With over seven per cent of the population in the country suffering from mental health disorders — normal to serious illness — a study has stressed on making preventive psychiatry as important component in the undergraduate (MBBS) and postgraduate medical curriculum for early identification of the condition to ensure timely treatment.
Not only developed countries like Denmark, the USA and the UK but even smaller nations such as Nepal have given prominence to psychiatry in medical curriculum.
Dr RC Jiloha, Head of Department Psychiatry, Rehabilitation Sciences, Hamdard Institute of Medical Sciences and Research, in his study “Preventive Psychiatry in medical curriculum”, published in the latest edition of Indian Journal of Social Psychiatry, said, “Clinicians can play an important role in implementation of preventive interventions.
“A skilled clinicians can play an important role in preventive interventions by identifying individuals at risk, consulting with agencies, school personnel and employers who may identify individuals at risk, providing treatment that can reduce the chronicity, severity, and total duration of psychiatric illness.”
Although preventive aspects of mental health have been included in the medical curriculum for undergraduates and postgraduates, most of the emphasis during training is on the curative aspects, said Dr Jiloha who has also headed the psychiatry department of the Delhi-based GB Pant Hospital in the immediate past.
“The curriculum should include topics in primary, secondary, and tertiary prevention; universal, selected, and individual preventive interventions; risk and protective factor identification; mental health epidemiology; use of screening instruments; and application of evidence-based preventive modalities," explained Dr Jiloha.
He noted that almost all the major psychiatric disorders affect the victims at their prime age — the second and third decades — and in the most crucial phase of development and maturity, and in most cases, leaving a significant disability and a scar on the personality.
Dr Jiloha knows better. Mental and behavioral disorders are responsible for 7.4 per cent of the total disease burden. Even with optimal care and service delivery, around 30 per cent of the burden of disease attributable to mental disorders can be averted, making a strong case for an increase in preventive efforts in psychiatry and mental health promotion.
The future is scary. The study says by 2020, neuropsychiatric conditions will account for 15 per cent disability, with unipolar depression alone accounting for 5.7 per cent of disability. Aggravating the situation is acute shortage of psychiatrists in the country.
The Indian Psychiatric Society too has been recommending psychiatry to be an independent subject in the teaching and training curriculum of undergraduate medical course. However, the Medical Council of India still continues with 20 hours of teaching and two weeks of clinical posting, which the Society feel is insufficient in view of growing need.