Dr T. S. Jaisoorya Consultant Psychiatrist in Co-operative Medical College, Kochi.

INTERVIEW

The World Health Organisation [WHO] commemorates October 10 as World Mental Health Day. The theme of the year 2007 was mental health in changing circumstances. Data suggest that the proportion of people affected mental health in Kerala is double the national average [128 people/one lakh people].

Dr T. S. Jaisoorya is currently working as a Consultant Psychiatrist in Co-operative Medical College, Kochi. He completed his MBBS from T. D. Medical College, Alappuzha and his M. D. in Psychiatry at NIMHANS, Bangalore. Following this he went to UK to finish his overseas training and was awarded MRCP. During the period of overseas training he was awarded the Daniel Cappon Proxime Accesit from Imperial College London in 2005 & Royal Society of Medicine – Psychiatry Sub-section award in 2006. He has produced research publications both nationally & internationally. His special interest is mental health of children & adolescents.

In an interview to Sreeni K.R, Dr. T. S. Jaisoorya talks about the aspects of sufferings of the vast millions who are afflicted with a variety of mental illnesses.

The World Health Organisation [WHO] Commemorates October 10 as World Mental Health day? What is the theme for the year 2007?
The World Health Organisation and the World Federation of Mental Health have been commemorating October 10 as World Mental Health day. Every year the theme varies, in an attempt to focus attention on the varying aspects of sufferings of the vast millions who are afflicted with a variety of mental illnesses. This year the theme has been Mental Health in a changing world: the impact of culture and diversity.

What is the impact of changing culture and tradition on the minds of people?
The recent years have seen rapid changes in the way people think and perceive. The social changes have turned people inward. Most people see life as ‘my, me, myself’. They fail to see & feel the distress of their fellow beings & even when they do, they have little time to spare. This has left most people vulnerable in the face of vagaries of life.

As far as Kerala is concerned what is the stress level on the average Keralite?

The recent socio-economic changes have significantly increased the stress of the average Keralite. Life is increasingly being examined on a purely materialistic standpoint. This has left the average man equating his happiness on his earning and spending power. Often this leads to frustration and disappointment. The materialism has also meant the social systems are nuclear and isolative. Families are disintegrating owing to varying aspirations. All these have contributed to increased stress levels.

Kerala has achieved impressive records in regarding education and mental health. Inspite of this, the proportion of people affected with mental illness is double in comparison to the national level. What are the reasons ?

Kerala has fostered a material culture in the background of social nuclearisation. In the pursuit of materialistic pleasures, the old and the young are living in emotional isolation. Mass suicides as a consequence of pursuit of unachievable materialism are increasing. Marriages are failing like never before. Alcoholism is rampant and considered culturally appropriate. Inspite of all this, mental health has had low priority in our society. Many continue to view mental illness as a character defect. There is very little care available in the community. This is further complicated by the stigma and lack of social supports. The government policy lacks sincerity. All this has turned out to be a recipe for disaster. This is reflected in the high prevalence of mental illness in our state.

What are the impacts of nuclear family in society?
Nuclearisation, in the social system, like all things, have had its benefits and drawbacks. It has ensured rapid economic advance. The small family has helped achieve health and social standards that are comparable to developed countries. Yet it has also resulted in the lack of social integration, limited social supports and materialistic drives, which is pushing the social system to the brink.

Could you explain why there has been increase in divorces among the younger generation?
There has been a significant increase in divorce rates in recent years. This has been closely linked to the social changes. Moral values are slowly receding. The young are aping the west. Individualistic values have taken priority over family commitments. In addition, alcohol consumption, long working hours, tendency to live away owing to work patterns, stress levels have all contributed to the rising divorce rates. On the brighter side, economic independence of women has ensured that they view divorce as an alternative to an unhappy marriage.

Alcohol consumption in Kerala is startling when compared to the national level. Explain?
Alcohol consumption has increased substantially in recent years. Its acceptance is spreading to the extent that it is considered an unavoidable aspect of every social gathering. The government policy of considering alcohol only as a means to fill its coffers is not helpful. The government led Beverages Corporation has outlets in every nook & corner of the state, ensuring continuous availability of alcohol. There is also limited awareness of the deleterious physical and psychological consequences of alcohol use. All this has resulted in an alarming increase in use of alcohol.

Suicide rates in Kerala are startling. How do you explain this?
The suicide rate in Kerala is 28/lakh population in comparison to the national average of 11. This is frightening. Like in all other places the commonest cause for suicide is underlying mental illness. Most often this is undetected and even when detected, it is untreated or under treated. It is estimated that in 80-90% of suicides there are underlying mental health issues. In our state in a subgroup of people we see mass suicides – this is more related to financial issues. In addition other factors like family history, lack of social supports, marital problems, inability to tolerate stress, etc contribute. The high prevalence of alcoholism is also a factor unique to our state.

What are the new challenges you face with regard to diagnosis and treatment methods?

For reasons explained elsewhere, there has also been a recent increase in severity and prevalence of mental illness affecting the old and the young. Stigma continues to ensure that many people do not get adequate treatment. But on the brighter side, there has been an avalanche of new medications and new modalities of treatments available. One can confidently say that if treatment is undertaken after adequate assessment and proper supervision, most mental illnesses show significant improvement.

What policies should be changed on the part of the government to ensure good mental health among Keralites?

The government should take the lead to improve mental health in the population. It should have a comprehensive policy to address various aspects of care. Improving awareness among the people should be a priority. There should be proactive measures to reduce stigma. Focus should be given to improve training and research for mental health professionals.Accessibility to cheap and standard care is crucial. Lastly but definitely, there should be a review of the government’s alcohol policy.

To what extent do human rights activists & NGOs help to increase awareness among masses?

Human rights activists & NGOs have a very important role to play. Very often because of financial constraints & political considerations, the government is unable to reach out to the neediest in our society. Human rights organisations & NGOs are already playing a crucial role in these cases. They not only identify but also educate and ensure adequate care. Human rights organisations have in recent years been in the forefront of the fight against stigma. They have ensured adequate media coverage and judicial interventions wherever appropriate. I think even in the future their presence and work will make a significant difference in the fight against mental illness.