A pioneer in mental health care

Print edition : September 10, 2004

BY SPECIAL ARRANGEMENT

THE National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, a 150-year-old multi-disciplinary hospital dedicated to the cause of mental health and neurosciences, has been long recognised as the premier institute of its kind in India. Almost 80 per cent of all psychiatrists produced in the country are alumni of the institute. Over 1,00,000 students and trainees come to the institute every year.

Declared a deemed university in November 1994, NIMHANS has been instrumental in developing advanced programmes pertaining to biological, behavioural and basic sciences in relation to the brain-mind-behaviour axis in the area of academics, research and health care. The World Health Organisation (WHO) has recognised the institute as a referral centre for head injuries, rabies and mental illnesses. All programmes of the WHO in the region are done through the institute.

The institute is funded by both the Union government and the Government of Karnataka. It also receives grants from agencies such as the Indian Council of Medical Research, the Department of Science and Technology, the Council for Scientific and Industrial Research, the University Grants Commission, the WHO and the United Nations International Children's Fund (UNICEF).

According to Dr. D. Nagaraja, Director/Vice-Chancellor of NIMHANS, the institute has three basic functions: education, services and research. In the field of education, NIMHANS has 21 departments, including biophysics, clinical psychology, epidemiology, human genetics, neuro anaesthesia, neuro imaging and interventional radiology, neuropathology, neurosurgery, psychiatric and neurological rehabilitation, psychiatry to psychopharmacology. While all departments offer Ph.D programmes, some offer diplomas and specialised courses.

The institute's Library and Information Centre subscribes to 315 national and international journals and its collection includes 35,000 books and 40,000 back volumes of journals, thesis, dissertations and research reports.

Nagaraja disclosed that the institute as part of its tele-education programmes regularly conducts three-day district-level interactive training sessions for doctors. With Karnataka facing an acute shortage of psychiatrists (currently there are only 13 psychiatrists in the entire State), the institute has stepped in and started three-month short-term training programmes as a short-term measure. It has not only provided the concept and module for the Government of India's District Mental Health Project, but is also actively monitoring it.

The institute's activities are not restricted to education. Its 912-bed state-of-the-art hospital complete with 300 staff (a majority of them are doctors) and six operating theatres is equipped to tackle any sort of medical emergency pertaining to the head. Over 4,00,000 patients, including 1,000 outpatients every day, are treated at NIMHANS every year. On an average, NIMHANS treats around 80 casualties every day. Over half of all the patients who visit the institute get free treatment, while others remaining pay rates that are a pittance when compared to what private hospitals charge. For example, bed charges are Rs.6 a day. The hospital is also equipped with a referral laboratory and its neuromuscular laboratory is one of the best in India.

The institute also conducts numerous camps to educate the people on mental health. Said Nagaraja: "Today we have to inculcate healthy habits and lifestyle changes taking a non-pharmacological approach to improve stress tolerance." With this in mind, NIMHANS has adopted four districts in Karnataka to train government teachers in detecting and counselling children with abnormalities. The programme's success has prompted Gujarat to adopt a similar one, with the institute as the technical consultant.

NIMHANS was the first to open a mental rehabilitation centre. It has successfully undertaken research on head injuries, epilepsy, suicides, paralytic strokes in the young, venous thrombosis and neurological complications of those who are HIV positive. The institute has also studied infections of the nervous system, neuro AIDS and viral encephalitis, pathology of developmental disorders, neuro oncology, the genetics of neuro mental disorders, and autism. It is in the process of introducing commercial test kits for rabies, virology, Japanese encephalitis and HIV. In the area of alternative therapies, NIMHANS has a programme to study yoga and meditation as treatment methods.

The institute has set up a brain bank with special reference to pathological states. This national facility intends to promote research in neurobiology using human neuron tissues. The brain tissues collected within 4 to 24 hours after the death of a patient, with informed consent of his/her relatives, are frozen for biochemical, immuno-histochemical and molecular biological studies. A large number of formalin-fixed brain tissues of those who had neurological, neurosurgical and psychiatric disorders are currently available for study.

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