Mental Health Limits, Priorities and Psychoethics

T h e Congress this year is memorable because it marks the incoming of its Lady President and those ladies who had gone before me were very prestigious women doctors who we:e the torch bearers of the Indian Psychiatric Society; it is memorable also because it is being held in Bombay which is hailed as the New York of India , beset with beauty, business and bustling activity. T h e intervening years have been kind to us. They have seen a tremendous growth in the Association under the leadership of others from a mere handful of members to a very encouraging current figures. Even though there have been a few ups and downs, displeasure and disappointments yet all these years have slowly slipped by making its mile-stones of progress due to the unflinching endeavours of its offke-beaiers and I am proud to know tha t my n a m e too would go down in the annals of the history as one of its presidents. Currently I a m glad to say that there have been impressive change? in Psychiatry. T h e number of Psychia trists and para-professionals involved in Mental Health programme have increased and the nature of services delivered have also improved after opening depar tment of Psychiatry in few of the general hospitals a t tached to Medical Colleges. A basic amou.it of Psychiatric knowledge is being imparted to medical students and majority of the institutions do have post-graduate courses in Psychiatry. Yet while institutions which were little more than warehouses for the unloved, uncared a n d unwanted and discarded personalities have virtually disappeared almost all over the western world, we still have Menta l Hospi tal with poor staff pat ient ra t io and at times run by non-psychiatrist. Wi th a modest improvement in public a t t i tude towards menta l illness mere and more patients a r e reaching the portals of a mental hospital which remain illequipped; poorly staffed and no one seems to take cognisance of the increased demand for Psychiatric services. T h e growth and improvement of these hospitals a re a t a very low ebb due to problem of heal th care financing and due to a long range of tiresome, unfulfilling, frustrating rules, Government policies and paper-work. T h e future of Psychiatry in our country still looks bleak and clouded, though we have come a long way in other medical fields. T h e criticism levelled against Psychiatrist and Psychiatry is iconoclastic and Psychiatry in India still faces crisis, criticism, controversy and confusion.