India's Mental Health Crisis
The Report of the United Nations Special Rapporteur, 28 March 2017, identified problems of power asymmetries, an over reliance on psychotropic drugs, and a system that revolves around ‘profits’ in the mental health care sector. These issues have culminated into a coercive and largely biomedical approach to mental health care. The Report explained that around the world, mental health care systems were in a ‘crisis’.
This crisis is even more serious in former colonies like India. In India, colonial asylums continue to function as mental hospitals. Little has changed in the architecture of these buildings and the culture of care within them. India’s psychiatrist to patient ratio stands only at 0.3:100,000. The Report rightly called for a revolution in mental health care. This 'revolution' will be made possible when patterns of systemic trauma are identified and dealt with.
Dr Pinto aims to get to the root cause of the current crisis through her research. Her research tackles questions around Indian attitudes and the apparent 'apathy' towards mental hospitals. By studying the history of 'lunatic asylums' in Bombay she argues that such institutions were a source of 'historical trauma' or 'soul wounds' for patients and families. Reinforcing the use of such hospitals, that were a colonial legacy, merely reinforces old wounds. The way forward for professionals and policy makers is to stop blaming the current 'crisis' on stigma and acknowledge the experience of 'soul wounds'. Acknowledging this wounding is the first step to healing from this trauma, and it will pave the way for new narratives in mental health care.
For a detailed analysis on the impact of mental hospitals (lunatic asylums) on indigenous patients and families read Lunatic Asylum in Colonial Bombay: Shackled Bodies, Unchained Minds (Cham: Palgrave Macmillan, 2018).
Ratnagiri Mental Hospital, Ratnagiri, India, 2014