The Beginnings of Psychiatry in India

Abstract

The history of psychiatry in India since independence is essentially the story of how psychiatry has largely come out of mental hospitals and has gradually become a part of mainstream medicine. During the colonial period of the eighteenth and the nineteenth centuries, the progress of psychiatry essentially meant the opening of asylums (later called mental hospitals) in different provinces, mainly for disturbed patients with psychotic disorders. Almost every mental hospital had the same story of overcrowding, neglect, inefficiency and deterioration, followed by strong efforts at reforms. The effect of such reforms usually lasted for short periods of 5–10 years, followed by another cycle of slow decline and fresh efforts at reforms. This frustrating narrative started changing around second quarter of twentieth century. The emergence of the psychoanalysis movement gave a new vision of psychological basis of normal and abnormal human behaviour. Neurotic, somatoform and adjustment disorders were now increasingly referred to psychiatrists. Psychiatry whose practitioners were once called ‘alienists’ started drawing to its fold, some of the very bright medical men and women. Another significant impact on psychiatry in India was the Bhore Committee recommendation for starting centres for training of mental health professionals; and the progress of military psychiatry. During the World War II, there was quick increase in the number of army psychiatrists by short training courses. Also, majority of the psychiatric causalities were treated not in mental hospitals, but in general hospital settings. Rapid progress of psychiatry occurred after independence with the opening of a large number of training centres, general hospital psychiatric units (GHPUs), the development of community psychiatry and the national mental health programme.