Until the 17th century, abnormal behavior in India was believed to be caused by evil spirits or demons and the mentally ill were considered witches and imprisoned. Gradually, mental illness came to be seen as a medical condition, and the mentally ill were placed in asylums for treatment. The modern history of psychiatry in India witnessed three major revolutions - from considering mental illness the result of sin/witchcraft to understanding its biological and social causes, and integrating mental healthcare into communities. Traditional Indian medical systems like Ayurveda, Unani, and Siddha also described and treated various mental disorders.
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Till about 17th century all abnormal behavior was
believed to be act of the ‘devil’ i. e. ‘Against God’, ‘
Mentally ill’ were considered evil & described as
witches.
Gradually over the passing time, mental illness was
considered as ‘deviant behavior & mentally ill were
considered socially unacceptable & put in jails along
with other criminals.
In the modern era, there was a shift from ‘evil’ to ‘ill.
Mentally ill were called as ‘mad’ or ‘insane’ and were
placed in special places called as ‘asylums’.
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gradually these asylums became the place for human
exploitation.
Phillipe Pinel was the first Psychiatrist to free these
mentally ill from asylum.
Clifford Beers work ‘ The mind that found itself’ brought
in light the treatment meted out to these people in
asylums, resulting in a strong reaction to the plights of
mentally ill.
In the 20th century, the work of Freud and ‘B. F.
Skinner & J. B. Watson’ gave a scientific combination of
biological & social theories to explain the etiology of
mental illness.
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
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Ayurveda
Unani System
Siddha System
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
5. Ayurveda
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Mental disorders are represented in Ancient India in
various types of literature.
The aetio-genesis of these disorders was thought to
be endogenous because of provoked humours like
vatonmad, Pittonmad & Kaphonmand.
Exogenously the causes were attributed to sudden
fear or association with ill influence of certain
mythological gods or demon, Charak Samhita
designated Psychiatry as ‘Bhuta Vidya’.
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The description of personality is to be in terms of
sathvik, Rajasik & Tamasik representing intellectual
& moral, emotional & passionatic & impulsive
respectively & Tamsik is more or less near mental
subnormality or angry.
Treatment of mental disorders mainly included
psychotherapy, physiotherapy, shock, drug
treatment, hypnotism & religious discourses by
Sages.
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
7. Unani System
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Najabuddin Unhammad (1222 A. D), an indian
physician, described seven types of mental disorders
viz. :-Sauda-a- Tabee(Schizophrenia); Muree Sauda
(depression); Ishk ( delusion of love); Nisyan
(Organic mental disorder); Haziyan (paranoid state);
Malikholia-a-maraki (delirium). Psychotherapy was
known as Ilaj-I-Nafsani in Unani Medicine.
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
8. Siddha System
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Siddhi’ means achievement and Siddhas are men
who have achieved results in medicine, as well as
yoga and tapas.
The great saga ‘Agastya’, one of the 18 Siddhas has
contributed greatly to the Siddha system of medicine
of the South. He formulated a treatise on mental
diseases called as ‘Agastiyar kirigai Nool ‘, in which
18 psychiatric disorders with appropriate treatment
methods is described.
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
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The history of psychiatry had witnessed 3 major
revolutions that have given its present status.
First Revolution occurred when it was believed that sin
& Witchcraft are responsible for mental illness and
mentally ill were chained in jails & asylums. They were
considered as outcaste from society.
Second revolution was the advent of psychoanalysis;
that explained the etiology of psychiatric disorders.
Third revolution was the development of community
Psychiatry that resulted in the integration of mental
health care in the community.
JAY PATIDAR (M.Sc. NURSING) 4/11/2013
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Indian culture has always given a great importance to
spiritual life.
One of the earliest Indian Psychiatrists to explain the
importance of health was Govindaswamy in 1948.
He gave 3 objectives of mental health - regaining of the
health of mentally ill person; prevention of mental
illness in a vulnerable individual; and protection &
development at all levels, of human society, of secure,
affectionate & satisfying human relationships & in the
reduction of hostile tensions in persons & groups
(Govindaswamy, 1970).
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During the reigns of King Ashoka, many hospitals were
established for mentally ill.
A temple of Lord Venkateswara at Tirumukkudal,
Chingleput District, Tamil Nadu, contains inscription on
the walls belonging to Chola period.
The hospital was named as Sri Veera Cholaeswara hospital
and contained 15 beds. Maulana zulur-Lah Hakim, an
indian physician was in charge of the first Indian mental
asylum, i. e. Mandu hospital opened by Mahmood Khilji
(1436-1469) at Dhar, M. P. First lunatic Asylum, Bombay
Asylum, was built in modern India in approximately 1750
A. D. at the cost of 125/-, no traces of it is present today.
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In 1794, a private lunatic asylum was opened at
Kilpauk, Madras.
The central mental hospital, Yerwada, Pune was
opened in 1889.
First asylum for insane soldiers was started at
Monghyr, Bihar and was known as Monghyr
Asylum(1795).
Maxell Jones in 1953 introduced the concept of
Therapeutic community resulting in the improvement
in the Mental Hospital conditions.
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on the recommendation of Bhore committee (in 1946),
All India Institute Mental Health was set up in 1954,
which became the National Institute of Mental Health
And NeuroSciences in 1974 at Bangalore.
An expert committee of WHO in 1974, made several
important recommendations, urging its members to
consider mental disorder as a high priority problem.
The recommendations included : to undertake pilot
projects to assess existing mental health care program
in a defined populations and training program for
health workers and to devise a manual for the same
(Isac 1986). 4/11/2013
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first community Mental Health unit (CMHU) was
started with the Dept. of Psychiatry at NIMHANS in
1975.
For short term training of primary care personal, a
Rural Mental Health Center was inaugurated in
Dec’1976 at Sakalwara, 15 km from Bangalore.
The first training program for Primary Health Care
was started in 1978-79. During 1978-1984 Indian
Council of Medical Research funded & conducted a
multicentre collaborative project on ‘severe Mental
Morbidity’ in Bangalore, Baroda, Calcutta & Patiala.
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Various training programs for psychiatrists, Clinical
Psychologists, Psychiatric Social Workers,
Psychiatric nurses and Primary Care doctors were
conducted at Sakalwara unit between 1981-82
(Ministry of health & family welfare, 1989).
JAY PATIDAR (M.Sc. NURSING) 4/11/2013