The problem with \u2018happiness\u2019, psychiatrists argue, is more fundamental.<\/p>\n
\u201cHappiness is a state of mind. A person with or without mental health issues can be happy or unhappy. It is not something treatable,\u201d Dr Mohan says.<\/p>\n
\u201cThe patient needs further care after discharge. The centre and the doctors provide treatment, not happiness. It is a fundamentally wrong metric.\u201d
Dr Mohan too calls for a \u201cserious modernisation plan\u201d.<\/p>\n
\u201cAllocating more staff for patient care, building modifications, exercise facilities, better treatment infrastructure, enhanced rehabilitation facilities, etc., are some urgent needs,\u201d Dr Mohan says.<\/p>\n
There is also the question of care after discharge. \u201cThis is vital,\u201d he says. \u201cContinuing care should be available through nearby PHCs and taluk hospitals.\u201d<\/p>\n
After hearing the objections raised by the IMA and IPS, the High Court asked the government to hear the concerns and suggestions of experts. This Wednesday, a panel representing the organisations will meet the health secretary to discuss the issues and their demands.<\/p>\n
For psychiatrists, the debate returns to the question with which it began. What exactly is the state trying to fix?<\/p>\n
\u201cThe ultimate goal is better patient care,\u201d Dr Mohan says. \u201cBoth doctors and the state need to work together to provide that.\u201d<\/p>\n
Need modernisation<\/p>\n
New infra: Many of the existing buildings have suffered decades of wear and tear and require urgent renovation and new treatment blocks.<\/p>\n
Better design: Outpatient and inpatient facilities need to be redesigned to make patients feel safer and more comfortable. The image of a dark, closed institution must give way to spaces that are pleasant, patient-friendly.<\/p>\n
Lifestyle support: Hospitals should provide adequate spaces for physical activity, nutritious meals and counselling on lifestyle modification.<\/p>\n
Rehabilitation for chronic patients: Rehabilitation centres could be established within hospital campuses to provide accommodation, education, skill development and vocational training. Those willing and able could eventually be offered employment opportunities, including within the institutions themselves.<\/p>\n
Training centres: Mental health centres could also be developed as centres for psychiatric education and training.<\/p>\n
Staff crunch<\/p>\n
\uf06cOn an average day, over 200 patients visit Kerala\u2019s mental health centres for outpatient treatment. Yet, just four or five doctors, assisted by a handful of postgraduate students, are often left to care for them.<\/p>\n
\uf06cThe most immediate requirement, experts say, is adequate staffing \u2014 including psychiatrists, psychologists and other mental health professionals, deployed according to their areas of expertise.<\/p>\n
\uf06cThe available numbers paint a grim picture. Data from 2017 showed that Kerala had only 5.53 beds per 10,000 people seeking mental health treatment. The National Mental Health Survey (2015\u201316)* recorded an overall prevalence of mental disorders in Kerala at 11.36%. According to the survey, the state has only 1.2 psychiatrists per 100,000 population.<\/p>\n
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