The Hindu : Kerala / Kochi News : State lacks a premier mental health institute

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Monday, Oct 06, 2008
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Kerala

Kerala - Kochi

State lacks a premier mental health institute

Shyama Rajagopal

An Institute of Mental Health and Neurosciences was set up in Kozhikode in 1982. But, till date, IMHANS does not have its own campus or even its own office.

Kochi: Lack of a premier institute for mental health is a major lacuna in the State’s plans and policies on the issue. Experts opine that a State which has the highest number of suicides, alcoholics and an ageing population, with perhaps depression disorders or anxiety disorders, needs to focus on providing better mental health facilities in the State.

An Institute of Mental Health and Neurosciences (IMHANS) was set up in Kozhikode as an autonomous body in 1982 and it started functioning in 1984. But, till date, IMHANS does not have its own campus or even its own office. The administrative office functions in a three-room building allotted to IMHANS after the intervention of the High Court. The rehabilitation centre functions in a dilapidated old building on the mental hospital campus. Even these buildings are under the control of the Superintendent of the Mental Health Centre and are allotted to IMHANS on temporary basis and the director has no control.

While the National Mental Health Programme, with scanty funding, is being implemented in four districts of the States —Wayanad, Kannur, Idukki and Thiruvananthapuram, the State requires more than that.

Presently mental health care in Kerala centres on the three mental hospitals at Thiruvananthapuram, Thrissur and Kozhikode and few psychiatric beds attached to medical colleges and a few district hospitals.

The total mental health beds are 1,714.

The number of psychiatrists per 100,000 people in Kerala is 0.77 only whereas in the developed world it is around 4 per 100,000 people.

The number of clinical psychologists and psychiatric social workers and psychiatric nurses are even less.

For example, the Health Services in Ernakulam district has only two psychiatrists, of which one is not posted in the specialty. Only the District General Hospital has a psychiatrist in the specialty cadre.

Ideally, there should be at least two mental health units in the district, said Dr. Thomas John, Secretary of the Ernakulam Psychiatric Society (which includes psychiatrists in Idukki, Alappuzha and parts of Thrissur).

He said that according to the World Health Organisation, depressive disorders will come to the forefront of diseases by 2020.

This is perhaps where the theme of the World Mental Health Day observed on October 10, comes into focus. This year the World Mental Health Federation has called for “making mental health a priority, scaling up services, citizen advocacy and action”.

Psychiatrist C. J. John says that availability of psychiatrists in Kerala is much better than other States in the country, though it is still rather inadequate if one considers the WHO’s estimate of about 12 per cent of the world’s population requiring some kind of treatment for mental health.

He said that the State’s high level of literacy combined with advocacy by some socio-cultural leaders have perhaps given a small boost to the mental health facilities but the stigma continues to surround the people going in for treatment.

A citizen advocacy is required to make the people take the right medical help similar to people taking up help for other ailments.

And to help the people, one requires more trained people, said Dr. John.

Dr. P. Krishnakumar, director IMHANS, said that epidemiological data on mental health problems in Kerala is scant. This is essential for planning strategies for prevention and policy making. The available data on mental health problems are based on western studies.

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