History of Psychiatry in India

By Nizamie, Haque; Goyal, Nishant | Indian Journal of Psychiatry, September 2010 | Go to article overview

History of Psychiatry in India


Nizamie, Haque, Goyal, Nishant, Indian Journal of Psychiatry


Byline: Haque. Nizamie, Nishant. Goyal

History is a screen through which the past lightens the present and the present brightens the future. Psychiatry by virtue of its ability to deal with human thoughts and emotions and provide a pathway for healthy minds provides an important platform towards being a mentally sound human being and largely the society. This review takes a sneak peek into the foundations of modern psychiatry in India. The description is largely based on the time frame, which provides a better understanding of the factual information in each period starting from the Vedic era and culminating in the post independence period.

Introduction

0Mental Health by virtue of its ability to deal with human thoughts and emotions, and to provide a pathway for healthy minds is a vital resource for our development, and its absence represents a great burden to the economic, political, and social functioning of human beings, society and nation. [sup][1] The scope of mental health is not only confined to the treatment of some seriously ill persons admitted to mental health centers, rather it is related to the whole range of health activities. [sup][2] India has developed an endogenous, alternative body of knowledge which is more suited to Indian conditions. [sup][3]

History is a screen through which the past lightens the present and the present brightens the future. The ancient Indian thought emphasized the theory of unity of body and soul and also explained how to deal with health and mental health problems in a psychosomatic way. [sup][4] A concern with mental health has long been a part of Indian culture, which has evolved in a variety of ways, attempting to understand and negotiate psychological disorder. [sup][5] This review takes a sneak peek into the foundations of modern psychiatry in India which has sailed through tides of time across the world.

History of World Psychiatry: A Prelude

The occurrence of mental illnesses has been identified and documented since ancient times. The earliest predecessor of mental hospitals on record was a Greek sanctuary at Epidauros. The fourth century AD witnessed the establishment of institutions solely for the mentally ill in Byzantium and Jerusalem. [sup][6] Thereafter, Christian and Muslim religious orders established places of refuge for the mentally ill and patients were treated by a variety of procedures with a religious coloring. The first psychiatric hospitals were built in the medieval Islamic world from the 8 [sup]th century. In the early 8 [sup]th century, the first hospital was built in Baghdad (705 AD) followed by hospitals built at Fes and Cairo. [sup][7] The first major modern mental hospital, the Bethlehem Hospital, was started/opened in 1247 in London. By the late 18 [sup]th century, the condition of mentally ill patients in these institutions was one of neglect, restraint and abuse with poor clothing, unhygienic conditions, poor nutrition, restricted movements due to chaining of hands, feet and lack of stimulation, largely contributed to by scarcity of funds, lack of interest among the ruling aristocracy and over-crowding of mental hospitals. [sup][8]

In the late eighteenth and early nineteenth century, Pinel revolutionized care of the mentally ill by propagating a humane approach to care. Around the same time the York retreat was established by William Tuke to provide a kind and tolerant approach towards the mentally ill. Dorothea Dix proposed setting up of State run hospitals for treatment of the mentally ill based upon Pinel's moral approach. [sup][6] Mid 1950s saw emergence of two major forces which influenced the evolution of modern psychiatry as specific drugs like chlorpromazine were discovered for treatment of mental illnesses; the second being the antipsychiatry movement led by the likes of Goffman, Szaz and others, which along with the economic recession were motivating factors for deinstitutionalization of mentally ill persons and the evolution of the concepts of community psychiatry.

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