Mental health in India

There is a sharp contrast between Western invented indicators to describe mental health services and the prognosis of 'severe mental illness' (schizophrenia).

WHO World Mental Health Atlas gives the following facts:

Psychiatric Beds and Professionals
Total psychiatric beds per 10 000 population 0.25
Psychiatric beds in mental hospitals per 10 000 population 0.2
Psychiatric beds in general hospitals per 10 000 population 0.05
Psychiatric beds in other settings per 10 000 population 0.01
Number of psychiatrists per 100 000 population 0.2
Number of neurosurgeons per 100 000 population 0.06
Number of psychiatric nurses per 100 000 population 0.05
Number of neurologists per 100 000 population 0.05
Number of psychologists per 100 000 population 0.03
Number of social workers per 100 000 population 0.03
There are 200 mental health workers of other types. One third of mental health beds are in one state (Maharashtra) and several states have no mental hospitals. Some mental hospitals have more than 1000 beds and several still have a large proportion of longstay patients. During the past two decades, many mental hospitals have been reformed through the intervention of the voluntary organizations (e.g. Action Aid India), media, National Human Rights Commission and judiciary (courts), and yet a survey in 2002 showed that about a quarter had shortages in terms of drugs/treatment modalities and three quarters in terms of staff. The current emphasis is on general health psychiatry units that support voluntary admissions and encourage family members to stay with the patient. Some beds are allocated to treatment of drug abuse and for child psychiatry. Very few mental health professionals are based in rural areas. Most states allow public sector psychiatrists to have private clinics. Many mental health professionals have emigrated. (World Mental Health Atlas 2005 http://www.who.int/mental_health/evidence/atlas/profiles_countries_e_i.pdf)

In contrast to the above poor image is the prognosis of schizophrenia.
"...the prognosis of certain mental disorders, e.g. schizophrenia, is better in developing countries. It is vital to identify factors that make it so, and the changing role of family, urbanisation and rapid Westernisation, especially with economic liberalisation and the influence of satellite television, cannot be underestimated. As the editor of the Journal under review asks in his editorial, "Are some of our problems like increased social unrest, waves of agitations and protests, the menace of drug abuse and the arrival of the dreaded evil of AIDS due to rapid social change? Could it be that technological growth has not only provided prosperity to a few but the parallel boom in telecommunications and information technology has brought into sharper focus
the economic disparity and the gulf between the rich and the poor?". These are relevant questions from the perspectives of the psychiatrist, not only in India but also in developed and other developing countries." (DINESH BHUGRA, Indian Journal of Social Psychiatry Vol. 8 3/4)

Then comes my question: is it acceptable to promote Western mental health and psychiatry without criticism while ignoring the fact on better prognosis in the name of right to health? What human rights are at stake? Who listens to users of services and their movements?

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