What is mental health?

Mental health refers to behavioural, cognitive and emotional well-being. It is a pivotal resource for our development and its absence can create a huge burden to the economic, political and social functioning of human beings, society and nation.

To convert this liability into an asset, mentally-abled people have been going under treatment since ancient times. The only difference is that earlier patients were treated by a variety of procedures with a religious colouring. The first mental hospitals were built in the medieval Islamic nations namely, Baghdad (705 AD), followed by Fes and Cairo in the early eighth century. But by the 18th century, the condition of the mental institutions situated all over the world was deteriorating. Due to the lack of interest among the ruling aristocrats of that time, the mental hospitals were facing shortage of funds which resulted in chaining patients, keeping them under unhygienic conditions, giving low level of nutritious food and providing poor clothes. Finally, in the late eighteenth and early nineteenth century, Philippe Pinel revolutionised the care system for mentally-abled by promoting a humane approach.

Lunatic asylums in ancient and medieval India

As per the scribes of Asoka Samhita, many hospitals were set-up for mentally-abled people during the reign of King Asoka. There is no evidence for the development of mental asylums in the period of the Mughal but there are proofs of some asylums were established during the period of Mohammad Khilji (1436-1469).

Some weak documentary evidences claim that modern hospitals and modern medicines were first brought to India by Portuguese in Goa during the seventeenth century.

Mental Hospitals in British era

The earliest mental hospital was established at Bombay in 1745, which could accommodate only 30 mentally-abled patients. The first government run lunatic asylum was set-up, especially for insane soldiers, at Monghyr in Bihar on 17 April 1795. During that period, excited patients were treated with opium, hot baths, sometimes, leeches were applied to suck their blood and even music was also used as a mode of therapy to calm down them.

The mid-colonial period (1858-1918) witnessed a steady growth in the development of mental asylums. Techniques which were developed and implemented in the west were also used in India during that time. And in 1858, the first Lunacy Act was enacted.

Under the Indian Lunacy Act 1912, a European Lunatic Asylum was built in Bhowanipore for European patients, which later closed down after the establishment of the European Hospital {now known as the Central Institute of Psychiatry (CIP)} at Ranchi in 1918. Unlike other mental hospitals, this institute never chained its patients, they all are free to roam within the boundary of it, a library is situated in it where books in English, Hindi and Bangla are available to read, music system is there, patients play football and women engage themselves in sewing, embroidery and other household chores. Probably, that’s why many prominent personalities in the past chose to treat themselves in this institution. They are Asrar ul Haq Majaz (an Indian Urdu poet, known for writing romantic and revolutionary poetry), Kazi Nazrul Islam (another revolutionary poet, musician and writer) and a few more.

Then in 1946, a health survey and development committee, known as the “Bhore Committee,” surveyed mental hospitals. The committee advised improvisation and modernization of most hospitals. Based on the recommendation of this committee, All India Institute Mental Health was set up in 1954, which later became the National Institute of Mental Health and Neurosciences (NIMHANS) in 1974.

Mental Health institutions in independent India

A new phase of development in mental hospitals began after 1947. The newly formed government started focusing more upon the building of general hospital psychiatric units (GHPU)  than constructing mental hospitals. In addition to this change, emphasis was placed upon improving conditions in existing hospitals.

Another innovative changes were seen in traditional institutions like CIP and Madras Mental Hospital. They started offering specialised services such as child and adolescent clinics. But CIP marked itself different from other asylums by coming first in many research work. Like it started Department of Clinical Psychology in 1949 which happens to have the first clinical psychology laboratory in the country.

Touching new heights

Around 1970s, the focus of mental health care shifts from mere medicinal treatment to combating stigma and widening social networks of patients for a successful rehabilitation because earlier, the recovered people were not welcomed socially which put them back into that depressing phase.

The last three decades have seen innovations in neurosciences, epidemiology and therapeutics and most importantly with it, there is a parallel growth in showing support towards those who are recovering and those who have recovered.