Public perception of psychiatry in India: A changing landscape

Abstract

Byline: M. Thirunavukarasu, Sathya. Cherukuri, Kothai. Pragatheeshwar, Pragatheeshwar. Thirunavukarasu In India, the practice of psychiatry in India has undergone several changes in the last few decades. The most striking aspect among these changes has been the perception of the general public towards the practice of psychiatry and psychiatrists in general. There are many circumstances that I could recollect from experience in the last 30 years to demonstrate this concept. During the early years of my practice as a young psychiatrist, a woman visited my clinic as she had been contemplating seeing a psychiatrist. During her first visit, I felt like I was being interviewed by her. She was interested in knowing my biographic details, most importantly my age and my marital status. I got the feeling that she was trying to assess my level of 'maturity' to deal with complex problems of life before entrusting me with information about herself. She left and returned a few days later to discuss her problems. She must have analyzed me in the interim, and according to her, my age and marital status might have been more consequential qualifications than my formal training in psychiatry. A few decades ago, such an attitude seemed widely prevalent among the public. But it has undergone a change. Nowadays, many potential clients search the Internet for reviews about psychiatrists and read their curriculum vitae before choosing their therapist. The reputation of the medical school from which a psychiatrist graduated may be more consequential than his or her age and marital status. I recollect taking a home call once to see a then celebrity. On entering the patient's home, the patient's family wanted my verbal assurance that I would maintain complete and absolute confidentiality. At present time, however, celebrities voluntarily disclose, and sometimes with pride too, that they are seeing a psychiatrist. The matters pertaining to sex and sexuality were considered tabooed topics and inappropriate for public discourse. Medical students were not formally educated or taught about the medical aspects of sexual problems. I remember an occasion when the dean of a reputed medical school in India requested that sexual problems are not to be discussed with the students. However, that situation has changed. These days we find that people are willing to discuss their sexual problems not only with their psychiatrists but also with the general public through the media. Changes in public perception have also led to changes in the treatment strategies of psychiatric illnesses. Electroconvulsive therapy (ECT) is an apt example. ECT was invented in 1938 [sup][1] and was widely used as a treatment tool for mood disorders and psychosis. [sup][2] I still remember administering more than 60 ECTs in 1 day. Because of its widespread use, the cost was also low. Now, ECT has gained negative publicity and people have developed an aversion to ECT. They consider it to be a crude and brutal method of treatment. Currently, even in teaching institutions, ECT is not administered. …