in treating illnesses such as rheumatism, cholera, and delirium tremens.[ 33] Dr. Fraser a psychiatrist posted in British Army during World War II wrote an article in the British Medical Journal on ganja psychosis.[ 34]

Owen Berkeley-Hill as medical superintendent of European Mental Hospital, Ranchi, was instrumental in changing the word asylum to mental hospital by a government notification in 1920. He also founded that the Indian Association for Mental Hygiene, which was affiliated to National Council for Mental Hygiene in Great Britain.[ 35, 36] Girindra Shekhar Bose, pioneer of psychoanalysis in the country, founded that the Indian Psychoanalytical Association in 1922 in Calcutta and got it affiliated with International Psychoanalytic Association.[ 24] He also set up the first psychiatric outpatient service at the Carmichael Medical College (now R. G. Kar Medical College), Calcutta in 1933. J. E. Dhunjibhoy, inspired by Western researchers, pioneered many a first in the country such as Sulfosin therapy, Cardiazol-induced seizure treatment for schizophrenia, subshock nitrogen gas inhalation in excited patients, glandular therapy, Soneryl as a hypnotic in excitement and insomnia, and benzedrine as a stimulant in depression, way back in the 1930s-1940s.[ 37] R. B. Davis as medical superintendent of European Mental Hospital, Ranchi (now Central Institute of Psychiatry), introduced electroencephalography (leukotomy, modified electroconvulsive therapy, and insulin coma therapy in India.[ 38]

Gananath Sen and Karthick Chander Bose were the first to report on the use of alkaloid extracts from the Rauvolfia serpentina plant in reducing psychosis.[ 39] Initially overlooked, but when rediscovered, reserpine became one of the first agents to be used in the treatment of schizophrenia.

Postindependence, there is not much of the biographical history to be mentioned. Probably because most of it is still contemporary with several distinguished figures still busy contributing to all aspects of mental illness research. In near future, as new paradigms develop, undoubtedly, they are deemed to become part of the illustrious history of modern Indian psychiatry.

THE FUTURE - WHERE FROM HERE?

Way back in the 1950s, Bhagwat had observed that for a bright future, psychiatry needs to establish itself as an independent discipline with specific stress on postgraduate training and research.[ 40] Needless to say, Indian psychiatry has come far ahead and in the right direction since then.

The District Mental Health Program started in 1996-1997[ 28] reflected a major shift in policies from the concept of custodial care to emphasis on treatment and care at the primary healthcare level. Still, a lot needs to be done proactively regarding financial allocation, training programs, etc., for the fulfillment of roles envisioned for mental hospitals in the national mental health program.[ 28]

The skills and capacity for research can be raised further through research-oriented training, providing resources, possible collaboration with ongoing projects and with help from international agencies such as WHO,[ 41] which can be influential in the further progress of Indian Psychiatry.

The acceptability of the alternative system of medicine in the masses and the cropping up of evidence-based research in their support cannot be denied. Recently, the National Rural Health Mission has recommended mainstreaming of AYUSH, the various forms of alternative medicines practiced legally in India.[ 42] By mainstreaming, they intend to integrate AYUSH with the existing healthcare system of the country at all levels to combat the existing workforce shortage. A similar bid to integrate the alternative system of medicine in psychiatric research can be contemplated upon. Especially, considering their better agreeability with the ancient and precolonial concepts, a more holistic understanding of mental illness and its management can be developed from the Indian perspective.

In the light of the mental healthcare bill, 2013, which is still in process of becoming an act and an issue of both positive and negative criticism among the mental health professionals in the country,[ 43] the future holds many exciting prospects. The effects of concepts such as judicial review and advance directives in an Indian context are difficult to be predicted in the present but for sure will have indelible impressions on the pages of history.

So far, the focus remains on a model of care which not only treats the illness but also addresses issues of self-respect and dignity, the progress will be in the right direction with a better comprehension of the complicacies of mental illness.

CONCLUSION

Based on studies[ 44, 45] of his time, which supported the fact that a significant proportion of patients with mental illness improved irrespective of the treatment type, Rao questioned if it was correct to ridicule ancient concepts on the ground of rationality.[ 21] Considering the fact that most of the outcome studies for an illness like schizophrenia[ 46] over the years have provided conflicting results, and major textbooks in psychiatry[ 47] also refrain from giving a strong opinion regarding this, Rao's question is still pertinent.

The difficulty in finding established causation and heterogeneity in presentation and prognosis were explained on the construct of "primitive", "gullible," and "superstitious" native mind during the 19 th century India as reported by Radhika et al. in their review of psychological symptom profile in colonial India.[ 30] In the same review, they go on to report how rarity of general paresis in Indian population was explained on the basis of it being a disease of civilized society and men who do brain work.

Such instances from history open not one but several questions. Who holds the authority to reject something as magic or superstition and accept other things as science and rational? What draws the line between fact and fiction? And what becomes history and what becomes story? Voltaire once rightly said that "History is a trick the living play on the dead", and the vetting which our precolonial history of psychiatry received from the zeitgeist of the colonial era, seems to prove him correct.

Colonialism brought in a dominant British flavor to Indian psychiatry when at best we could prove ourselves to be good followers. One would hardly disagree with Varma's[ 48] comment that "the history of Psychiatry in this country is the history of establishment of mental hospitals and then increasing its accommodation from time to time as the exigencies of the time demanded".

One of the greatest achievement of modern psychiatry has been its openness to inputs from other disciplines. The zeal to grow in the right direction allows us to entertain all sorts of ideas, For example-an anthropological perspective of mental illnesses, which calls for considering International Classification of Diseases and Diagnostic and Statistical Manual of Mental Disorders phenotypes as culture-bound syndromes.[ 47] In appreciation of the same argument, imposition of a particular diagnostic system on a different cultural setting has been questioned by many.[ 15] Similarly, many suggest that in case of Indian patients, an understanding of illness through a Vedantic model of psych seems more appealing in comparison to the Western constructs, as such an attitude has been transferred over generations.[ 16] Therefore, a knowledge of the history of psychiatry, especially from an Indian perspective becomes important and not just interesting, for who knows what truth the future might prove or end up agreeing upon.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Hoff P. Vol. 73. Berlin: Springer-Verlag; 2013. Emil Kraepelin und die Psychiatrie als Klinische Wissenschaft: Ein Beitrag zum Selbstverständnis Psychiatrischer Forschung. [ Google Scholar]

14. Weiss MG. Caraka Samhita on the doctrine of karma. Karma and Rebirth in Classical Indian Traditions. 1980:90-115. [ Google Scholar]

20. The Cultural Heritage of India. Ramakrishna Mission. Ramakrishna Mission, Institute of Culture; 2013 [ Google Scholar]

27. Bhore JC. Report of the Health Survey and Development Committee. 1946;3 [ Google Scholar]

33. O'Shaughnessy WB. On the preparations of the indian hemp, or Gunjah: [[ Cannabis indica their effects on the animal system in health, and their utility in the treatment of tetanus and other convulsive diseases. Prov Med J Retrosp Med Sci. 1843;5:363. PMC free article] [ PubMed] Google Scholar]

37. Ernst W, Mueller T. Cambridge: Cambridge Scholars Publishing; 2010. Transnational Psychiatries: Social and Cultural Histories of Psychiatry in Comparative Perspective c. 1800-2000. [ Google Scholar]

47. Kaplan HI, Sadock BJ. 1-2. Philadelphia: Williams & Wilkins Co; 1989. Comprehensive Textbook of Psychiatry. [ Google Scholar]

Articles from Industrial Psychiatry Journal are provided here courtesy of Wolters Kluwer -- Medknow Publications

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History of psychiatry: An Indian perspective

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A knowledge of history becomes important in learning the way concepts have evolved and how they are understood in different and conflicting traditions in psychiatry. Modern psychiatry and its history has always been observed through the prism of western ...

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Abhinaya Suresh- How can we reduce Prejudicial Attitudes towards the mentally ill?

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Abhinaya Suresh- How can we reduce Prejudicial Attitudes towards the mentally ill?

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Research shows that around 60-70 million people in India suffer from common mental disorders; stigmatization & financial barriers prevent timely treatment (Dr Ruchi Jain, Jaslok Hospital, ET CONTRIBUTORS, 2023).

The most common prejudice of people with mental illness is that they tend to cause harm and are very dangerous. A study published by Scarf, et. al. in 2020 looked at a recent example, the popular film Joker (2019), which portrays the lead character as a person with mental illness who becomes extremely violent. The study found that viewing the film "was associated with higher levels of prejudice toward those with mental illness."

It is very important for us to take initiatives to help reduce prejudice.

When people with mental illness share their lived experiences, it creates awareness to the society to empathize and prevent forming prejudices about them. This will also help them understand that not every person who has a mental illness is dangerous. Lived experiences also provide assurance to other people with mental illness by helping them realize that they are not alone.

Social media plays a very important role in creating awareness about mental health. When celebrities share experiences about their mental health and the steps they take to overcome their mental health related issues, people who look up to them get inspired to gain more knowledge about mental health and mental illness.

Encouraging the society to have a direct personal contact with people with mental illness, tends to reduce mental illness related stigma and helps in practicing empathy.

While creating awareness, language (the choice of words) is super important. One should be very cautious about the choice of words they use while addressing mental health issues.

Create awareness to help the society understand that mental illness, just like physical illness is equally important and that proper care and treatment is required for mental illness as well.

REFERENCE:

World Mental Health Day: ​60-70 mn people in India suffer from common mental disorders; stigmatisation & financial barriers prevent timely treatment (indiatimes.com)

Psychiatry.org - Stigma, Prejudice and Discrimination Against People with Mental Illness

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ROSHINI V GOPALAKRISHNAN – How can we reduce Prejudicial Attitudes towards the mentally ill?

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ROSHINI V GOPALAKRISHNAN – How can we reduce Prejudicial Attitudes towards the mentally ill?

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In India, stigma around mental illness persists, with many viewing it as taboo or a personal weakness, making it hard for people to seek help

Reducing stigma against the mentally ill in India isn’t an easy task. It requires a thoughtful and culturally sensitive approach. Public awareness campaigns, TV, radio, social media, and newspapers to educate people about mental health and share inspiring stories. A few students shared their thoughts on mental illness and care. Ajay: “Mental illness has improved recently, but most Indians still hold traditional views and don't understand it. I wouldn't ask for help from family or others because I fear being scrutinized.” Mahendra: “There were around 3-4 suicides in my college consecutively. The mental health help provided wasn’t taken seriously, and people avoided sessions, thinking they could handle it themselves.” This shows the fear of judgment in seeking help and the insufficiency of current mental health awareness efforts.

To tackle such issues, we need to step up. The use of media to share real stories of recovery and educate folks about mental health. Schools and colleges need to start talking openly about mental health in their classes to make it less of a taboo. It's crucial to get local leaders on board to change how communities think about mental health. It is also important we train healthcare workers to treat mental health with care and make those services easier to access and to tighten up laws against discrimination and get more mental health support into workplaces.

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Mridhula : How to reduce prejudicial attitudes towards the mentally ill ?

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Mridhula : How to reduce prejudicial attitudes towards the mentally ill ?

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The following are some of the ways we can reduce the prejudiced attitudes towards mental health and the mentally ill-

Firstly, educating yourself about the nature and causes of mental disorders and getting to know and interact with people with mental disorders will help us to understand to view them as an individual for who they are rather than for the mental disorder which they have. And this education must start from the base root at home, that is with family members and then extend this education in the form of awareness to social circles through social media or post blogs in forums so as to break the stigma and misconception associated with mental disorders. This grassroots approach ensures that the message spreads organically and effectively within the community.

An individual can also share their own experience of mental illness if they have experienced it so as to encourage others to share their experience as well and to normalise having and living with mental disorders in the society. A study tracked more than 700 students across two years in a randomized controlled trial and found that watching videos of people sharing their personal experiences and videos with information on mental health improved students' mental health care access (da Conceição, et al 2023).

In educational settings, implementing anti-bullying programs specifically addressing mental health-related bullying can be effective. These programs should educate students on the negative effects of bullying, promote empathy, and teach conflict resolution skills. By increasing awareness, these initiatives can reduce ignorance and prejudice, fostering a more inclusive environment.

People with mental illnesses should be given equal opportunities in the workplace. This can be accomplished by launching awareness campaigns that educate employers, employees, and the general public about the capabilities and potential of people with mental illnesses, highlighting success stories of employees who have thrived despite their mental health challenges. These campaigns can break stereotypes by showcasing real-life examples and demonstrating that mental illness does not prevent people from contributing effectively at work. These campaigns can also include workshops and seminars to increase their impact.

References:

Da Conceição, V., Mesquita, E., & Gusmão, R. (2024). Effects of a stigma reduction intervention on Help-Seeking Behaviors in university Students: a 2019-2021 randomized controlled trial. Psychiatry Research, 331, 115673. https://doi.org/10.1016/j.psychres.2023.115673

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SUCHETA SRIVATSAN - Mental Disorders and their Treatments, The Indian Perspective

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SUCHETA SRIVATSAN - Mental Disorders and their Treatments, The Indian Perspective

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Mental Disorders and Treatments in Ancient Texts

The Atharvaveda describes ‘Manas’ as an instrument of hypnotism, and details will power, emotion and consciousness. The Vedas prescribe treatments including medicine, and preventive measures including behaviour control and physical activity.

The Tamil Tholkappiyam texts describe the psychophysiological aspects of emotion and classify them into 8 types, including laughter, wonder and fear. The Tamil-Buddhist text, Manimekalai, has a poem describing a man who displays symptoms fitting of schizophrenia.

Ayurveda describes mental disorders, referencing tridoshas and trigunas and state various causes of mental disorders including immoral behaviour and weak mind. In Ayurveda, over 200 herbs have been mentioned as treatments. Some categories are memory enhancers, antipsychotics and anticonvulsants.

Pre-colonial and Colonial India

During the reign of King Asoka, many hospitals were established for the mentally ill. There are also references to asylums in Khilji’s period. Although there is evidence showing the existence of mental asylums pre-colonial era, colonialism saw the upcoming of more mental asylums (firsts in Calcutta and Madras). The Lunacy Act, 1858, mentioned guidelines for establishment of asylums and admission processes. In an attempt to reduce stigma, in the 1920s, mental asylums were renamed mental hospitals.

Independent India and the Current State

Independent India, in the beginning, focused on control of communicable diseases. However, poor conditions in mental hospitals promoted opening of psychiatric wards in general hospitals. Some advancements include the National Mental Health Programme and establishment of prominent institutions such as NIMHANS. Current trends focus on deinstitutionalisation and outpatient care. India is slowly coming to recognise the importance of mental health and is promoting related services and working on de-stigmatisation.

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Dhanika - Historical origins and treatments of MD in India 

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Dhanika - Historical origins and treatments of MD in India 

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This essay examines the historical and sociological development of psychiatry in ancient India.

The study distinguishes two primary stages: 1)The  early Vedic Age (c. 1500 -  800 BCE)

2)The later Vedic Age (c. 800 - 600 BCE)

It describes how societal shifts affected the evolution of psychiatry from group-focused to individualistic methods, emphasizing the importance of the vaidya. The paper addresses the Western-centric perception of Indian psychiatry and highlights how crucial it is to incorporate political, social, and economic aspects for comprehending the history of psychiatry.

The study charts the transition in ancient India from mystical justifications for mental illness to more logical, materialistic theories. Early Vedic literature, including the Atharvaveda, describe mental illnesses as impacted by natural and supernatural forces and necessitating ritualistic treatments. Later Vedic psychiatry reflected wider social and economic shifts by concentrating more on endogenous and external imbalances in the individual.Mondal argued for a more complex view that takes into account social, economic, and political factors, criticizing the propensity to write off traditional Indian psychiatry as pseudoscientific. It also demonstrates how critical it is to acknowledge the historical contributions of traditional Indian psychiatry and incorporate these understandings into modern mental health procedures. This essay emphasizes how the vaidya's function has changed over time, going from that of a ceremonial specialist to one that is more grounded in science.

By integrating historical, social, and economic contexts, Mondal's work challenges Western-centric historiography and demonstrates the richness and complexity of ancient Indian psychiatry. It also offers a comprehensive understanding of the evolution of psychiatric practices in ancient India and advocates for a balanced perspective that incorporates modern scientific perspectives while respecting traditional knowledge.

Reference

https://nimhans.ac.in/wp-content/uploads/2020/10/2.-Psychiatry-in-Ancient-India-Towards-an-Alternative-Standpoint_167-199.pdf

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Sri Manasveni: Reduction of prejudicial attitudes in persons with mental illnesses

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Sri Manasveni: Reduction of prejudicial attitudes in persons with mental illnesses

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Factors driving prejudicial attitudes against people with mental illness:

Superiority complex over those suffering from mental illnesses

Lack of understanding concerning the concept of mental disorders

The role of media in wrongthe ful portrayal and promulgation of harmful stereotypes about mental disorders

Socially perceived inefficiency of individuals suffering from mental illnesses, even when they prove themselves worthy of opportunities

Their identity is reduced to their illness

Attitude reversal:

Spreading awareness: There have been considerable attempts at spreading awareness, but the lack of efficiency of these measures may be attributed to the generational gap in the reach of awareness regarding mental disorders. It is commonly seen that while the youth are more informed in this sense, older generations lack this understanding. So a more holistic approach has to be taken, to reduce stigma throughout generations.

Fair and equitable opportunity dispensation: The general stigma around mental illnesses and the perpetuation of inaccurate stereotypes by mass media have been influential in the neglect of persons with mental illnesses in the job market. Employers’ perceptions, hostility in the work environment, etc act as factors that not only promote inequity in the dispensation of jobs, promotions, incentives etc but also influence the internalization of prejudicial attitudes in people with mental illnesses. Legality must be involved in this matter, as this is no more niched, but a general violation of human rights.

Effective use of media: using media such as movies to propagate factually accurate messages regarding mental illnesses can be an integral step, in an age where movies such as Anniyan, Atrangi Re etc have promoted false stereotypes regarding mental illnesses.

Politicizing rights for persons with mental illnesses: As seemingly radical as this suggestion is, it has worked historically. Appearing homogenous regardless of religious identity, the rights of oppressed Muslim citizens, Jallikattu, etc were never paid heed to by the entire nation until they were politicised in the form of the Uniform Civil Code, Citizenship Amendment Act, Jallikattu protests, etc. At the risk of giving rise to polarized values, this may be the most effective way to vocalise the concerns of persons with mental illnesses. This is also the only way to increase legal involvement in the protection of their rights.

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HISTORY OF INSTITUTIONS AND INSTITUTIONALISATION IN INDIA - VEERAGANTA SREE THARINI

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HISTORY OF INSTITUTIONS AND INSTITUTIONALISATION IN INDIA - VEERAGANTA SREE THARINI

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As mentioned before, mental asylums were mostly a British concept. Except for a few institutions scattered in time across various parts of India, the institutions and institutionalization were introduced to India in the colonial era. The institutions were initially started for European soldiers only but later went on to treat the local population too. The following are the 5 phases of development of mental institutions in India

FIRST PHASE

Some of the first mental asylums (Calcutta (1787), Kilpauk(1794) and Monghyr (1795)) were established during this period with the sole guiding principle of separating the mentally ill patients from the society.

SECOND PHASE

The first Lunacy Act (1858) was promulgated which mentioned guidelines for establishment of asylums and their admission procedures. Several new asylums were built in places such as Patna, Dacca, Calcutta, poona, Agra, etc.

THIRD PHASE

These institutions were overloaded which led to deterioration in services along with the health and hygiene of these places.

The introduction of Indian Lunacy Act in 1912 further refined and systemized the admission, treatment, and discharge procedures of the mentally ill with the introduction of the provisions for voluntary boarder admissions.

FOURTH PHASE

In a bid to promote the illness model and to reduce stigma, the “asylums” were renamed as “mental hospitals” in 1920. Occupational therapy and rehabilitation were stressed on as a core issue with respect to mentally ill. The Bhore committee health survey for the first time surveyed and made recommendations for mental hospitals.

FIFTH PHASE

A series of conferences were held in Agra (1960), Ranchi (1986), Bangalore (1988), Delhi (1995), and Bangalore (1999), in which the state of existing mental hospitals were reviewed and recommendation for their improvement were made. Considering the experience of the Indian Lunacy Act, 1912 as outdated, The Mental Health Act, 1987 came into force from 1993.

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Conceptualisation of mental illness in India - VEERAGANTA SREE THARINI

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Conceptualisation of mental illness in India - VEERAGANTA SREE THARINI

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Vedanta philosophy conceptualizes Atman as the core of personality which is the prime control of the mind, body, and intellect, but “Vasanas” (inherent tendencies) determine nature and activities originating from them. Upanishads understood the mind “more from within than from without.”

Atharvaveda describes “Manas” as an instrument of hypnotism and talks in details about will power, emotion, inspiration, and consciousness.

“Unmad” (psychosis) has been mentioned as a deluded state of mind in Vedas with etiology suggestive of both organic and functional origin.

Vedas also mention treatment for mental disorders ranging from psychosis, epilepsy, sleep disorder, and aggression in the form of “Bheshaj” and prayers to God, along with preventive methods such as “Yam” and “Niyam” and “Asan” and “Pranayam”.

Ichchha Shakti & Kriya Shakti and Jnana-Shakti were described by them as the three mental potencies, and the psychopathology was understood by Trigunas and Tridosas.

Buddhism and Jainism (around 6th century AD) brought in the philosophical systems (Nyaya, Vaiseshika, Samkhya, Yoga, and Vedanta) following which medicine separated from the magicoreligious tradition and entered into an alliance with these philosophical systems.

Earliest evidence of attribution of mental illness to demons and treatment by magic and occult practices was note in the Indus valley period (around 1500 BCE).

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Srithi Sriram, Strategies to reduce prejudicial attitudes towards the mentally ill

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Srithi Sriram, Strategies to reduce prejudicial attitudes towards the mentally ill

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Reducing prejudicial attitudes towards the mentally ill is an important step in addressing the stigma and discrimination they often face.

strategies to help reduce such prejudices are:

1.Increasing public education and awareness about mental illness can help challenge negative stereotypes and misconceptions by incorporating mental health campaigns, posters and create awareness through social media. This can involve sharing accurate information about the causes, symptoms, and treatments of different mental health conditions by referring to proper sources.

2.Promoting positive and personal contact with individuals living with mental illness has also been shown to be effective.

3.Addressing self-stigma(the negative attitude that people with mental illness may have about their own condition) is crucial, as people with mental illness may internalize negative societal attitudes. Providing support and empowering those affected can help build self-acceptance and resilience.

4.Policy changes like enacting anti-discrimination laws and implementing programs which is mentioned in the mental health act,2017 to increase mental health literacy in communities can help reduce prejudice at a systematic level.

A multi-pronged approach targeting individual, interpersonal, and societal levels is needed to meaningfully reduce prejudicial attitudes towards the mentally ill. Sustained efforts over time are required to shift deep-seated negative biases.

REFERENCES

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360426/

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Abinaya P, Historical Origins & Treatment of MD in INDIA 

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Abinaya P, Historical Origins & Treatment of MD in INDIA 

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The ancient texts of Vedic India contain some of the earliest descriptions of mental illnesses. The Charaka Samhita by Charaka and the Sushruta Samhita by Sushruta laid the foundation for modern Indian medicine. The Atharva-Veda associated mental illness to divine curses and provided descriptions of conditions related to schizophrenia and bipolar disorder. Traditional medical systems like Siddha recognized various mental disorders, mainly in southern India. The great epics, the Ramayana and the Mahabharata, referenced mental disorders (grief, depression, existential crisis)and coping mechanisms, while the Bhagavad Gita showed crisis intervention psychotherapy.

Ayurveda contributed significantly to understanding the diet-disease relationship and the association of disease with specific physical constitutions. Diagnosis in ancient times involved the five senses and interrogation, focusing on cause (nidana), premonitory signs (purva-rupa), symptoms (rupa), therapeutic tests (upashaya), and the disease's natural history (samprapti). Sushruta emphasized that successful therapy relies on four pillars: the physician chikitshak, the drug -dravya, the attendants- upasthata, and the patient -rogi.

Indian physician Najabuddin Unhammad introduced the Unani system of medicine, identifying types of mental disorders including schizophrenia (Sauda-a-Tabee), depression (Muree-Sauda), and delusion of love (Ishk). Psychotherapy in Unani medicine was termed Ilaj-I-Nafsani. The sage Agastya authored 'Agastiyar Kirigai Nool,' detailing 18 psychiatric disorders and their treatments. Charaka Samhita outlined hospital attributes, including location, equipment, food, cleanliness, and conduct for medical staff.

Indian psychiatry evolved from beliefs in sin and witchcraft causing mental illness to the advent of psychoanalysis and community psychiatry.

Reference:Mishra A, Mathai T, Ram D. History of psychiatry: An Indian perspective. Ind Psychiatry J. 2018 Jan-Jun;27(1):21-26. doi: 10.4103/ipj.ipj_69_16. PMID: 30416288; PMCID: PMC6198594.