Psychiatric services in Jaipur: Past and present

Abstract

Byline: Shiv. Gautam Era of Asylums (1856-1944) To view the changing perspective of Psychiatry in Rajasthan, we must begin with the story of establishment of lunatic asylums in Rajputana states. It was after the treaty of alliance signed between the native states of Rajputana and the East India Company (1803-1818) that each native state created/established an asylum for detention and care of the lunatics. Initially the lunatics were seen in dispensaries and detained in jails tied with chains. An asylum outside the jail was first established in 1881 in Jaipur state. Ajmer had an asylum inside jail in 1865 (Hendley 1900). Forty unfortunate lunatics were incarcerated inside 'cells' in this asylum, which was situated near Ghatgate (Jaipur). In year 1894, another enclosure in a walled garden near Central Telegraph Office, Jaipur in the southern part of the city was used as asylum by Jaipur state. Here the lunatics were left to enjoy the Open Court Yard and a 'Baradaree', no cots were provided but the atmosphere was more humane and sympathetic towards the unfortunate lunatics who were confined in this asylum. Food and protection were provided by the jail department till 1922, when this asylum was shifted to a Dharamshala situated near Chandpole Gate opposite the present Janana Hospital. Here the lunatics were again put in cells. The medical supervision was provided by the part-time doctors from the jail department. Administration, watch and ward of asylum remained under the jail department till year 1943 (Annual Administrative Reports of Jaipur State, 1894-1943). In 1943, Jaipur state enacted Jaipur Lunacy Act for detention and treatment of lunatics; the criminal procedure code 1926. Jaipur State was amended for the detention and care of the criminal lunatics 1943 (C.P.U. 1943). From the year 1944, the Mental Hospital Jaipur (Lunatic Asylum) started running as an independent hospital under Medical Department of Jaipur State. Till 1922, the control of lunatic asylum was placed under the Rajputana Agency, but after 1922 the administration of lunatic asylum was transferred to Jaipur Durbar. The annual returns from these asylums show a high mortality of lunatics admitted there in, on account of diarrhea, dysentery and fever. Under orders from Jaipur Durbar, the lunatics could be released from asylums for the care of relatives and friends if assured for kind sympathetic care and protection from doing harm to others. All lunatics were admitted under court orders. The discipline of psychiatry is rather a new specialty of medical science. Though understanding of human mind has existed from times immemorial in different philosophical and religious schools, in the middle ages, due to lack of knowledge, superstitions like evil spirits dominated the explanation for various mental disorders. It is only in the late 19[sup] th century that psychoanalytic explanations came in and the last four decades have seen tremendous scientific advancements in understanding of human behavior through biopsychosocial research. The treatment of mental disorders has also been revolutionized in the last four decades and as a result to this the specialty is now a very fast growing subject. As a result of research in mental health, now intricate complexities of the human mind have been understood in terms of neuroelectrical and neurochemical changes occurring in the brain. Specific change occurring with different mood states has been identified and an intervention to bring desired changes in human behavior is now possible. Mental illnesses once thought incurable are now treatable. Mental illness is now considered like any other illness and there is no reason that it should be concealed, and like patients with physical disorder the mentally ill after treatment can be rehabilitated and made useful citizens. Psychiatric Center, Jaipur Psychiatric Centre, Jaipur is the premier institute of the state for treatment and care of mentally ill. …