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 Table of Contents  
EDITORIAL
Year : 2021  |  Volume : 37  |  Issue : 4  |  Page : 341-342

Leadership for mental health


1 Gupta Mind Healing and Counselling Centre, Chandigarh, India
2 The Association for the Mentally Challenged, Bengaluru, Karnataka, India

Date of Submission10-Nov-2021
Date of Acceptance10-Nov-2021
Date of Web Publication25-Nov-2021

Correspondence Address:
Dr. R Srinivasa Murthy
Project ENRICH, Mental Health Advisor, The Association for the Mentally Challenged, Bangalore-560078, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_324_21

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How to cite this article:
Gupta N, Murthy R S. Leadership for mental health. Indian J Soc Psychiatry 2021;37:341-2

How to cite this URL:
Gupta N, Murthy R S. Leadership for mental health. Indian J Soc Psychiatry [serial online] 2021 [cited 2021 Dec 8];37:341-2. Available from: https://www.indjsp.org/text.asp?2021/37/4/341/331133



In human history, cataclysmic events have brought forward major social changes, and there are many instances in recent history. One such event in the 20th century that brought mental health into focus was the Second World War. The National Institute of Mental Health, USA was the product of recognition of the importance of mental health of the general population and army personnel.

Currently, the whole of humanity is living through massive challenges to all aspects of life, in the form of the COVID-19 pandemic. Everything which one took for granted has been brought for reconsideration and shockingly countries, both rich and poor, have experienced similar disruptions of their lives and livelihoods. An important outcome of this pandemic experience is the recognition of the vulnerability of all people-both in their bodies and minds (“wounded bodies and wounded minds“). The mental health pandemic is a “much talked about” topic of discussion in all sectors of the society, and is a ripe setting for leadership to emerge. At another level during the last three centuries leaders like Philippe Pinel, Dorothea Lynde Dix, Clifford Beers, Sigmund Freud, to name a few, took the profession to a different level by developing an understanding of mental disorders and humanizing the care for persons with mental disorders.

In India, during the last 75 years of psychiatry, a number of professionals have been pioneers in redefining psychiatric practice in India[1] Such leadership helps to bring major advances in the community. In this editorial, we want to make an attempt at recognizing the importance of leadership by discussing a few of such leaders (the list being representational, and not a comprehensive one) in the fields of social psychiatry, community psychiatry, and rehabilitation.

One of the important developments has been of the General Hospital Psychiatry Units as the primary places for providing mental health care. The other development of importance has been the Community Psychiatry movement, spearheaded by Dr. NN Wig of Chandigarh and Dr. RL Kapur of Bangalore who moved mental health care from hospitals to clinics and into the community. The bold assertion of Dr. Wig, “Mental health is too important to be limited to mental health professional“ in 1989 was prophetic.[2] In the last decade we have seen how mental health has been taken up by a wide range of personnel, who would not be thought of as mental health professionals where basic mental health interventions can be provided through a brief training of the community members;[3] additionally the concept of “scaling up” of services and “task sharing” was advocated by Eaton et al.[4] and successfully implemented in the care for people with schizophrenia in India (COPSI) Trial.[5] Finally, in the area of rehabilitation, Dr. Sarada Menon spearheaded the movement related to rehabilitation psychiatry.

The city of Chandigarh is a symbol of modern India. It has many firsts to its credit. The one area in which it has been relatively ahead of the rest of the country is that of social and community psychiatry and rehabilitation. It will not be an exaggeration to recognize that Chandigarh is ahead of any other city in terms of both the range and coverage of community-level mental health services. Starting from the Raipur Rani work in the mid-1970s,[6] to the Home Based Treatment Services,[7] and the DART-based rehabilitation work[8] as part of the Urban Mental Health Model, there is much that can be learned by the rest of the country from Chandigarh.

In this context, one of the leaders of recent times, whom we lost prematurely, is Dr. BS Chavan, who was Professor and Head, Department of Psychiatry, Government Medical College Hospital-32, Chandigarh at the time of his untimely demise.[9],[10] He took the concepts of, and ideas related to, community care to a higher level by creating a wide range of social and community psychiatry and rehabilitation services, tried to empower the caregivers and persons living with mental disorders, with the active involvement of the politicians and planners to scale up interventions and most importantly document the initiatives to provide leadership to others to take up similar initiatives.[11]

Section A of the journal, consisting of 6 papers and the 3 book reviews, provides a vivid understanding of the role of leadership in social psychiatry and rehabilitation. We, on behalf of the profession, pay respect to all other leaders (including Dr Chavan as his 1st death anniversary, i.e. 4th December, coincides with the bringing out of this issue). The six perspective papers cover the areas of substance abuse services, the role of voluntary organization, the caregiver movement, vision for comprehensive care of persons with developmental disabilities, rehabilitation services, and home care programs. They provide overviews of the selected areas, present the progress in the specific areas, and identify the tasks for future. The three book reviews focus on the individual leadership of Dr. Sharada Menon and Schizophrenia Research Foundation, the collective force of caregivers, brought together by Mr. Amrit Bakhshy's book on caregiving, and the community life of persons with disabilities (Gifted) which presents the leadership opportunities of persons with disabilities, families, community, mentors, policymakers, and every one of us in the society to improve the lives of persons with disabilities.

In the final analysis, leadership can be conceptualized as akin to a lighthouse that guides the ships to their destination and helps to avoid obstacles. There are a few common characteristics of leaders in the field of mental health. First, the high personal commitment to the larger cause of mental health. Second, the ability to see the bigger picture, vision, against the background of the day-to-day work. Third, to use innovation as a way of bypassing the barriers and reach the goals. Fourth, to work with a range of disciplines, groups of people and bring them to a common platform. Fifth, to convert ideas to visible services that change the lives of people. Sixth, to document so that the experiences can become stepping stones for future initiatives. Finally, most importantly, maintain their commitment to care when others do not necessarily share their vision for changes.

We are confident that there will be many leaders like the ones we have mentioned, in future, to take “Social Psychiatry,” “Community Psychiatry,” and “Rehabilitation” to greater heights and to ensure better quality of life for persons living with mental disorders and their caregivers, and toward a more mentally healthy society.

Last but not the least, Section B of this issue also has 11 papers related to a wide range of current issues of importance related to “Community Psychiatry“, and “Rehabilitation“. These contributions illustrate the commitment of the professionals to address the new challenges by conducting systematic studies and innovative interventions.

We hope this special issue on “Community and Rehabilitation Psychiatry” will inspire more innovations and the emergence of leadership in a number of areas of mental health across the country.



 
  References Top

1.
Srinivasamurthy R. From local to global – Contributions of Indian psychiatry to international psychiatry. Indian J Psychiatry 2010;52 Suppl 1:S30-7.  Back to cited text no. 1
    
2.
Wig NN. The future of mental health in developing countries. Community Ment Health News 1988;13-14:1-4.  Back to cited text no. 2
    
3.
Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T, et al. Global priorities for addressing the burden of mental, neurological, and substance use disorders. In: Patel V, Chisholm D, Dua T, Laxminarayan R, Medina-Mora ME, editors. Mental, Neurological, and Substance Use Disorders. Disease Control Priorities. 3rd ed., Vol. 4. Washington, DC: World Bank; 2015. p. 1672-85.  Back to cited text no. 3
    
4.
Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, Araya R, et al. Scale up of services for mental health in low-income and middle-income countries. Lancet 2011;378:1592-603.  Back to cited text no. 4
    
5.
Chatterjee S, Naik S, John S, Dabholkar H, Balaji M, Koschorke M, et al. Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): A randomised controlled trial. Lancet 2014;383:1385-94.  Back to cited text no. 5
    
6.
Wig NN, Murthy RS, Harding TW. A model for rural psychiatric services-Raipur rani experience. Indian J Psychiatry 1981;23:275-90.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Tyagi S, Gupta N, Chavan BS, Kaur H, Sharma V. Delivery by “trained hospital-based health workers” of “family psychoeducation package” to caregivers of patients with schizophrenia through “task-sharing” strategy. World Soc Psychiatry 2019;1:70.  Back to cited text no. 7
  [Full text]  
8.
Gupta N, Chavan BS, Rao GP, Kumar P. Various facets of community care and the interface of private and academic psychiatric practice. Indian J Psychiatry 2016;58:S14.  Back to cited text no. 8
    
9.
Professor B S Chavan, MD, DHM, FAMS, FIMSA (1961–2020). Indian J Soc Psychiatry 2020;36:366-7.  Back to cited text no. 9
    
10.
Gupta N. Professor BS Chavan: The ever optimist. Indian J Soc Psychiatry 2020;36:365.  Back to cited text no. 10
  [Full text]  
11.
Basu D. Prof. B. S. Chavan – A life well lived. Indian J Soc Psychiatry 2020;36:368-9.  Back to cited text no. 11
    




 

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